Return to Sports Guidelines

Return to Sports Guidelines
The American Academy of Pediatrics just released a Covid-19 Interim Guidance: Return to Sports and Physical Activity on February 9th.

This guidance applies to “children and adolescents who are participating in and/or returning to physical activity, inclusive of but not limited to, organized sports and physical education class within school.” Many children have been affected by the pandemic in relation to their sport activity. It has shut down many programs and restricted children from participating in physical activity. It has led to a sedentary lifestyle which has increased obesity prevalence.
The guidance includes family considerations, transmission mitigation and resumption of activity for a child with Covid-19. It clarifies CDC guidance for quarantine and isolation and when to return to play if diagnosed. Some of the key points include:

Family considerations include the benefits of physical and psychological health for children and adolescents. It improves their cardiovascular health, strength, body composition and overall fitness. The increased socialization has mental benefits of inclusion, structure and comradery.

The prolonged absence of physical activity puts athletes at a higher risk of injury when returning to organized or competitive sports. The AAP strongly recommends the opportunity for children to participate resume, with a gradual return to activity if they have been consistently inactive for over 1 month.

Spectators should follow the current regulations and children should continue to get their return to sports physical examinations. The PPE and Physical examination forms have been revised to incorporate questions relating to Covid-19.

Balancing the risk vs return to sports is driven by the sport setting, local disease activity and individual circumstances, including health risks.

Recommendation for facemasks include the proper use of a face mask for all indoor sports training, competition and on the sidelines is strongly recommended for all athletes (regardless of vaccination status) in counties with substantial or high transmission per CDC criteria. For athletes who are not fully vaccinated, proper use of a face mask for all indoor sports training, competition and on sidelines is recommended regardless of local transmission rates. Exceptions are listed in the guidelines.

Traveling for sports competitions include the evaluation of the risks for the location of travel and the current health status of the athlete.

Close contact with a person that has Covid-19 should be evaluated based on the CDC guidelines of quarantine.

Testing positive – if a child/adolescent tests positive for Covid-19, their pediatrician, team officials and the health department should be notified. Return to play is determined on severity and recommendations on quarantining.

Returning to play after testing positive  The AAP recommends not returning to sports until children or adolescents have completed isolation, the minimum amount of symptom-free time has passed, they can perform normal activities of daily living, they display no concerning signs/symptoms and a physician evaluation has been completed if indicated.


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