Being Cleared By Your Doctor Doesn’t Mean You’re Ready
Luckily, we work with some great Orthopedics that recognize the importance of integrating performance training with and after physical therapy. When an athlete is cleared by their doctor, there are several considerations that play into that; some of which include time, strength, quad-to-quad strength ratios, quad-to-hamstring ratios, pain, etc. However, there are several areas that we commonly see when an athlete is “cleared” that may not mean they are ready to compete.
1. The ability to move well: We know that strength gains are obviously extremely important when returning from a surgery, but re-learning proper movement patterns are just as important. In our “Bridging the Gap between Sports Medicine and Sports Performance” series we discuss that returning from an injuring is a great time to re-establish proper movement patterns. So many times we receive an athlete after physical therapy who says they have been squatting, jumping or cutting, but it is still done with poor patterning. It’s not just about squatting to build strength, it’s about squatting with proper patterning, and the same goes for jumping, landing, running and cutting.
2. Conditioning levels for sport are not adequate: Before an athlete is ready to compete it is critical that conditioning levels are up to par with the task that will be required. If an athlete fatigues too quickly while returning from injury they are putting themselves at risk for re-injury. When the body is asked to perform under significant fatigue, especially when returning from injury, the athletes risk for injury is that much greater.
3. Progression of re-introduction to sport: This goes right along with conditioning levels, but one of the hardest things for an athlete can be PROGRESSION. Many times the athlete and coach hear, “cleared,” and think that means good to go where they left off. There needs to be a detailed progression plan that everyone is clear on. At the collegiate and professional levels this is coordinated between the athletic trainers, strength and conditioning coach and most importantly, the sport coaching staff. The problems usually lie in the youth club and high school scene where this support staff may not be applicable.
4. Confidence: Possibly the most important one. On one hand we have the over-eager athlete who forgets about progressions and conditioning, and then on the other hand, we have the athlete who is very tentative about returning to their sport. As athletes get closer to returning to their sport it is important to incorporate reactive, sport-like environments so the athlete begins to re-establish the confidence to compete.
When the doctors say you are clear, it is important to understand that you are clear to begin participation back into your sport. However, as mentioned above, there are extremely important actions to consider on your road back to a successful athletic career.
The clearance protocol is different at every level to return back to a sport. Through my experience of working in a training room and also as a player, your AT takes you through a series of test before letting you return to the sport which the tests information is told to the team doctor of those results. Communication is the key to letting the athlete return to active. This is called Readiness!