Return to sport after injury. When? How?
What protocols do YOU use to guide return to sport after injury?
For many, I suspect the answer is none!
And this is not because we are lazy or don't care, but for the most part because such protocols are thin on the ground.
A new protociol, just published in BJSM and called "the control-chas continuum" really does knock some snese into this dilemma.
The control-chaos continuum
Using retrospective player chronic running loads (GPS) in conjunction with estimated tissue healing times, the authors propose a five-phase framework. They give the example of a central defender with a hamstring injury; estimated return to training after 6 weeks of rehabilitation, with a sample chronic load progression. However, the model applies to both short-term and long-term injuries using shorter or longer phases—particularly as progression is criteria based, not time dependent. They also share examples of strength and power diagnostics that they use to accompany GPS data to inform phase progression decisions.
In an elite environment, RTS is a dynamic process balancing the benefits and risks of RTS to the player and the team.2 The CCC moves from high control to high chaos, prescribing running loads under progressively riskier conditions. The continuum is the product of scientific evidence blended with years of experience. This framework provides the practitioner with an individualised approach to RTS that integrates quantitative and qualitative progression criteria.
The article is open access and well worth a read and you can access it here.
Director of Bartold Clinical