When to Return

Returning to regular activities or sport after an injury is about more than simply being pain-free. An athlete may feel good during everyday activities but still lack the strength, mobility, coordination, or confidence required for higher-level demands. A successful return to activity should therefore be viewed as a progression rather than a single moment when someone is declared “ready.” We discuss this topic and more with Scott Armistead, Director of Sports Medicine for Real Salt Lake on the Zelos Podcast.

One of the first considerations is physical capacity. The injured area should have regained appropriate strength, mobility, stability, and endurance compared with the uninjured side or the demands of the activity. Movement quality is equally important. Can the person squat, jump, land, change direction, accelerate, decelerate, or perform sport-specific movements without compensation? The goal isn’t necessarily perfect symmetry, but rather demonstrating that the body can tolerate the forces and positions it will encounter during normal activity.

Another important factor is load tolerance. Being able to perform an exercise once doesn’t mean the body is ready to perform it repeatedly. Training volume and intensity should gradually increase so that the athlete demonstrates the ability to recover between sessions without a significant increase in pain, swelling, stiffness, or other symptoms. This is where a progressive return-to-play or return-to-activity plan becomes particularly valuable.

The mental side of recovery is often overlooked. Fear of reinjury, hesitation, lack of confidence, and anxiety can alter movement patterns and limit performance even when physical testing looks good. An athlete should progressively regain trust in the injured area and feel confident performing increasingly demanding movements. Confidence doesn’t mean ignoring fear; it means building enough positive experiences to demonstrate that the body is prepared for the task.

Ultimately, readiness is best determined by looking at the whole person rather than a single test or number. Physical capacity, movement quality, workload tolerance, recovery, confidence, and the specific demands of the activity should all be considered. Returning to sport isn’t simply about asking, “Does it hurt?” The better question is, “Can this person confidently and repeatedly handle the physical and psychological demands of what they want to return to?” That answer provides a much stronger foundation for a safe and successful return.