Safe and Timely Return to Sport for Adolescents

“If you can walk you can run. No one is ever hurt. Hurt is in your mind.” Any guess as to whom this quote belongs to?  None other than the great former Green Bay Packers coach, Vince Lombardi.  Examples of this mentality in sports history are many: Michael Jordan battling the flu in the 1997 NBA Finals; Curt Schilling’s bloody sock in Game 6 of the 2004 AL Championship series; and gymnast Kerri Strug sticking her vault landing on a severely sprained ankle at the 1996 Olympics.  Unfortunately, because of the adulation bestowed upon such performances, playing with pain is a behavior that a lot of young athletes may feel inclined to emulate.

Young athletes should not be encouraged to “play through the pain” because mismanaged injuries can have long term consequences including the development of chronic musculoskeletal dysfunction, impaired sports performance and shortening of athletic careers.  Emphasis instead should be on constructing positive sports experiences and preventing injury.  That being said, pain and injury are common in sport and it’s important to understand how to manage them appropriately.

So how do we know when our young athlete is ready to return to their sport? First, it’s important to determine if the athlete is “hurt” or “injured”. “Hurt” can involve exhaustion, contusions, abrasions, and blisters whereas “injured” may involve fractures, muscle strains, joint sprains, concussions, and overuse injuries. Athletes experiencing the former can usually return to participation with no or very brief downtime, while the latter will require substantially more time away from sport and medical management with rehabilitation. Also important to understand is an athlete’s typical reaction to pain and that some individuals tolerate “hurt” better than others.

A second question to ask is “Where is the athlete within the season?” Injuries occurring during the off-season, pre-season or beginning of the regular season should be rehabilitated to facilitate the athlete returning at full capacity for the end of the season and/or playoffs rather than rushing to get back on the playing field before fully recovered. Injuries occurring during the heart of the competitive season or playoffs may need to stop playing if continued participation is contributing to increased pain.

If your young athlete is experiencing any of the following symptoms, you should consult with a doctor for examination: 1) pain persisting more than 2 weeks despite relative rest, 2) pain getting worse, 3) swelling, 4) impaired or painful range of motion, and 5) a noticeable limp with walking.

Here are some key points to remember when determining when to return a young athlete back to their sport following an injury:

  • Understand the individual athlete’s situation and goals
  • Determine the severity of the injury
  • Evaluate the risks of return to play
  • Discuss the risks and benefits with the athlete and parent
  • Give the athlete another outlet for physical and mental energy, such as physical therapy or practice modification.

Here at CPMC, we have a great team of physical therapists along with an array of wellness programs that can help your athlete return to his/her beloved sport. Contact us at for more information!


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