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Athletico Physical Therapy EXOS Pivot Physical Therapy Andrews Sports Medicine
Inside this journey
  1. Clinical & Outcome Discovery

    Capture injury details, timeline pressures, stakeholders (athlete, family, trainers, team staff), and measurable return-to-play goals and constraints.

    Discovery Questions

    Tell Me the Moment That Changed Everything

    • In a few sentences, describe how and when this injury or problem first happened.
    • What were the immediate symptoms and how severe did they feel on a 1–10 scale? Options: 1–3 (mild), 4–6 (moderate), 7–8 (severe), 9–10 (extreme)
    • What immediate evaluation or care did you receive at the time of injury? Options: Emergency department/urgent care, On-site athletic trainer, Team physician, Primary care, No immediate care, Other
    • Have you had imaging (MRI, X‑ray, ultrasound) or specialist reports since the event? Please list dates and brief findings.
    • Has a clinician given you a working diagnosis yet? If so, what language or terms were used?
    • Who should we include from day one when discussing options (parent/guardian, coach, trainer, team physician, agent)? Options: Athlete, Parent/guardian, Coach, Athletic trainer, Team physician, Agent/manager, School/club medical director, Other

    Are You Comfortable Betting Your Season on a Guess?

    • If we had to commit to a plan today, how confident are you that your current diagnosis and timeline would get you back by your key event? Options: Very confident, Somewhat confident, Unsure, Not confident at all
    • What is the concrete date or event you are targeting (game, tryout, championship)? Please give the specific date if you can.
    • How would missing that date affect you personally and professionally (emotionally, academically, financially, roster status)?
    • Which outcomes would you find unacceptable in this recovery—select all that apply. Options: Not returning to previous level, Persistent pain, Reduced range of motion, Need for revision surgery, Extended time away from sport, Other
    • Have any coaches, scouts, or decision-makers explicitly communicated expectations or deadlines to you? If yes, who and what was said?
    • Which matters more right now: a guaranteed timeline to play or minimizing long‑term risk to your career? Options: Timeline is everything, Prefer a balance, Prioritize long‑term function even if slower, Unsure

    What's the Real Goal — Winning, Playing, or a Second Career?

    • Is your primary goal to return as quickly as possible, to return at the same or higher level, or to protect your long‑term athletic career? Options: Return as quickly as possible, Return at same or higher level, Protect long‑term career even if slower, Undecided/need guidance
    • List specific, measurable performance metrics you or your coaching staff will use to judge readiness (e.g., sprint time, minutes, vertical, position‑specific skills).
    • What percentage of your pre‑injury performance would you consider a successful return? Options: 100% or better, 90–99%, 75–89%, Under 75% would be disappointing
    • Which objective tests or milestones do you and your team trust most? Options: Single‑leg hop/symmetry, Triple hop, Isokinetic strength testing, Y‑Balance, Sport‑specific drill performance, Video/analytics comparison, Other
    • Who will have final say to clear you for full competition (athlete, coach, team physician, surgeon)? Please describe how that decision is usually made. Options: Athlete, Parent/guardian, Coach, Athletic trainer, Team physician/medical director, Surgeon/therapist consensus, Other
    • Beyond physical readiness, what mental or confidence milestones need to be met for you to feel truly ready?

    What Have You Tried That Shouldn't Be Overlooked?

    • Could something you've already tried explain why you're not improving—or point us toward the better next step? Tell us what you've attempted.
    • Which conservative treatments have you used and for how long? Options: Rest/ice, NSAIDs/medication, Physical therapy, Bracing/taping, Corticosteroid injection, Platelet/biologic injection, Activity modification, None
    • How consistently did you follow prescribed therapies or home exercises? Options: Fully compliant, Mostly compliant, Occasional adherence, Sporadic, Didn't follow at all
    • Did any treatment give partial relief? If so, what changed and how long did that improvement last?
    • Have you had prior surgeries or procedures on the same joint/area? Please include dates and outcomes.
    • Are there medical conditions, medications, or allergies that could alter our treatment choices?

