VIDEO 13. Summary
The voice of the narrator again: As mentioned earlier, it is important to ascertain the athlete’s readiness to return to play before testing is carried out. According to the attending physician, can the athlete be tested if the muscle strength and range of motion are correct, the athlete does not feel pain at rest and during movement, there is no swelling and other disturbing symptoms, and the gait and run are normal, i.e., without pain, feeling of instability, compensation. It has not been clearly defined how many tests should be carried out, but it is important that they are not just tests consisting of forward jumps. Tests involving jumps to the side, medial, and with rotations may turn out to be crucial. The psychological readiness of the athlete is also important. It must not be forgotten that returning to sport is not the same as returning to competition. The competition requires tolerating full training sessions with opponents and contact (if the discipline requires it, e.g, judo).
In summary, now let’s revisit what to look for in the decision-making process of an athlete returning to sport after injury.
- You should ask about the time since injury, as you need to be sure that the tissues have had sufficient time to recover. The time when you can consider returning to sport depends on the type of injury, e.g. min. 9 months after ACL reconstruction. How the treatment was carried out, i.e. the type of surgery performed, is also important.
- You should measure muscle strength symmetry of the right and left side of the body, as muscle strength asymmetry is strongly correlated with secondary injuries. Symmetrical muscle strength is essential for proper movement technique and correct movement patterns. A desirable score is >90% symmetry. Manual assessment of muscle strength can be done, but a dynamometer, Biodex or similar device can also be used.
- Muscle endurance should also be measured, which is essential in running and many sports involving repetitive movement patterns. The result you expect is satisfactory muscle endurance and >90% symmetry. A good method of testing muscle endurance is adequate functional tests (e.g. toe raises for calf muscles), dynamometer or Biodex devices.
- Another important point is the assessment of the range of motion. The correct range of motion reduces the risk of injury, allows to perform the correct movement without compensation, and generate maximum force. The ideal score here is 100% of normal. You can use a goniometer to measure this.
- The next important step is to assess symmetry in dynamic tests, such as jump tests. With these tests you will assess explosive strength, dynamic balance and landing mechanism, asymmetry of these elements in the involved and uninvolved limb is strongly correlated with secondary injury. The desired score is >90% symmetry. You can use the tests you have learnt in this lesson.
- Finally, something you cannot forget is the athlete’s readiness to return to play. It is strongly correlated with the risk of secondary injury. You should use one of the validated scales and questionnaires, for example those suggested in the lesson or in the e-manual. The interpretation of the results of the scale or questionnaire should follow the recommendations for the specific tool used.
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