2016 Consensus statement on return to sport from the First World Congress in Sports Physical Therapy, Bern

Abstract

Deciding when to return to sport after injury is complex and multifactorial-an exercise in risk management. Return to sport decisions are made every day by clinicians, athletes and coaches, ideally in a collaborative way. The purpose of this consensus statement was to present and synthesise current evidence to make recommendations for return to sport decision-making, clinical practice and future research directions related to returning athletes to sport. A half day meeting was held in Bern, Switzerland, after the First World Congress in Sports Physical Therapy. 17 expert clinicians participated. 4 main sections were initially agreed upon, then participants elected to join 1 of the 4 groups-each group focused on 1 section of the consensus statement. Participants in each group discussed and summarised the key issues for their section before the 17-member group met again for discussion to reach consensus on the content of the 4 sections. Return to sport is not a decision taken in isolation at the end of the recovery and rehabilitation process. Instead, return to sport should be viewed as a continuum, paralleled with recovery and rehabilitation. Biopsychosocial models may help the clinician make sense of individual factors that may influence the athlete's return to sport, and the Strategic Assessment of Risk and Risk Tolerance framework may help decision-makers synthesise information to make an optimal return to sport decision. Research evidence to support return to sport decisions in clinical practice is scarce. Future research should focus on a standardised approach to defining, measuring and reporting return to sport outcomes, and identifying valuable prognostic factors for returning to sport

Interprofessional Collaboration in Sports Medicine: Findings from a Scoping Review

“…Ardern et al (2016) and Courson et al (2014) have developed consensus statements which surround approaches to collaboration in sports medicine. Both papers maintain on some level that in order for safety to be enhanced for a range of patient/ athletes, there needs to be an alternative model where more rigorous methods of performance evaluation are put in place in a way which both encourages and benefits from IPC.…”

Using Patient Evidence to Guide Clinical Care: Consulting the Other Expert in the Room

“…Second, while clinicians strive to restore previous levels of performance in athletic patients during controlled rehabilitation settings, it is not uncommon for some deficiency in performance to remain after discharge from care has occurred. 15 In these instances, the athletic trainer should continue to follow and assess the patient until the deficiencies have been corrected. Finally, the timeframes included here are based on both internal and external evidence.…”

Match-related risk factors for injury in male professional football

“…The decision on when players RTS after an injury is made difficult by the fact that there are few evidence-based criteria for when an athlete should be considered ready for RTS, as pointed out in a review article from 2016 [51]. A period of absence from football due to an injury could also have caused deterioration in a player's physical fitness level, which could make him more vulnerable to the increased workload that he is subjected to on RTS and return to competition.…”

“…This could be an indication that the RTS criteria that are currently used in professional football do not provide sufficient information about whether players can return to football without sustaining a subsequent injury [51]. Future studies should therefore continue to evaluate these criteria.…”