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Joerg Teichmann, Rachel Tan, Kim Hébert-Losier, Yeo Wee Kian, Shabana Jalal Din, Ananthi Subramaniam, Dietmar Schmidtbleicher and C. Martyn Beaven

, kinesiophobia decreased). Typically, the rehabilitation follows a process of 5 general phases, namely restoring the integrity, regaining the mobility, acquiring muscular strength and reflex actions, integrating sport specific movements, and finally return to play incorporating prevention exercises. 3 However, the

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Jenny H. Conviser, Amanda Schlitzer Tierney and Riley Nickols

and recovery status and, as such, ongoing re-evaluation by the MDTT during treatment is necessary. It is critical that the MDTT agree upon previously established parameters for return to play ( Cook et al., 2016 ) since a premature return to sport may increase risk of aggravated illness, injury or re

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Nathan Oakes and Jennifer M. Medina McKeon

athletes to not only return to play (RTP), but also to return to the same level of play (RTSP). 1 Currently, the gold standard treatment for a UCL injury is to undergo UCL reconstruction, a surgical procedure developed in 1974. 5 Since its establishment, multiple studies over the years have reported RTP

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Bhanu Sharma and Brian W. Timmons

inform return-to-play decisions ( 11 ). Therefore, exercise testing can help assess concussion recovery as it relates to symptom burden, although future studies should incorporate alternate recovery end points and outcome measures (cognitive and/or neuroimaging) to determine whether non

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Matt Hausmann, Jacob Ober and Adam S. Lepley

Clinical Scenario Ankle sprains are the most prevalent athletic-related musculoskeletal injury treated by athletic trainers, often affecting activities of daily living and delaying return to play. 1 Most of these cases present with pain and swelling in the ankle, resulting in decreased range of

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Luke M. Mueller, Ben A. Bloomer and Chris J. Durall

Clinical Scenario:

Anterior cruciate ligament (ACL) injuries are associated with a lengthy recovery time, decreased performance, and an increased rate of reinjury. To improve performance of the injured knee, affected athletes often undergo surgical reconstruction and rehabilitation. Determining when an athlete is ready to safely return to play (RTP), however, can be challenging for clinicians. Although various outcome measures have been recommended, their ability to predict a safe RTP is questionable.

Focused Clinical Question:

Which outcome measures should be used to determine readiness to return to play after ACL reconstruction?

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Iñigo Mujika, Juanma Santisteban, Paco Angulo and Sabino Padilla

A 7-week, 10-session individual training program was implemented with a youth elite football (soccer) player who had been underperforming because of poor aerobic fitness. The intervention focused on developing aerobic power and high lactate production and contributed to a 32.3% improvement in a football-specific performance test. The player was able to return to play and exceed expected performance levels during competitive match play.

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Nicole Reams, Rodney A. Hayward, Jeffrey S. Kutcher and James F. Burke

Purpose:

Lingering neurologic injury after concussion may expose athletes to increased risk if return to play is premature. The authors explored whether on-field performance after concussion is a marker of lingering neurologic injury.

Design:

Retrospective cohort study on 1882 skill-position players who played in the National Football League (NFL) during 2007–2010.

Methods:

Players with concussion based on the weekly injury report were compared with players with other head and neck injuries (controls) on measures of on-field performance using Football Outsiders’ calculation of defense-adjusted yards above replacement (DYAR), a measure of a player’s contribution controlling for game context. Changes in performance, relative to a player’s baseline level of performance, were estimated before and after injury using fixed-effects models.

Results:

The study included 140 concussed players and 57 controls. Players with concussion performed no better or worse than their baseline on return to play. However, a decline in DYAR relative to their prior performance was noted 2 wk and 1 wk before appearing on the injury report. Concussed players performed slightly better than controls in situations where they returned to play the same week as appearing on the injury report.

Conclusions:

On return, concussed NFL players performed at their baseline level of performance, suggesting that players have recovered from concussion. Decline in performance noted 2 wk and 1 wk before appearing on the injury report may suggest that concussion diagnosis was delayed or that concussion can be a multihit phenomenon. Athletic performance may be a novel tool for assessing concussion injury and recovery.

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Gail M. Ronchetti, Christopher A. Welch, Brent I. Smith and Danielle E. Blair

A 19-year-old female basketball athlete sustained a right shoulder injury during collegiate competition resulting from a collision causing severe pain and discomfort. The patient was diagnosed with a unique type IV acromioclavicular (AC) separation. Surgical stabilization of the AC joint and slow progression in rehabilitation with immobilization assisted in protecting the reconstruction. Accurate diagnosis and appropriate intervention helped to lead to the successful recovery and return to play for this patient. There are few cases of type IV acromioclavicular separation reported in the literature and none related to basketball. This case presents the challenges related to the diagnosis and rehabilitation following surgical reconstruction of a type IV acromioclavicular separation.

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William L. Wang and Aaron V. Mares

Bilateral epidural hematoma is a rare complication of blunt head trauma. Few cases of bilateral epidural hematomas have been described in the literature and there have been no cases that have been described in a college or professional athlete. This case report presents an unusual case of a Division I collegiate football athlete who sustained a bilateral epidural hematoma with parietal skull fracture after falling down a flight of stairs. It highlights the initial presentation to rehabilitation up until eventual return-to-play 4 months later. There were no setbacks or complications in rehabilitation process.