    How Will Others Judge This Decision?

    • If the plan requires trade‑offs, whose opinion will be hardest to convince and why?
    • Which stakeholder typically carries the most weight when decisions are made? Options: Athlete, Parent/guardian, Coach, Athletic trainer, Team physician/medical director, Agent/manager
    • Are there insurance, pre‑authorization, or coverage limits we need to plan around? Options: In‑network provider required, Pre‑authorization needed, High deductible/out‑of‑pocket, Limited PT sessions, Advanced therapies not covered, Self‑pay/financially flexible, Unsure—need verification
    • Do season schedules, tournaments, school exams, or travel plans create fixed windows for procedures or rehab?
    • Would you consider pausing competition, seeking a second opinion, or delaying a decision to optimize the outcome? Options: Yes—pause and reassess, Yes—seek second opinion first, Willing to delay procedure, Prefer immediate decision, Unsure
    • What would make you feel we handled external pressures well (examples: clear plan shared with coach, fast authorization, protected roster status)?

    What Would Failure Look Like — And Who Notices First?

    • If recovery goes poorly, what single outcome would feel catastrophic to you?
    • Which complications worry you most? Select all that apply. Options: Reinjury/instability, Chronic pain, Loss of performance/career impact, Need for revision surgery, Joint stiffness or decreased ROM, Infection/medical complication, Other
    • What objective thresholds would force us to change course (for example, <80% strength at 6 months or failed hop symmetry)? Please be specific if you can.
    • Who will be responsible for collecting objective progress data (therapist, athletic trainer, surgeon, self) and how often should we review it? Options: Physical therapist, Athletic trainer, Team physician, Surgeon, Self‑reported via app, Other
    • How likely is the athlete to follow home programs, attend scheduled rehab, and meet testing appointments? Options: Very likely (highly motivated), Generally reliable, Sometimes misses, Often noncompliant, Unwilling
    • If early warning signs appear, how would you prefer we communicate and escalate (immediate call, secure message, team meeting)? Options: Immediate phone call, Secure platform message, Text/SMS, Email summary, Team triage meeting

    What Does Moving Forward Look Like — Are You Ready?

    • If we agreed on a path today, what would you need to feel ready to give us your full trust?
    • Which care pathway are you currently leaning toward? Options: Non‑operative / conservative care, Surgical intervention, Undecided—need guidance, Second opinion first
    • How soon could you attend additional imaging, a specialist consult, or, if necessary, a surgical date? Options: Within 48 hours, Within 1 week, 1–4 weeks, 1–3 months, Longer/unsure
    • Which ways of receiving updates and results work best for you and your support team? Options: Secure messaging in platform, Phone calls, Text/SMS, Email, Video visits
    • Do you need cost estimates or insurance verification before we schedule anything? Options: Yes—need cost estimate, Yes—need coverage verification, No—cleared to proceed, Unsure
    • What immediate next step would be most valuable—a focused plan review, ordering imaging, referring to our sport‑specific rehab, or booking a consultation? Options: Plan review with surgeon/doctor, Order imaging/tests, Refer to specialized therapist, Schedule procedure consultation, Obtain second opinion
  2. Solution Experience

    Translate the diagnosis into realistic care pathways (non-operative, surgical, rehab) using the athlete’s context to confirm expected outcomes and risks.

