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Monday Medical: Returning to sport explained

Susan Cunningham
For Steamboat Pilot & Today

You’ve made it through your initial surgery or injury, have worked hard in physical therapy, and now, you’re ready to get back to your favorite sports. Or are you?

Before jumping back in, it’s important to work with your physical therapist on an individualized return-to-sport program.

“It’s not like therapy ends and playing sports starts — there’s a transition phase,” said Aaron Zagrodnik, a physical therapist with UCHealth SportsMed Clinic in Steamboat Springs. “Return to sport is the phase of rehab after surgery or an injury in which you’re close to being done with formalized therapy but need to transition back to playing sports.”

Below, Zagrodnik outlines what you need to know about the return to sports process.

A phased approach

When beginning physical therapy after a surgery or injury, the first goals are to minimize pain and swelling, protect the injured area so it can heal and maintain mobility. After that, physical therapy focuses on strength and function.

It can take months or even years for athletes to get back to their pre-injury level of competition. Go back too soon, and you’re at risk for re-injury and other issues.

“Just because you feel good doing your daily life doesn’t mean you’re ready for sports,” Zagrodnik said. “If you re-strain or re-injure yourself, you could be back at square one again.”

Sports-specific exercises

Physical therapists help patients progress through the stages of therapy, testing strength and mobility at each stage to be sure a patient is ready to move to the next.

Eventually, movement patterns and tasks specific to a patient’s favorite sports and activities are incorporated into the exercises.

“We’ll start to mimic the things they’ll have to do when they go back to sport, and build up that load and intensity,” Zagrodnik said. “If they love hiking, I’m going to connect everything we do to hiking. That keeps them motivated.”

Moving too fast

If a patient gets the go-ahead to return to sports, but pain and swelling ensue, they may need to take a step back.

“When you get back to a sport, it shouldn’t be painful,” Zagrodnik said. “If you have pain and swelling, either you’re pushing too much, you can’t keep mechanics right or the tissues aren’t ready for that much stress and load.”

Athletes who get back to their regular activities but find they can’t hit the times or other metrics they did before may be still compensating for the original injury.

Getting out of your head

Don’t forget there’s an important mental component when returning to sports. A recreational skier who doesn’t feel completely confident on their newly healed leg may struggle to make it down runs they previously skied with ease. A mountain biker who broke a collarbone on a downhill trail may find themselves avoiding similar trails.

“There can be some aversion to certain movements or even to going by the location where it happened,” Zagrodnik said. “It’s about the patient gaining confidence and realizing they’re strong and stable.”

A team approach, in which the athlete works with coaches, physical therapists, their surgeon, family members and even a sport psychologist, can be especially important during this process.

Maintaining motivation

Don’t feel bad if recovery takes longer than you expect. While progress may sometimes be made quickly, many surgeries take about nine to 12 months for a full recovery.

“The biggest question is always, ‘When will I be able to go back?’ And everybody loves the answer: it depends,” Zagrodnik said. “But it really does depend on the age of the individual, their status before, how the surgery turned out.

“There are definitely days when people struggle. It’s a long process, and every day isn’t going to feel like a win. But we meet them where they’re at, give support where needed and push them when they need to be pushed so that they can get back to the sports and activities that drive them.”

Susan Cunningham writes for UCHealth Yampa Valley Medical Center. She can be reached at cunninghamsbc@gmail.com.


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