Return to Play After Injuries: A Survey on the Helpfulness of Various Forms of Assistance in the Shared Decision-Making Process in Semiprofessional Athletes in Germany.

OBJECTIVE: To assess how different decision-guiding factors, such as health- and performance-related stakeholders, as well as evidence-based guidelines, support the process-oriented final positive return-to-play (RTP) decision of head coaches responsible for semiprofessional sport teams.
DESIGN: Cross-sectional survey.
SETTING: Team sport. PARTICIPANTS: A survey consisting of questions on the importance of different decision-guiding factors used when making the RTP decision after injuries was administered to and completed by head coaches (N=238) of semiprofessional players' teams.
INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: With respect to helpfulness in the RTP decision-making process, the coaches rated both the importance of the opinions of physicians, physiotherapists, strength and conditioning coaches, and the athletes themselves, and the importance of the general and injury-specific RTP guidelines.
RESULTS: Our survey revealed that the head coaches rely on physicians and physiotherapists to a large extent, to the athletes and to themselves to a medium extent, and to strength and conditioning coaches and RTP guidelines to a small but still relevant extent. The coaches' efforts to seek a shared decision-making process in RTP are, hence, partially evident.
CONCLUSIONS: A multitude of actuators intervene when making the RTP decision. The professionalization of the RTP process in semiprofessional sports includes the athletes themselves, the head coaches, the (external) physicians, the (external) physiotherapists, and the strength and conditioning coaches based on general RTP decision-making models and specific criteria related to injury type, sports type, level, and playing position. The development of awareness and implementation strategies of RTP models should be subject to further research.