    Experience Meetings

    • Current State & Consequence Alignment
    • Solution Pathways Workshop (Non‑op, Surgical, Rehab)
    • Timeline, Risk Mitigation & Resource Alignment (Team Integration)
    • Pathway Decision & Validation
    • Handoff meeting invitation to Treatment & Rehab Scope owners with the finalized pathway and milestone playbook attached.
    • Schedule discipline-specific consults (surgeon, sports PT, strength coach) for any pathway with open technical questions.
    • Order any directed tests or clearances required to refine likelihood estimates (e.g., advanced imaging, functional tests).
    • Record the athlete's prioritized outcomes and confirm them in writing.
    • One-sentence Future State Confirmation
    • Agree on a time-bound milestone plan and objective testing criteria tied to competition dates.
    • Confirm resource commitments (rehab slots, clinician time, facility) and identify any gaps to resolve.
    • Define concrete contingency triggers and decision owners if progress deviates from plan.
    • Establish the communication protocol and reporting cadence to keep all stakeholders aligned.
    • Book required rehab and testing windows aligned to milestone dates and season events.
    • Submit requests for insurance pre-authorization for planned services identified in the pathway.
    • Assign and document primary owners for milestone sign-offs and contingency approvals.
    • Create and share a one-page Timeline & Criteria playbook that will be the single source of truth.
    • Rapid Recap (Problem → Consequence → Future State)
    • Obtain explicit, documented agreement from athlete/family and primary stakeholders to proceed with the chosen pathway.
    • Ensure the recommendation is tied to the problem and proven to achieve the defined future state.
    • Confirm administrative prerequisites (insurance, scheduling, consent) are in place or assigned owners to complete them.
    • Trigger the transition into Treatment & Rehab Scope with a clear handoff packet and owners.
    • Prepare and distribute the signed recommendation/consent packet and the pathway summary to all owners.
    • Schedule first treatment/rehab appointments and any pre-op clearances required.
    • Complete insurance authorization and document any out-of-pocket estimates for the athlete/family.
    • Introductions & Objectives
    • Create a single, explicit one-sentence current-state diagnosis agreed by all parties.
    • Quantify and document the concrete consequences of inaction or each pathway in time, performance, or risk terms.
    • Identify all decision constraints and required pre-work to enable a valid solution experience.
    • Agree on owners for outstanding clinical data (imaging, tests) needed before pathway design.
    • Document and circulate the one-sentence current-state and consequence summary.
    • Obtain any missing imaging or specialist reports identified during the meeting.
    • Collect and record stakeholder contact list and explicit constraints (season dates, insurance limits).
    • Schedule the Solution Pathways Workshop once pre-work is complete.
    • Recap: Current State & Decision Criteria
    • Provide concrete, evidence-based care pathways mapped to the athlete's context and decision criteria.
    • Demonstrate how each pathway changes the future state and removes quantified consequences.
    • Obtain initial, explicit validation from athlete/family/coach on which pathway(s) align with priorities.
    • Identify remaining evidence or approvals needed to finalize a recommended pathway.
    • Produce a side-by-side, personalized pathway summary (non-op vs surgical vs accelerated rehab) and circulate to stakeholders.
    • Season & Competition Mapping
    • Present Recommended Pathway & Rationale
    • One-sentence Current State
    • Non-operative Pathway Walkthrough
    • Milestones, Testing Windows & Objective Criteria
    • Clinical Evidence Review
    • Outcomes, Risks & Likelihoods
    • Surgical Pathway Walkthrough
    • Consequence Quantification
    • Athlete/Family Forced Validation
    • Resource & Capacity Assessment
    • Rehabilitation Phased Model
    • Stakeholder & Constraint Mapping
    • Side-by-side Outcome & Risk Comparison
    • Administrative Readiness Check
    • Risk Mitigation & Contingency Triggers
    • Communication Protocol & Owners
    • Decision & Next Steps
    • Decision Criteria & Pre-work Agreement
    • Validation Exercise (Forced Confirmation)
    • Agree Preferred Pathway(s) & Next Evidence Needs
  3. Treatment & Rehab Scope

    Define the clinical plan, scope of services, phased rehabilitation modules, objective testing criteria, and roles for surgeon, therapist, and coaching staff.

