Psychological readiness to return to sport: three key elements to help the practitioner decide whether the athlete is REALLY ready?

Return to sport (RTS) outcomes after severe injury are consistently poor. 2 Psychological factors are important influences on returning to sport yet what it means to be psychologically ready to RTS is unclear. Rarely will an athlete be held back from RTS because he/she is not psychologically ready to return. Psychological factors correlate with injury occurrence, therefore these factors should be offered greater weighting in RTS decisionmaking. Characteristics of an athlete who is psychologically ready to RTS are multifaceted and include, among others: realistic expectations, high levels of self-efficacy and low levels of anxiety. 4 6 Psychological readiness to RTS is likely influenced by multiple social agents, personal and contextual factors (eg, coaches, sports medicine practitioners, personality traits, performance level). Consequently, RTS decisions should be made from an interdisciplinary perspective, with multidimensional monitoring of psychological factors (eg, concurrently monitoring selfefficacy and re-injury anxiety levels). Psychological readiness to RTS is not commonly monitored in practice, despite specific instruments being available. Many practitioners feel underprepared to work within this area or might view evaluating psychological readiness to RTS as being outside their scope of their practice. On the other hand, sports medicine practitioners are ideally positioned to monitor athletes, because of the strong working relationship developed throughout injury rehabilitation. In this editorial, we describe three key elements that practitioners can consider when monitoring psychological readiness to RTS in preparation for RTS decisionmaking.