Athlete Return-to-Play Decisions in Sports Medicine

Abstract

Jordan is a 17-year-old senior in high school who has been his football team's star quarterback, led his team to two state championships, and has a real possibility of receiving a full scholarship to a top college sports program next year.In his last session of summer training camp, Jordan took a fierce hit, a tackle that knocked him to the ground. He landed on his right arm and shoulder and instantly felt sharp pain and then lost some sensation. Jordan was taken to the hospital. An MRI was taken, which showed that Jordan had a torn labrum in his right shoulder that would require surgery and months-long recovery, meaning that he would miss the rest of his final season. A week later, Jordan underwent surgery and soon thereafter began seeing physiatrist Dr. Brown for further treatment and follow-up.Two months after his surgery and continued treatment with Dr. Brown, Jordan felt that his recovery was lagging. He was worried that his slow recovery process coincided with the recruitment period for college programs. Top programs were increasingly inquisitive about his recovering shoulder, so he scheduled an urgent appointment with Dr. Brown.Dr. Brown had known instances in which this particular type of injury ended a quarterback's athletic career. She had also read about a few cases in which athletes recovered fully from the injury. Since so much of recovery depends on the injured person's following the rehabilitation and physical therapy plans, Dr. Brown wanted Jordan to approach his injury with the optimism that adherence to the plan would enable him to return to athletics. At the same time, she did not want to hold out false hope that might keep Jordan focused exclusively on football when, in the long term, that might not be the best use of his senior year. CommentaryThis scenario-frequently encountered by physiatrists who practice sports medicineencompasses many of the common challenges in care and return-to-play decisions for high-level athletes. Physiatrists with board certification in sports medicine are physicians who complete postgraduate training in physical medicine and rehabilitation, in addition to a 12-month sports fellowship and a written examination [1]. Sports medicine physiatrists specialize in the treatment and prevention of medical and orthopedic injuries AMA Journal of Ethics, June 2015 511