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A major limitation of the traditional return to sport (RTS) decision has been the exclusion of the athlete in question.1 Recently, two frameworks have underscored the importance of involving the athlete in a multidisciplinary team (MDT) and putting them at the centre of a shared decision-making process that collectively decides RTS protocol.2 3 RTS should also be considered as a continuum that begins at the onset of injury, rather than an isolated step occurring at the end of rehabilitation.3 It should be a process that fosters athlete autonomy; this has been shown to promote personal development, improve motivation and task performance, and subsequently improve rehabilitation outcomes.4
To date, little has been published on the practicality of integrating these principles into a rehabilitation programme within a high-performance environment. The purpose of this editorial is to outline four key habits that clinicians and practitioners can focus on to improve RTS outcomes and maximise rehabilitation outputs : empowerment, engagement, feedback and being transparent. We refer to this as the ‘athlete-centred return to sport approach’ (figure 1).
Four key habits underpinning the athlete-centred RTS approach
Empower the athlete
Educate the athlete early about their injury. Take the time to describe potentially injured structures and explain the basic stages of tissue healing. Having this conversation within the first days of injury is an opportunity to empower the athlete early in taking ownership of their rehabilitation. An example of this would be educating the athlete how they can modify their nutrition to optimise recovery during the acute phase of injury. We have found that these early discussions can help establish a strong collaborative working relationships between the athlete and clinician for the journey from injury through to RTS and performance. It also reminds the athlete that RTS starts from the very moment of …
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