Return to Play, Athlete Readiness and Planning Load in Rehab

Ian separates physical from psychological readiness, which do not always match, and both from mental health. Questionnaires include fear avoidance tools and the DASH, with the 11-item QuickDASH giving similar information. A recent qualitative study found that shared decision making with athletes was often missing even when therapists believed it was happening. Planning uses the 2016 Bern consensus continuum of return to participation, sport and performance, or keeping a full-time athlete available for training. Macro planning sets a target date agreed with the whole team, and micro planning breaks each week into intensity, volume and frequency of exposure. A 2017 McCreesh study found that tendinopathic shoulders took about 24 hours to recover after isokinetic loading compared with 6 hours in controls, so timing rehab matters. He describes rehab as the cake and passive treatment as the cherry on top, and notes that weakness with pain may be pain inhibition. His clinical equation combines subjective findings, objective measures, optional special tests and scans, and shared decisions to reach return to play.