After a Sports Injury: Is My Child Ready to Return to Play?

Blog post written by Kristin Flynn, PT, DPT, Physical Therapist II, Rehabilitation, Children's Hospital Los Angeles

No matter the age or intensity of play, after a sports injury an athlete’s main goal is usually to get back on the field. However, as a parent your main concern should be safety rather than athletic competition. You may be wondering:

• How do I know if my child is ready to return to their sport?
• What can I do to prevent this injury from happening again?

Safe return to sport is a team effort

The athlete should first receive medical clearance from his or her doctor in order to return to play. In addition, the athlete should demonstrate a basic foundation of strength, power, flexibility, balance, aerobic endurance and agility before stepping back on the field. A physical therapist or athletic trainer is usually involved during the recovery process to help athletes reestablish a baseline of fitness in order to make sure they have the ability to perform sport-specific movements with good technique. Having this strong base will decrease apprehension, improve confidence on the field, and greatly reduce the risk of re-injury. Some recommendations for safe return to sport include:

• Equal strength in both legs and the core
• Full flexibility and range of motion
• Adequate biomechanics with running, sprinting, cutting and jumping
• Ability to jump, hop and cut with equal power on each leg
• Ability to return to sport-specific movements without apprehension, hesitation or fear

Preventing future injury

After recovery, parents should encourage continued health and fitness in order to maintain healthy bodies during play. Here are some recommendations that may assist in preventing a future injury:

• Strength training: Incorporating strength training 3 to 4 days a week for core muscles such as abdominals, gluteals and scapular muscles is key in a conditioning program. The American Academy of Pediatrics states that strength training is safe for children 7 years old and older, with use of body weight, light free weights or resistance tubing. Some basic exercises include planks, side planks and squats. Strength training should be initiated under the care of a physical therapist or athletic trainer with medical clearance from a doctor.

• Warm up with dynamic stretching: An adequate warmup is imperative in preparing the body for gameplay by increasing heart rate and warming up muscles. It is recommended that athletes break a sweat before participation in the game. Some dynamic stretches include high knees, lunge walking and jumping jacks.

• Hydration: Drinking enough water is essential in preventing dehydration. You should encourage your child to drink water before, during and after gameplay. Some signs of dehydration may include diminished activity, sleepiness, thirst, decreased urine output, dry skin, headaches, constipation and/or dizziness.
• Caution when participating in multiple sports: Participation in a school sport in addition to multiple traveling teams at the same time may lead to overtraining and a higher risk for injury. Children should be encouraged to play a variety of sports and activities, giving them the opportunity to cross-train to avoid constant stress to specific muscle groups and ligaments.
• Rest: Rest is imperative for muscle healing, recuperation and overall performance. Children should have one to two days per week without gameplay or practice. In addition, children should be getting 8.5 to 9.5 hours of sleep per night, as recommended by the American Academy of Pediatrics, as lower amounts of sleep have been linked to increased risk for injury.