By Dev K. Mishra, M.D., President, Sideline Sports Doc
There’s never a good time to be injured. As we come up to the end of many spring sports, players often have their eyes on championships or important tournaments. When an injury happens one of the most important questions the young athlete wants to know is “when can I play again?” Usually their point of reference is the newsfeed on some professional athlete’s injury, and the answer from the news media is almost always “2-3 weeks.” The reality, however, is that full recovery as I outline below can often take much longer than that. My first bit of advice to athletes I’m treating is to try and “let it go”, and understand that an injury occurred, understand that treatment will almost always get you successfully back to play, and understand that it will take some time to get back. Let me outline the general phases for injury recovery, and finish with some rough timelines for return to play.
Treating the Injury
The treatment phase involves the healing of the injured part. For an ankle sprain, this may involve a brace, sometimes crutches. For a broken foot or ankle there may be a cast placed on the leg. For a torn ACL in the knee, surgery is usually needed. This phase of treatment is directed by the doctor, and will take days to weeks depending on the type of injury.
Rehabilitating the Injury
Once the treatment for the injury has started, the next phase of recovery begins. This will often involve referral to a qualified physical therapist. The physical therapist is highly trained in techniques to restore function of the injured part, develop a plan for sport-specific training, or suggest equipment modification such as bracing. For many injuries, we’ve learned over the years that early involvement by a physical therapist speeds up return to play.
Conditioning the Injured Athlete for Return to Play
Here’s the part that can take some time, often much longer than you initially realize. Let’s say you’ve had a significant ankle sprain. You were treated in a brace for 2-4 weeks, and then you started getting some movement skills back for another 2-4 weeks. Now we’re up to 4-8 weeks from the time of your injury, and you know what you haven’t been doing- practicing or playing sports. Getting yourself fit will take a few more weeks (or even months, if you’ve been out a long time). In this phase we will usually rely on the trainer to start sport specific conditioning drills designed to safely return you to play.
Putting it All Together- How Long Until You Can Play Again?
I’ve broken the process into “phases” above, but the reality is that there’s a lot of overlap between the phases. For example, treatment and rehabilitation will be going on at the same time and will overlap, and rehabilitation and conditioning will also overlap. Each situation can vary quite a bit with the specifics of your injury, but here are some very rough guides based on my practice.
“Moderate” or Grade 2 ankle sprain:
- Brace 2 weeks
- Rehab and conditioning 2 weeks
- Full return to training 4-5 weeks after injury
Foot fracture treated in a cast or boot
- Cast or boot 4 weeks
- Rehabilitation and conditioning 3-4 weeks
- Possible return to training 8-9 weeks after injury
ACL tear treated with surgery
- Surgery takes place 3-4 weeks after the initial injury
- Rehab begins immediately after surgery, continues through 4 months
- Sport specific conditioning months 5-8
- Full return to training at 9 months