By Dev K. Mishra, M.D.
President, Sideline Sports Doc
Clinical Assistant Professor of Orthopedic Surgery, Stanford University
As a sports medicine doctor, I’m often dealing with decisions about return to play after an injury. This is true at the professional level
even down to the club sport level for young athletes. Fundamentally what we try to do is educate the athlete (and parents if it’s a young athlete) about the possible risks of playing and weigh that against possible special circumstances around a game or event.
For example, if the Super Bowl were held today, Patriots tight end Rob Gronkowski likely would not be cleared to play after suffering a concussion in last week’s AFC Championship Game. The Patriots’ injury report lists him as “out” as of a few days ago. The risks of playing without proper recovery from a concussion are simply too high, even for the Super Bowl. Plus, the NFL has a very strict post-concussion protocol that must be followed. Fortunately for the Patriots, they have a few more days until game day and Gronk may yet be cleared.
When any team gets to the end of a long season it’s very common that players are not at 100% of their physical function. This is true for a club basketball team or an NFL team. There are lots of minor things that add up by the end of the season, like knocks and bruises. Bye weeks before a championship certainly help with getting those players as healthy as possible.
At the high school or youth sport level we often hear from players about an intense desire to play in a rivalry game, a championship game, or a college showcase tournament. If you’re coming off an injury, these are the times when it’s really important to work with your trainer, physical therapist, or doctor to clearly discuss what can be done to allow you to participate.
For example, there may be strategies to play in key tournament games and sit out less important games. Also, we can suggest limits on playing time or reps that can reduce exposure to possible re-injury. In some injuries a brace might allow you to play and reduce your injury risk. The point is that if you involve your care providers they’ll typically work with you to find a way to have you play as long as it’s reasonable.
Our colleague Dr. Scott Rodeo at the Hospital For Special Surgery in New York put it this way when describing Super Bowl preparation: “It’s obviously a huge game so the stakes are high,” he said. “Obviously the players’ health and safety come first, but our job as the team physician like any time of the year, whether it’s Week 1 or Week 20, is to educate the players about their injuries so they can make an informed decision. But at this point for a game like this, they may play with some injuries and our job is to help them understand what the risk would be and if there are any long-term issues.”
Your “Super Bowl” might be the game against your crosstown rival high school. If you’re coming off an injury be sure to get advice about how to play at your best and reduce risks of long term problems.