Table 4 A clinical checklist to determine readiness to return to play after a calf muscle strain injury based on information provided by experts
Return to play criteria | ✔or ✖ |
|---|---|
Symptom resolution and psychological readiness | |
Self-reported symptoms: VAS 0/10 (pain, tightness, ‘cramping’ sensation) | ☐ |
Self-perceived readiness & confidence to return to performance | ☐ |
Residual clinical signs and impairments | |
Palpation tenderness: VAS 0/10, length: 0 cm | ☐ |
Weight bearing ankle dorsiflexion range of motion: normalised knee-to-wall lunge (cm) and straight leg stretch, asymmetries ≤ 10% | ☐ |
Single leg calf raise test from the floor*: capacity (≥ 30 repetitions), asymmetry ≤ 10% | ☐ |
Normalised strength-power qualities | |
Loaded strength: sports-specific benchmark (knee extended, knee flexed) | ☐ |
Power: normalised vertical and horizontal calf function; instantaneous and repeated tests (Supp file 2); asymmetries ≤ 10% | ☐ |
Reconditioned for exposure to sport demands | |
Running conditioning: total volume, volume across speed bandwidths, accelerations, decelerations | ☐ |
Intensity of running and other dynamic activities: cutting, reactive agility, jumping, maximum velocity, maximum acceleration | ☐ |
The mechanism of injury | ☐ |
Successful re-integration into full training | |
Return to full training for ≥ 1 session, pending the length of the rehabilitation period | ☐ |
Consensus among stakeholders about readiness to perform at the required level (e.g. elite vs sub-elite vs amateur) | ☐ |