    Scope Configuration

    • Perform arthroscopic ACL reconstruction
    • Perform ACL revision and graft reconstruction
    • Perform arthroscopic rotator cuff repair
    • Perform arthroscopic shoulder labral repair
    • Perform meniscal repair or partial meniscectomy
    • Administer ultrasound-guided PRP injection
    • Administer ultrasound-guided corticosteroid injection
    • Provide supervised postoperative physical therapy session
    • Provide supervised sport-specific rehabilitation session
    • Deliver progressive plyometric and agility training session
    • Provide vestibular and balance rehabilitation session
    • Fit and provision of sport-specific bracing or orthosis
    • Provide postoperative wound care and suture removal

    Scope Questions

    Perform arthroscopic ACL reconstruction

    • What is the timing of the injury and current presentation? Options: Acute (<2 weeks), Subacute (2-6 weeks), Chronic (>6 weeks), Recurrent instability
    • Which graft option do you prefer or is indicated based on prior imaging/consult? Options: Hamstring autograft, Patellar tendon autograft, Quadriceps autograft, Allograft, Undecided / need surgeon recommendation
    • Are there concomitant injuries documented on imaging that should be addressed during the procedure? Options: Meniscal tear, Cartilage lesion / chondral defect, Collateral ligament injury, None documented, Unknown / needs imaging review
    • Are there scheduling or timeline constraints for the athlete (season deadlines, travel, academic calendar)? Options: Immediate (within 2 weeks), Near-term (2-6 weeks), Elective (>6 weeks), Season-critical deadline
    • Is preoperative strength / prehab planned prior to reconstruction? Options: Yes - formal prehab program, No - proceed to surgery, Short home program only, Undecided
    • Please list any medical comorbidities, anticoagulation, or prior knee surgeries that may affect operative planning.

    Perform ACL revision and graft reconstruction

    • What is the primary reason for revision? Options: Graft failure/rupture, Persistent instability, Malpositioned tunnels, Infection, Pain/arthrofibrosis, Other
    • What was the prior graft type and fixation (if known)? Options: Patellar tendon autograft, Hamstring autograft, Quadriceps autograft, Allograft, Unknown / not documented
    • Is there evidence of compromised bone stock or tunnel widening on imaging? Options: No significant widening, Mild-to-moderate widening, Severe widening requiring bone grafting, Imaging not available
    • Do you anticipate staged reconstruction (bone grafting first) versus single-stage revision? Options: Single-stage revision, Staged (bone graft then revision), Undecided / surgeon to determine intraop
    • Will concomitant procedures be required (e.g., meniscal repair, chondral procedures, osteotomy)? Options: Meniscal repair/meniscectomy, Cartilage restoration/microfracture, High tibial osteotomy / alignment procedure, None anticipated, Unknown / depends intraop
    • Provide any prior operative reports, infection history, or graft-related pathology details that affect planning.

    Perform arthroscopic rotator cuff repair

    • What is the tear characterization based on imaging? Options: Partial-thickness, Small (<1 cm), Medium (1-3 cm), Large (3-5 cm), Massive (>5 cm)
    • What is the chronicity and symptom trajectory? Options: Acute traumatic onset, Gradual onset with progressive weakness, Chronic long-standing symptoms, Acute-on-chronic
    • Is tendon quality or fatty infiltration noted that may affect repair technique? Options: Good tendon quality, Moderate degeneration/fatty infiltration, Severe degeneration/irreparable
    • Do you plan biological augmentation (e.g., PRP, graft augmentation) alongside repair? Options: No augmentation, PRP augmentation, Patch/biologic graft augmentation, Undecided / surgeon recommendation
    • Are there concomitant shoulder pathologies (e.g., impingement, biceps pathology, labral tear) to address? Options: Biceps tenodesis/tenotomy, Subacromial decompression, Labral repair, None known, Unknown / needs further imaging
    • Describe the athlete's sport, throwing status, and season/timeline goals to inform postoperative immobilization and return timeline.

