When you get injured, whether from sports, daily activities, or even a minor accident, one of the most common questions is, “When can I get back to doing what I love?” Returning to physical activities after an injury is a process that needs careful planning to avoid re-injury and ensure long-term recovery. Let’s dive deeper into what experts look for before giving the green light to return to play, with detailed examples and evidence-based medical terminology.

1. Pain-Free MovementThis is the foundation of recovery. Pain during movement is often a sign that the injured tissues are not fully healed or that there is ongoing inflammation.
   
   Example 1: 
   If you’ve had a Grade 2 ankle sprain, walking should be entirely pain-free before considering higher-impact activities like jogging or jumping. Persistent pain may indicate incomplete ligament healing or compensatory stress on surrounding tissues.
   
   Example 2: 
   After a rotator cuff injury, overhead motions like reaching for a shelf should not cause discomfort. If pain persists during these movements, it may point to unresolved tendonitis or impingement. Medical Terminology: Pain can be assessed using the Visual Analog Scale (VAS), with a score of 0 (no pain) being a critical benchmark. Additionally, tenderness during palpation (manual examination) can signal incomplete recovery.

   

2. Full Range of Motion (ROM)After an injury, stiffness or limited motion is common. Restoring full ROM is crucial to prevent compensatory movement patterns that could lead to new injuries.
   
   Example 1: 
   Following an ACL reconstruction, achieving at least 0° (full extension) to 130°-140° (flexion) in the knee is a key milestone before progressing to running or jumping.
   
   Example 2: 
   For a frozen shoulder, external rotation (e.g., turning your arm outward) should be fully restored to approximately 90° to ensure functional mobility. Medical Terminology: ROM is measured using a goniometer, a tool that quantifies joint angles. Deviation from normal ROM values, such as restricted dorsiflexion (<10°) in an ankle injury, can hinder performance and increase the risk of re-injury.

   

3. StrengthStrength imbalances between the injured and uninjured sides increase the likelihood of re-injury. Recovery programs often focus on restoring at least 90% of the strength of the uninjured side.
   
   Example 1: 
   For hamstring strains, eccentric strength (controlled lengthening of the muscle) should be tested using exercises like the Nordic Hamstring Curl. Weakness in eccentric contraction is a major predictor of recurrence.
   
   Example 2: 
   In cases of shoulder injuries, the External Rotation to Internal Rotation Strength Ratio (normally 65-75%) is assessed to ensure rotator cuff stability. Medical Terminology: Strength can be evaluated using isokinetic dynamometry, which measures force production at different speeds. Handheld dynamometers may also be used for practical testing in clinical settings.

   

4. Confidence in MovementConfidence plays a significant role in recovery. Hesitation or fear can lead to altered movement patterns, increasing the risk of compensation injuries.
   
   Example 1: 
   An athlete recovering from an ankle sprain might avoid putting full weight on the injured foot, leading to overloading the opposite leg and potential knee or hip issues.
   
   Example 2: 
   A person recovering from a back injury may avoid bending or lifting due to fear, despite their spine being physically ready. This fear can perpetuate stiffness and reduce overall function. Medical Terminology: Psychological readiness can be assessed using the Injury-Psychological Readiness to Return to Sport Scale (I-PRRS). Scores below average suggest the need for additional mental preparation.

   

5. Testing Everyday MovementsTesting functional tasks ensures that the injured area can handle daily demands before progressing to more complex activities.
   
   Example 1: 
   For knee injuries, a Single-Leg Squat Test can reveal imbalances in strength and stability. Difficulty maintaining alignment during the squat may indicate incomplete recovery of quadriceps or hip stabilizers.
   
   Example 2: 
   For shoulder injuries, the Wall Push-Up Test can assess scapular control. Uneven shoulder movement during the test may suggest weakness in the serratus anterior or rotator cuff. Medical Terminology: Functional movement screening often uses tools like the Functional Movement Screen (FMS), which scores movement patterns to identify risk factors for re-injury.

   

6. No Swelling or InstabilitySwelling often indicates ongoing inflammation or joint irritation. Instability, on the other hand, can signify that the injured ligaments, tendons, or muscles haven’t regained their full support capabilities.
   
   Example 1: 
   Persistent knee swelling after an ACL reconstruction may suggest synovitis or a cartilage issue. Joint aspiration (removal of excess fluid) might be necessary to reduce swelling and aid recovery.
   
   Example 2: 
   An unstable shoulder that "slips" or "clicks" during certain movements might indicate laxity in the glenohumeral ligaments, requiring further rehabilitation or surgical intervention. Medical Terminology: Instability can be assessed using specific tests like the Lachman Test for ACL injuries or the Apprehension Test for shoulder dislocations.

   

7. Clear Guidance from a ProfessionalEvery injury is unique, and recovery should be personalized. A physiotherapist or healthcare provider will perform assessments to ensure you meet all criteria for a safe return to play.
   
   Example 1: 
   After a hip labral tear, a therapist may use the FABER Test (Flexion, Abduction, External Rotation) to check for hip joint integrity before approving running or jumping.
   
   Example 2: 
   For Achilles tendon injuries, completing a series of Single-Leg Heel Raises (20 repetitions) with proper form is often required before returning to running. Medical Terminology: A Return-to-Sport Checklist typically includes functional tests (e.g., hop tests), strength assessments, and psychological readiness measures to provide a comprehensive evaluation. Final Thoughts Returning to play or any physical activity after an injury isn’t just about feeling ready; it’s about ensuring your body is ready too. By following these criteria—pain-free movement, full range of motion, strength, confidence, and professional guidance—you’re setting yourself up for a successful and safe recovery. If you’re recovering from an injury and need personalized guidance, reach out to our online rehabilitation program. We’ll help you every step of the way, so you can get back to doing what you love—safely and confidently!