Exploring the Factors Involved in Being “Ready” to Return to Sport Following a Concussion

Abstract

Objective: To explore the factors involved in athletes being ready (or not) to return to sport (RTS) after sport-related concussion (SRC). Design: Qualitative, semistructured interviews. Setting: Videoconference. Participants: Twenty-two sport-injury stakeholders involved in contact and collision sports at various levels of competition (high school, university, professional), including: formerly concussed athletes (n = 4), coaches (n = 5), athletic therapists (n = 5), physiotherapists (n = 4), nurse practitioner (n = 1), and sports medicine physicians (n = 3). Interventions: N/A. Main Outcome Measures: We included questions in the interview guide regarding factors participants believed were involved in athletes being ready (or not ready) to RTS after a concussion. Results: Participants described physical (concussion symptoms, return to pre-injury fitness), behavioral (changes in behavior, avoidance, malingering), psychological (individual factors, cognitive appraisals, mental health), and social (isolation, social support, communication, pressure) factors that they believed were involved in athletes being ready to RTS after SRC. Conclusions: The graduated RTS strategy outlined in the most recent Concussion in Sport Group consensus statement focuses on physical aspects involved in being ready to RTS, which does not address behavioral, psychological, and social factors, which were identified by participants as being related to returning to sport post-SRC. More research is needed to determine whether the additional factors outlined in this study are relevant among larger samples of athletes, coaches, and healthcare professionals.