    Perform arthroscopic shoulder labral repair

    • Select the labral pathology identified on imaging or exam. Options: Anterior Bankart / anterior instability, Posterior labral tear, SLAP lesion, Combined lesions, Imaging not definitive
    • How many prior dislocation events or instability episodes has the athlete experienced? Options: None / first-time, 2-3 events, 4+ recurrent dislocations, Subluxations only
    • Is there associated bony loss (e.g., glenoid bone loss, Hill-Sachs) requiring bony augmentation? Options: No significant bone loss, Glenoid bone loss noted, Large engaging Hill-Sachs, Imaging pending
    • Will repair include biceps management (tenodesis/tenotomy) or other adjunct procedures? Options: Yes - biceps procedure planned, No biceps procedure, Undecided
    • Are there sport-specific considerations (collision sport, overhead throwing) that alter repair strategy or rehab? Options: Collision/contact sport, Overhead throwing athlete, Non-contact/field sport, Unknown
    • Please confirm what preoperative imaging is available (MRI, MR arthrogram, CT) and attach if possible. Options: MRI, MR arthrogram, CT scan, X-ray only, No imaging available

    Perform meniscal repair or partial meniscectomy

    • What is the tear pattern and location? Options: Bucket-handle, Radial/complex, Longitudinal/vertical, Degenerative flap, Root tear
    • Is the meniscal tissue considered repairable based on imaging/arthroscopy expectations? Options: Likely repairable, Likely partial meniscectomy, Root repair required, Undetermined - surgeon to decide
    • Is the meniscal procedure concurrent with ACL reconstruction or other ligament surgery? Options: Concurrent with ACL reconstruction, Concurrent with cartilage procedure, Isolated meniscal procedure, Unknown
    • Are there weight-bearing or activity restrictions anticipated post-procedure that affect rehab planning? Options: Immediate weight-bearing as tolerated, Protected weight-bearing period, Non-weight-bearing, Depends on repair type
    • Does the athlete prioritize meniscal preservation over earlier return-to-play (i.e., favor repair when possible)? Options: Prioritize preservation/repair, Prefer faster RTP (partial meniscectomy), Undecided/need surgeon guidance
    • Provide any cartilage status or degenerative joint disease information that may affect decision-making.

    Administer ultrasound-guided PRP injection

    • What is the target indication for PRP? Options: Tendinopathy (e.g., patellar, Achilles), Intra-articular OA/joint injection, Muscle strain/tear, Adjunct to tendon/ligament repair, Other
    • How many PRP injections are planned in the treatment course? Options: Single injection, Series of 2, Series of 3, Undecided / surgeon protocol
    • Which PRP formulation is preferred or recommended? Options: Leukocyte-rich PRP, Leukocyte-poor PRP, Undecided / surgeon preference, Not applicable
    • Are there contraindications or anticoagulation issues to review prior to injection? Options: On anticoagulation, Active infection at site, Platelet disorder / hematologic condition, No contraindications known
    • Is image guidance confirmation available and preferred (ultrasound location, joint vs tendon)? Options: Ultrasound-guided intra-articular, Ultrasound-guided tendon injection, Landmark-based (no ultrasound), Undecided
    • Please list any prior biologic or injection treatments (PRP, corticosteroid, HA) and dates.

    Administer ultrasound-guided corticosteroid injection

    • What is the target site for the corticosteroid injection? Options: Intra-articular knee, Subacromial space, AC joint, Peritendinous bursa, Other
    • What is the timing relative to planned surgery or high-stakes competition? Options: No imminent surgery/competition, Within 2 weeks of competition, 2-6 weeks before surgery (acceptable), Less than 2 weeks before surgery (avoid)
    • How many steroid injections have been given to this region in the past 6 months? Options: None, 1, 2, 3 or more
    • Are there contraindications (active infection, uncontrolled diabetes, anticoagulation)? Options: Active local infection, Uncontrolled diabetes, On anticoagulation, No known contraindications
    • Do you require ultrasound guidance for accuracy or patient preference? Options: Yes - ultrasound guidance required, No - landmark injection acceptable, Prefer ultrasound but optional
    • Describe expected goals from the injection (diagnostic, short-term pain relief, facilitate rehab progression). Options: Diagnostic (confirm pain source), Short-term pain relief to enable rehab, Longer-term symptom control, Other

