Return to Sport: Post injury

Injuries happen but how do you get back into training following an injury? It's important not to jump straight back in and to understand the process. Returning back to sport is a marathon not a sprint. Here are the steps you need to take to have a safe return back into sport and reduce the risk of injury recurrence.

Recovery:

The recovery process will vary person to person depending on the injury and severity.

Tissue Healing times:

These are only average healing times, each individual's healing can depend on many factors. Some factors that can affect your body's capacity to heal are other preexisting medical conditions, gender, nutrition and stress.

Stages of recovery:

The Acute phase: Involves understanding the injury and what recovery is required. Set realistic expectations for healing times and recovery times. Gain the diagnosis and begin treatment for the injury; this may be manual therapy, mobility training and stretching. Seek a medical opinion for guidance.

Rehab Stage: This will include more mobility training and begin the strengthening of the structure once healing has started. This can include more exercises and functional rehabilitation.

Are you ready to return?:

You need to consider these factors before returning to sport: Physical readiness, Mental readiness and Gradual return.

Risk of reinjury: there is a heightened risk of re-injury when in the recovery and rehabilitation stages.

It is important to remember, if cared for correctly, that your injury is temporary. Short term changes for long term recovery and results should be the aim. A rushed return to sport will lead to higher chance of re-injury therefore putting you further back in your training. Your body has to last you a lifetime - it's worth prioritizing recovery!

Return to sport: This is a gradual return where you are building back up your strength and return to physical activity.

These stages of recovery don't keep you out of the gym but you have to adjust your mindset and expectations from your workouts. The intention is to heal and recover, not to hit personal bests. Therefore setting up your sessions to best support recovery and healing is important.

Rehabilitation strategies: Set realistic expectations

Getting guidance from a specialist in injuries is important; they can provide both treatment and create a personalised recovery and rehabilitation plan while managing your pain/symptoms and healing.

Musculoskeletal specialists: Chiropractors, physiotherapists, sports rehabilitation/medicine.

Treatment can be beneficial for promoting healing, assessing for changes due to the injury and gradual structured return to activity. Treatment can involve massage, active/passive release technique, adjustments, Soft tissue work (Instrument assisted myofascial tools, acupuncture). Treatment promotes healing by keeping muscles and joints relaxed and moving, promoting blood flow to the area and preventing compensations from other structures.

Strength and conditioning:

Depending on the injury creating stability around the joint or area of injury is extremely important. Then introducing progressive overload: this will cause a gradual increase into physical demand.

Nutrition and recovery:

Nutrition can aid in muscle recovery and repair. The body only has a certain capacity for healing. We have to be correctly fueling our body so it has the energy to heal and repair torn/damaged structures. Not fueling for the body effectively can lead to higher risk of reinjury or longer healing times. Your healing times will be slower on a calorie deficit or a ‘Cut’.

The Injury Reduction Pyramid

Surround yourself with the correct people: They should support and motivate you.

These can include:

Coach communication
Medical professionals
Peers
Research

Red flags and when to seek help: Prevention is better than Cure.

Warning signs: pain, swelling, decreased range of motion, not able to perform certain movements. Pain can be difficult when training as we may experience an odd niggle. My personal rules for my own training is if something hurts more than a 4/10 when training or has been present for more than 4 days then check it out. Even if it's a discussion with your coach.

If in doubt check it out: seek the opinion of a medical profession and discuss with your coach.

Charlotte Mackie DC MCHRIO LRCC

Registered Chiropractor

References:

Kraemer, W., Denegar, C. and Flanagan, S. (2009) ‘Recovery from injury in sport: Considerations in the transition from medical care to performance care’, Sports Health: A Multidisciplinary Approach, 1(5), pp. 392–395. doi:10.1177/1941738109343156.

Cools , A.M. et al. (2020) The challenge of the sporting shoulder: From injury prevention through sport-specific rehabilitation toward return to play, Annals of physical and rehabilitation medicine. Available at: https://pubmed.ncbi.nlm.nih.gov/32320753/ (Accessed: 31 March 2025).

Meakins, A., 2019. The Injury Reduction Pyramid. [image] Available at: https://www.thesports.physio (https://www.thesports.physio) [Accessed 31 Mar. 2025]

Guo, S., & DiPietro, L.A. (2010). Factors Affecting Wound Healing. Journal of Dental Research, 89(3), 219-229. doi:10.1177/0022034509359125

Soft tissue healing (no date) Physiopedia. Available at: https://www.physio-pedia.com/Soft_Tissue_Healing (Accessed: 31 March 2025).