Return to sport after injury: Guidelines to shared decision making. Summary of a multi-professional symposium

 Yonatan Kaplan1,2, Clare Ardern3, Ofer Ben-Tzvi4, Ori Bar Ze'ev5, Yuval David5, Yosef Weiss6,
David Morgenstern7, Meir Nyska8, Osnat Raveh1, Ella Been1,9, Heidi Sugarman1

1Department of Physical Therapy, Ono Academic College
2The Jerusalem Sport and Physical Therapy  Centre
3Linkoping University, Sweden
4Sport Therapy Centre
5Sport and Spine Physiotherapy Centre
6Israel Basketball Association
7Meir Hospital
8Hadassah Hebrew University Hospital
9Department of Anatomy, Sackler Medical School Tel Aviv University,


Introduction: The question of when to return to full participation in sports activities after an injury or an operation is one of the most challenging and difficult issues with which athletes and their support teams must contend. To examine this question, a symposium on the subject of return to sport (RTS) after injury was held in September 2016 at the Ono Academic College in Kiryat Ono, Israel.  The topics discussed at the symposium included: What is RTS, who is responsible for making the decision, and what are the criteria determining the rate and degree of  RTS?


Aims: To summarize the main topics that were discussed at the symposium, to present the range of opinions, to examine the current state of research evidence and to highlight directions for future research.


Results: To a large extent, the answer to the question "What is RTS?" depends on whom you ask. The athlete, the coach and the clinician have different goals and perspectives. The current model for training and RTS is one of shared decision- making. In this model, the final decision is made by the athlete in cooperation and consultation with the coach and with health professionals. The criteria determining the rate and degree of RTS include psychological factors, specific functional tests for the relevant sport, strength, range of movement, clinical measures, evaluation of risk, and time.


Conclusions: The most important factors in determining the safety relating to successful RTS within a reasonable time are still unknown. Therefore, future research should concentrate on developing a unified approach to diagnosis, measurement, and documentation of the results relating to physical activity after injury.


Key words: sports injuries, return to sport, shared decision making

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