    Provide supervised postoperative physical therapy session

    • Which postoperative phase will this session cover? Options: Immediate post-op (0-2 weeks), Early rehab (2-6 weeks), Strengthening phase (6-12 weeks), Advanced strengthening/return prep (>12 weeks)
    • What is the recommended frequency and duration for supervised sessions per week? Options: 1 session/week, 2 sessions/week, 3 sessions/week, More than 3 sessions/week
    • Which objective measures should be tracked during sessions? Options: Range of motion, Strength testing (isometric/isokinetic), Pain score, Functional tests (hop, Y-balance), Wound check/incision care
    • Do you require therapists with sport-specific or post-op orthopedic specialization? Options: Yes - sports specialty required, Standard post-op PT acceptable, Prefer experience with athletes
    • Will sessions include manual therapy, modality use (e-stim/US), or purely exercise-based rehab? Options: Manual therapy + exercise, Exercise only, Modalities + exercise, Depends on phase
    • Is telehealth or remote monitoring acceptable for some sessions or home exercise check-ins? Options: Yes - hybrid model, No - in-person only, Occasional telehealth only

    Provide supervised sport-specific rehabilitation session

    • What sport and position-specific demands should be addressed in sessions?
    • Which sport-specific components are required? Options: Throwing/overhead mechanics, Cutting and change-of-direction drills, Sprint/acceleration training, Sport-specific agility and decision-making
    • Will the coaching staff/athletic trainer be present or involved in sessions? Options: Yes - coach/TR present, No - clinician-led only, Occasional coach involvement
    • What performance metrics should be collected during sessions? Options: Jump height/vertical, Sprint times, Agility times (T-test, pro agility), Biomechanical video analysis, Subjective readiness scales
    • Do sessions require field/arena access or can they be performed indoors in clinic? Options: Field/arena required, Clinic/gym space sufficient, Either depending on drill
    • Are there athlete load management constraints (e.g., minutes per week, pitch counts) to respect during progression? Options: Yes - strict load caps, Moderate restrictions, No specific caps

    Deliver progressive plyometric and agility training session

    • Has the athlete met baseline readiness criteria for plyometrics (strength benchmarks, pain-free movement)? Options: Yes - cleared for plyometrics, Partially - modified program, No - not ready
    • What intensity and progression model is preferred? Options: Low-to-moderate progressive, High-intensity plyometric loading, Conservative return-to-sport progression
    • Which surfaces and equipment will be used (turf, hardwood, grass, hurdles, boxes)? Options: Turf/grass, Hardwood/gym floor, Track/synthetic, Clinic equipment only, Mixed
    • Which objective measures should be recorded to progress safely? Options: Single-leg hop distance, Symmetry indices, Reactive strength index, Agility test times
    • How frequently should plyometric sessions be scheduled per week? Options: 1 session/week, 2 sessions/week, 3 sessions/week, Tailored to athlete schedule
    • Are there any return-to-play windows or competitions to time peak readiness for? Options: Yes - specific date, Approximate timeframe, No firm deadlines
  4. Mutual Commit

    Finalize consent, scheduling, financial/insurance terms, and communication protocols to align expectations and readiness to proceed.

    Agreement Modules

    • Treatment Statement of Work (SOW)
    • Informed Consent & Procedure Authorization
    • Scheduling & Pre-Procedure Commitment
    • Financial Agreement & Insurance Authorization
    • Communication & Care-Team Information Release
    • Rehabilitation Scope Acceptance
    • Home Program & Compliance Commitment
    • Cancellation, Rescheduling & Refund Policy
    • Post-Procedure Support & Complication Response Plan
    • Medical Records Release & Appeals Authorization
  5. Rehabilitation Deployment

    Schedule and execute surgical care (if applicable) and progressive, sport-specific rehab with clear owners, milestones, and testing windows.

  6. Return-to-Play Success

    Validate objective return-to-sport criteria, confirm outcomes, capture lessons, and maintain a shared channel for complications or ongoing performance support.

