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When Can Young Athletes Return to Sport After Illness?

Returning to sport from illness of any kind can be tricky, and with the COVID-19 pandemic, it’s only gotten more difficult. But even a simple cold or stomach bug can leave an athlete sidelined without a clear idea of when it’s safe or advisable to return to sport.

Here, Dr. Michele LaBotz, TrueSport Expert and sports medicine physician, will dig into the signs, symptoms, and feelings that can help athletes, parents, and coaches determine when it’s time to get back in the game.

Before we dive into specific ailments and illnesses, it’s important to note that even when an athlete is no longer infectious or isn’t running a fever, they may still not be ready to return to play. “Even something like an ear infection can be really difficult when it comes to returning to play,” says LaBotz. “An athlete may technically be cleared to return to practice, but I think it’s critical to understand that an athlete’s comfort and capacity to be fully engaged with the sport are just as important as a fever being gone. If a player is distracted because their ear hurts too much or because their tooth hurts too much, they’re potentially risking injury. An athlete has to be feeling well enough that they can perform effectively.”

Assuming your athlete is ready to get back on the field, here’s what you need to know:

Asymptomatic COVID-19

We’ve written about returning to sport after COVID in the past, but as LaBotz points out, the recommendations are changing constantly. Unfortunately, it’s not as simple as getting a negative test—there also needs to be a complete resolution of even mild symptoms, and an all-clear from a physician before an athlete comes back. “Once symptoms have resolved, it is recommended that they touch base with their primary care provider,” says LaBotz. “Many primary care providers are doing a phone call follow up to make sure that there are no other factors that need to be considered.”

Approach an athlete’s comeback the same way you would progress an athlete with a concussion, LaBotz says: “Take a stepwise approach, starting with low intensity activity, and then gradually building back up to sport-specific and higher intensity training over the course of five to seven days.”

Symptomatic COVID-19

“For moderate symptoms, the current recommendation is that athletes get seen by their primary care provider before returning to play,” says LaBotz. “In the United States, the recommendations are that an EKG be done, and the doctor may decide to order additional tests looking at the health of the heart muscle.”

With severe symptoms, it is presumed that an athlete has myocarditis, which is an inflammation of the heart muscles. “For them, it’s a three-to-six-month time period before they can get back to sport,” says LaBotz. “The recommendation is that all of those children with severe symptoms get cleared by a cardiologist before going back.” (If you want to learn more about how COVID-19 can impact heart health, check out this article.)