Apr 20, 2018Rethinking Recovery
Determining how hard to push athletes to return to play can be a difficult call. Encouraging them to play through pain can set them up for an increased risk of osteoarthritis (OA) down the road.
A blog from Board of Certification suggests that athletic trainers and coaches should take a conservative stance in these situations. One strategy that’s suggested is to ask student-athletes about their goals for the future.
“It is also beneficial to consider utilizing patient-rated outcome measures (PROMs), as part of practice, to better capture all that an athlete is wanting and focus care on achieving the appropriate end goal. PROMs are important in driving treatment decisions, determining effective treatments and supporting patient-centered care,” Elizabeth L. Augustine, MS, LAT, ATC, wrote. “I also found that talking with the parents about goals was important because high school kids are still young people finding their way in the world. As minors, their parents should share in the decision process.”
When working with high school student athletes, it’s sometimes easy to assume that each student-athlete’s goal is to return to play. Some individuals may have different goals as they recover from an injury, though, so it’s important to ask them.
“Another key component to protecting young athletes is education,” Augustine wrote. “We have a role to educate patients on the risks of injuries, not just in the short term but in the long term of risks like developing OA. Just as we have done with concussion education, it is important to discuss with the athletes and their parents, all risk factors. Armed with this education, I think we can make a more informed decision about long term risks. As a clinician, I want to be honest with my athletes. They deserve to know some potential consequences of being injured and playing through pain.”
Especially for athletes who have been injured with cartilage damage, fracture, acute ligament sprain, or chronic ligamentous instability, OA is a risk. Athletic trainers should follow up with these patients to uncover ongoing pain or problems.
“Continued rehabilitation can also help decrease the risk of OA for athletes. According to the Athletic Trainers’ Osteoarthritis Consortium, injury prevention and the appropriate management of acute injuries are recommended to decrease the risk of OA. We are in the unique position to see our patients on a continued basis and provide basic rehabilitation and immediate interventions for our athletes. I think that continued rehabilitation exercises are necessary for those who sustain injuries and tend to encourage it with my athletes long after they have returned to sports,” Augustine wrote.