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Return to play in elite sport: a shared decision-making process
  1. H Paul Dijkstra1,
  2. Noel Pollock2,
  3. Robin Chakraverty3,
  4. Clare L Ardern4
  1. 1Sports Medicine Department, ASPETAR, QATAR Orthopaedic and Sports Medicine Hospital, Doha, Qatar
  2. 2British Athletics, Hospital of St Johns and St Elizabeth, London, UK
  3. 3British Athletics, National Performance Institute, Loughborough, UK
  4. 4Research Department, ASPETAR, QATAR Orthopaedic and Sports Medicine Hospital, Doha, Qatar
  1. Correspondence to Dr H Paul Dijkstra, Sports Medicine Department, ASPETAR, QATAR Orthopaedic and Sports Medicine Hospital, PO Box 29222, Doha, Qatar; paul.dijkstra{at}

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Illness or injury affected four out of every five athletes on the Great Britain Track and Field Team before, during or immediately after the 2012 Olympic Games.1 The return to play (RTP) decision is a case of risk management, and athletes may continue to train or compete, despite being ill or injured. This begs the question: ‘How is the return to play decision made in elite sport’?

RTP decisions are complex, specific to the athlete and type of sport, and often influenced by ‘decision modification’ factors (eg, pressure to return for a major event).2 In the case of a sprinter with a hamstring strain 2 weeks from the World Championships, the final RTP decision-maker might be the athlete. However, the healthcare professional should be the final RTP decision-maker when athlete decision-making capacity is compromised (eg, concussion). Decisions regarding the immediate medical management (including RTP) of an ill or injured player on the field of play should be made by a healthcare professional. The coach or manager should have no say in whether the medical team should attend the athlete, or in immediate player assessment.3 …

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  • Twitter Follow Hendrik Dijkstra at @DrPaulDijkstra, Noel Pollock at @drnoelpollock, Clare Ardern at @clare_ardern

  • Contributors HPD substantially contributed to conception and design, coordinated authors, drafted, revised and approved the final version of the manuscript. NP, RC and CLA participated in drafting and revising the manuscript and approved the final version to be published.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.