Return to Play – When Is the Right Time? – Written By Steve Nance

To answer the above question, we first have to look at what we are returning from (and how long we have been out) and what we are returning to.

Research indicates that we start to lose our fitness adaptation(s) (detraining) somewhat between 6-10 days of cessation of training due to injury or illness. This varies greatly and is very dependent upon the actual levels of fitness or adaptations that the individual has created. The higher the adaptation the normally faster the drop off especially in the components of aerobic capacity and power.  There is then a corresponding slower redevelopment (re-training) process to get back to where they were. As stated in previous articles, elite swimmers work as roughly a 3:1 paradigm. This means that far every week out of the pool, it takes approximately 3 weeks to get times back, or 2 weeks out will take 6 weeks before pre-injured times are obtained. I worked at The Brisbane Broncos for 10 years in varying captives. In 1997 when I was in charge of performance, we had a massive involvement in State of Origin, 10 players for QLD and 2 for NSW. It those days Origin was a very social experience with excessive drinking/ partying and little or no focus on players conditioning. Over the 3-game series our players detrained, and there was no doubt about it, especially their power. Dan Baker and I measured Upper Body Power (UBP) (bench throw) and Lower Body Power (LBP) (Jump Squat) regularly using Plyopower which was one of the first made Ballistic Measurement Devices. After Origin was over, both UBP and LBP was down, sometimes way down on pre – Origin scores. Will UBP they took up to 2 months to return to normal, but in LBP they did not regain their power for the rest of the season even though we won the Grand Final.

So, we know that cessation or missing training for a period of time definitely causes a loss of fitness. So, if injured, a player can’t usually do the normally training and will start to detrain (Cross Training is a massive tool to stop or delay the effects of detraining.) If they are out for several weeks e.g., for a Grade 2 Medial Ligament Tear or a Grade 1-2 Hamstring tear both taking about 4-6 weeks to repair. What usually happens?

Firstly, the injury is diagnosed with or without some type of scan. Athlete is passed on to a physio who begins treatment usually after the acute phase is over. Athlete continues treatment until asymptomatic and then returns to play. Injury is fixed, no doubt. But what about their loss of power, O^2 capacity, agility etc? If they were competing at a high level, then the loss of fitness components would be quite substantial. In a professional or even a semi-professional setting the S+C staff work closely with the medical staff to not why repair the injury back to its pre-injured athletes but also work to retrain any of the fitness that is lost. If this is not done properly and the athlete returns to train and to play when the injury has healed without any real re-conditionings the consequences can be traumatic and possibly catastrophic. How many players do you see coming back from a knee injury, only to injure a hamstring or calf on the same or other leg.

Remember the amount of time and effort that goes into the pre-season developing all their fitness components. If we just neglect this and throw the athlete straight back into competition without any re-training, we are doing them a complete dis-service, and it is not only very risky but is very unprofessional.

Fitness Markers

Markers should be in place to assess the athlete’s fitness. These do not have to be complicated. Some examples are as follows:

• Aerobically -collet data on specific drills and/or tests when the athlete is fit and record times and /or distances covered
• Power – (single/double leg hopping for speed and/or distance) – Use ballistic measurement devices to measure vertical power or newer models that can measure horizontal power as well
• Strength – RM Test in weight room
• Flexibility/ Mobility – any test that can be compared to pre-injured measurement
• Speed – timing over running distances. Can be hand timed, but better and far more accurate through timing gata.

The above are only examples.

This isn’t Rocket Science. If an athlete misses training for more than 6-10 days they will begin to detrain. Their return to play data should be determined by all stakeholders: Doctors, Physios, S+C Staff, and even the coaches themselves (if a sports psych is available use them) to make sure they are in the right head space to return after a serious injury and they are going back into a contract sport.

Written by Steve Nance