    Success Reviews

    • Objective Return-to-Play (RTP) Validation
    • Outcomes Confirmation & Data Capture
    • Lessons Learned & Ongoing Performance Plan
    • Complication Response & Escalation Protocol
    • Final Clearance Handoff & Stakeholder Communication

    Issues & Enhancements

    • Publish and distribute an escalation flowchart and contact list to athlete, family, coach, and clinical team.
    • Deliver a clear, owner-assigned maintenance and performance plan for the athlete.
    • Establish a reliable communication cadence among clinical and performance staff.
    • Produce a one-page Lessons Learned summary and circulate to the care team for protocol updates.
    • Create and share the individualized maintenance program with the athlete, coach, and AT.
    • Assign monitoring owners and schedule recurring check-ins (weekly -> monthly cadence as needed).
    • Update the clinic's RTP checklist/protocols with agreed improvements.
    • Put a tested, stakeholder-aligned escalation protocol in place with clear SLAs.
    • Review likely complications and early-warning signs
    • Ensure every stakeholder knows their role and contact expectations during a complication.
    • Create a feedback loop so incidents inform pathway improvements.
    • Current state summary
    • Implement an incident report template and assign responsibility for post-event review.
    • Schedule a quarterly review of complications and protocol effectiveness.
    • Confirm final clearance status and restrictions
    • Deliver a final, documented clearance and a clear phased reintegration plan to all stakeholders.
    • Resolve outstanding administrative items so there are no barriers to competition participation.
    • Ensure ongoing monitoring is scheduled and owners are assigned for performance follow-up.
    • Send formal clearance letter with restrictions and monitoring plan to athlete, coach, AT, and team medical director.
    • Confirm competition entry/eligibility with league if required and finalize any necessary paperwork.
    • Schedule and calendar post-return performance assessments and check-ins.
    • Close or escalate any unresolved billing/authorization items with admin.
    • Confirm whether objective RTP criteria are met and record the decision (full/conditional/delay).
    • Ensure all stakeholders understand the consequences and next steps tied to the decision.
    • Document objective proofs that support the decision for future audit and continuity.
    • Upload validated test results and decision rationale to the athlete record (attach raw data and thresholds).
    • Notify coach, athletic trainer, and team medical director of decision and any conditional restrictions.
    • If delayed or conditional, schedule targeted intervention(s) and follow-up testing window.
    • Provide athlete and family with written clearance or delay explanation and return-to-play expectations.
    • Recap pre-injury goals and expected outcomes
    • Confirm that documented outcomes meet or do not meet the athlete's stated goals and clinical expectations.
    • Capture and store standardized outcome measures for continuous improvement and benchmarking.
    • Clarify psychosocial readiness and whether additional support is needed before full competition exposure.
    • Add standardized outcome measures and PRO scores to the athlete's record and the practice registry.
    • If athlete consents, forward anonymized data to the outcomes registry and note consent in the chart.
    • Schedule psychosocial or sport-psych consult if readiness concerns are identified.
    • Set follow-up performance assessment dates at 3, 6, and 12 months post-return.
    • Timeline and deviation review
    • Capture concrete lessons that improve the RTP pathway and reduce future risk or delays.
    • What worked / what didn't
    • Competition reintegration plan
    • Define escalation pathway and decision thresholds
    • Present aggregated outcome data
    • Review objective test results
    • Design ongoing performance & load-management plan
    • Compare results to predefined RTP criteria
    • Athlete-reported readiness and psychosocial status
    • Administrative closeout
    • Confirm contact roster and response SLAs
    • Long-term limitations and monitoring plan
    • Assign roles and communication cadence
    • Tabletop scenario and validation
    • Surface consequences of results
    • Stakeholder communication checklist
    • Incident reporting and follow-up loop
    • Document protocol improvement items
    • Decision and conditional plan
    • Data sharing and consent
    • Schedule post-return performance check-ins
    • Communication & documentation
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