Nearly half of doctors and physical therapists surveyed were willing to return a child to sport after a knee injury despite more than minimal pain, continued swelling, and limited range of motion in the joint, finds a surprising new Canadian study.
While previous studies reported that older athletes in elite sports were often returned to activity despite continued pain, whether such a practice is appropriate for younger athletes remains to be seen.
The study is in the October 2011 issue of the British Journal of Sports Medicine.1
Doctors, PTs and ATs in the survey generally agreed that the absence of knee pain and swelling, and the regaining of full range of motion in joint, muscle strength, sport-specific skills and balance, should all be weighed, but disagreed on the weight each should be given, and how much impairment was acceptable before a child would be allowed to return to sports.
"The marked difference for MDs may reflect a different philosophy, training or focus on health issues, [which] needs to be explored in future studies if interdisciplinary guidelines for return to sport for children are to be developed," said lead author, Mathieu Boudier-Revéret of the School of Physical and Occupational Therapy at McGill University in Montreal, Quebec, Canada.
The challenge for doctors and physical therapists, says Keith Cronin, a physical therapist in St. Louis, is in explaining to parents the many gray areas in the return to play decision, including the following factors:
For example, Cronin says, he would allow a right-handed pitcher with a right ACL tear to return faster than a right-handed pitcher with a left ACL tear because the left leg is his landing leg, which the pitching follow-through subjects to more pressure and uncontrolled rotation.
Another example: Cronin would allow a football player with mild pain while running, but not while walking, climbing stairs, or sleeping, to return to practice, but that same football player with no "reported" pain while running not to return to play if he was limping around the house and experienced pain while sleeping.
1. Boudier-Revéret M, Mazer B, Ehrmann Feldman D, Shrier I. Practice Management of musculoskelatal injuries in active children. Br J Sports Med 2011;45:1137-1143.
Posted October 18, 2011
Links:
[1] https://momsteam.com/node/284
[2] https://momsteam.com/health-safety/general-safety/injury-treatment/recovery-from-youth-sports-injury-step-by-step process
[3] https://momsteam.com/health-safety/muscles-joints-bones/ankle-foot/ankle-sprains-recognition-and-treatment
[4] https://momsteam.com/health-safety/knee-pain-physical-therapy-can-help
[5] https://momsteam.com/health-safety/lower-back-injuries-in-female-athletes-identifying-cause-rehabilitating-problem
[6] https://momsteam.com/back-pain/mid-back-pain-can-affect-athletic-performance
[7] https://momsteam.com/team-experts/physical-therapy-injured-athlete-pressure-to-pain-not-pain-and-torture
[8] https://momsteam.com/team-experts/evaluating-pain-during-sports-injury-recovery-process