Advice from medical professionals on how to ensure a safe return-to-sports…
After a year of disruption to nearly every aspect of life due to the COVID-19 pandemic, many industries are now seeking guidance for how to get back to normal — including athletic programs.
While it may be tempting to make up for lost time and go all in right away, OrthopedicsToday recently published an article expressing physicians’ concerns about athletes returning to play during and after the pandemic. 
As Christopher S. Ahmad, MD, professor of orthopedic surgery and chief of sports medicine at Columbia University, New York Presbyterian Hospital stated in an interview with Orthopedics Today, “What we were fearing is when you have been shut down for a period of time and then the world opens up to sport, that the combination of deconditioning along with intense enthusiasm could lead to…high injury risk.” 
Teenage athletes should take special care. Growth spurts combined with periods of inactivity can be especially treacherous. Injuries in soft tissue injuries, such as sprains, hamstring injuries and the much-dreaded ACL tear, are spiking as athletes are beginning to get back in the game.
Here’s 4 key takeaways from the OrthopedicsToday article and their interviews with leaders in the medical community about ensuring safe post-pandemic return to play.
1. Progressive return to play and cross-training encouraged
Young athletes might be seeking an outlet for pent-up energy, but it’s important to direct that energy in a way that will help them reduce risk of injury.
Why wait to see a doctor until after the damage is done? Instead, be proactive and seek out a medical professional who can help you prevent injuries. Schedule an appointment with an orthopedic surgeon or physician who has expertise in sports medicine. They can assess athletes’ “overall range of motion, strength and flexibility…[and] muscular imbalances,” and fill in the gaps left by routine yearly physicals.
Athletes should also be taking advantage of their time off. Prep for the upcoming sporting season with a “home exercise program specific to the sport they play” to help get their bodies back in condition.
Cross-training is especially important for younger athletes. Get back to basics with free play, which develops “strength, muscle control, coordination, and reflexes,” in addition to helping kids learn independence when it comes to pushing limits and taking risks (not to mention the intellectual, social, and emotional benefits!)  If your sport is not in season, enroll in some other sports and avoid those overuse injuries.
Finally, all athletes stand to benefit from an incremental, managed approach to returning to play post-pandemic. Even athletes who are out for a week or two due to COVID-19 or injury are at an increased risk for injury when returning to play. Which is why Robin V. West, MD, president of Inova Musculoskeletal Line and chair of Inova Sports Medicine recommends setting up a graded, 21-day plan to transition back to normal play and practice.
Athletes who are returning after COVID-19 are recommended to “complete activities of daily living and walk without excessive fatigue or breathlessness, have at least 10 days of rest, be symptom-free for 7 days and conclude all COVID-19 treatment before returning to sport.”
2. Be aware of impacts on overall health
Re-entry to sport can be difficult even during normal times. With the pandemic, uncertainty about the future can increase stress and anxiety. It’s more important than ever to take a more holistic approach to health and well-being.
COVID-19 restrictions may lead athletes to attribute a loss in performance to a deficiency in themselves rather than — quite reasonably! — assigning blame to circumstances completely beyond their control.
A sports psychologist can help, but parents, coaches, and athletic trainers should also be taught to identify athletes who need additional support and mental health resources.
And since sleep and nutrition are huge factors when it comes to managing stress and anxiety as well as physical injuries, take that time you have saved commuting to practices and games and use it to focus on balancing athletes’ energy through good sleep hygiene and proper nutrition.
Athletes who have tested positive for COVID-19 should also be tested according to a cardiology protocol to rule out myocarditis, which can cause trouble breathing, abnormal heartbeat, and chest pain.
3. Coordinate your care
Everyone from parents, athletic trainers, and coaches to school health officials to doctors, psychiatrists, and physical therapists should be enlisted to appropriately manage return to play.
James E. Zachazewski, PT, DPT, ATC, and athletic trainer in the department of orthopedic surgery at Brigham and Women’s Hospital, recommends especially staying in close touch with the athletic trainer:
Reach out to the professional who is dealing with the child athlete on a day-to-day basis and say, ‘Here is what I am hearing from mom and dad, tell me what you are seeing. Let’s talk collaboratively about where we go and how do we progress this’.
Sharing information and uniting around the athlete as a team will help put the child’s health and welfare ahead of the date and time or return to play.
4. Share resources and educate
Good communication also means sharing resources and providing everyone involved with accurate and helpful information. Take the time before starting up to ensure everyone has the knowledge and resources they need to get on board with the same policies.
Identify in advance the tools and resources you need to assess risk profiles, mitigate risk, implement protocols and diagnose before kids start showing up at the gym.
While return to play during a time of pandemic can seem overwhelming, it is essential for everyone involved in youth athletics to exercise patience, above all.
It’s more important than ever to remember that while many things are outside of your control, there are things you do have control over. Implementing these 4 steps gives you an opportunity to return to play — the right way.
 Physicians tackle return to play issues in COVID-19 pandemic (healio.com). All quotes are from this article, unless otherwise indicated.
 The Social, Emotional, and Academic Benefits of Free Play for Children in the Summer (harvard.edu)
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