Athletes are often sidelined with play ending injuries during the season. The question- Are athletes ready to return when cleared to play? Could those who are tasked with making the decision to clear a player for return to play benefit from more data driven insight? Unfortunately, clearance doesn’t always equal full recovery. This is exhibited by rate of re-injury. It’s become the ultimate dilemma for the modern athlete when recovering, returning fast vs. returning ready. In today’s performance-driven environment, athletes and sports medicine teams need objective data to guide the return-to-play process. That’s where DEXA scans provide a measurable advantage.
Even short periods of reduced training can significantly impact body composition. It creates system wide changes in muscle mass and lean mass. When an arm or leg is immobilized, muscle protein synthesis decreases, muscle breakdown increases and cross sectional muscle size decreases. Research shows measurable loss of lean mass can occur in as little as 1-2 weeks of reduced loading. This is most common in the lower extremities, e.g. quad and calf atrophy.
Don Dengel, a Professor in the School of Kinesiology at the University of Minnesota and a co-founder of Dexalytics, had a doctoral student that was doing a study on females that have undergone ACL surgery.
DEXA scan technology was used as part of the study to examine the changes in regional composition that occurred in the surgically repaired leg as well as the contra-lateral non-surgical leg following 4 and 6 months of post-surgical rehabilitation. They found both legs had undergone changes. The non-surgical leg had gained 762 grams (1.68 lbs.) of total mass while the surgical (left) leg lost 331 grams (0.73 lbs.) of total mass. As expected the surgical leg lost lean mass. While the non-surgical leg gained lean mass, most likely due to added weight bearing required of the non surgical leg post surgery. Another interesting find was the fact that both legs lost bone mineral content. Both legs also gained similar amounts of fat mass.
Professor Dengel took away 2 things from the DEXA scans done during the study. First, the changes in leg composition that occurred in this individual immediately post surgery and then again 4 months out are easily identifiable with a DEXA scan. Second, the evidence shows the potential to use DXA in helping to monitor recovery from surgery and, possibly, in determining when it would be safe for this individual to return to training and competition. DEXA scans make it easy to track loss of muscle and hopefully return of muscle as the athlete works through rehab.
In elite sports, whether at the collegiate or professional level, marginal differences really do matter. Relying solely on subjective testing can leave gaps in the recovery process. Typical strength and functional testing, such as maximal strength testing, movement quality and balance, and sports specific agility can fall short when analyzing an athletes ability to return to play for several reasons. While functional gains are important, they don’t guarantee structural recovery and this is a common cause of re-injury. This type of measurements can mask imbalances if compensation occurs and they can’t quantify muscle loss. Just because there is a perceived recovery in performance doesn’t mean there is true tissue restoration after injury. DEXA scans provide objective and actionable insights that strengthen return-to-play decisions. Cleared to play is not the same as ready to perform. Data-driven recovery ensures athletes return stronger, more balanced, and better prepared for the demands of competition.
