Criteria-based return to play. Psychological readiness. How? Whose call? Dr Clare Ardern explains

A recent keynote speaker at the Return to Play conference in Bern, the Arsenal FC Sport and Exercise Medicine Conference and the Isokinetic Football Medicine Strategies Return to Play conference in London, Clare Ardern is an emerging voice in sports medicine research. She currently occupies a postdoctoral position in the research department at Aspetar Sports Medicine Hospital, after doing the bulk of her research at La Trobe University in Melbourne, Australia. Her work focuses on the factors influencing return to play, particularly psychological readiness after ACL injury, as well as shared decision making and evidence based medicine. Follow Clare on Twitter @clare_ardern Timeline: 1:35 When can Sarah play again? Should she be playing again? 2:30 Need criteria-based progession through the rehab process , so that the focus shifts from “when” I can play again to “what” I need to achieve for successful return to play. 3:00 Education is key – both the patient and the coach. Motivation is important and can be positive or negative. Young athletes even more important 4:40 Are we moving back to biopsychosocial models, or have we moved on? 5:30 Understand the inherent risks that Sarah is facing, and make sure she understands them! 6:20 Psychological readiness for return to play – the ACL-Return to Sport after Injury (ACL-RSI) scale developed by Dr. Kate Webster and Dr. Julian Feller . It considers: confidence, risk appraisal and the athletes emotions. 12 questions completed in a few minutes. Also available as an Iphone app. It’s sport specific AND IT’S FREE!! 7:45 We should be thinking different for all time-loss injuries. 8:15 Criteria-based rehabilitation – but beware – early return to sport for young athletes increase the risk of re-injury. 9:00 We need to become more systematic to address the psychological/emotional aspects of return to play during our clinical management of these athletes. 12:00 Should we get “informed consent” from the athlete before return to play? 12:50 SUMMARY – When can I play again? 1. Reshape the question – Will I play again? Not all athletes get back, and that doesn’t mean fail. What is the right thing for Sarah? 2. Consider the psychological aspect more systematically! CONSENSUS PAPER on return to sport coming soon! Check out some recent papers from Dr. Ardern: Br J Sports Med 2014;48:1613-1619 doi:10.1136/bjsports-2014-093842The impact of psychological readiness to return to sport and recreational activities after anterior cruciate ligament reconstruction http://bjsm.bmj.com/content/48/22/1613.full Br J Sports Med 2014;48:1543-1552 doi:10.1136/bjsports-2013-093398 Fifty-five per cent return to competitive sport following anterior cruciate ligament reconstruction surgery: an updated systematic review and meta-analysis including aspects of physical functioning and contextual factors http://bjsm.bmj.com/content/48/21/1543.full Br J Sports Med 2016;50:506-508 doi:10.1136/bjsports-2015-095475 It is time for consensus on return to play after injury: five key questions http://bjsm.bmj.com/content/50/9/506.full Further listening:

Podcast from Adam Gledhill which discusses a case study of ACL return to play considerations and different examples of strategies used to aid return to play experiences - https://soundcloud.com/bmjpodcasts/i-cant-return-to-play-when-fear-of-reinjury-dominates-after-acl-reconstruction-adam-gledhill