Friday, 14 Jun 2024

When Can Young Athletes Return to Sport After Illness?

Returning to sports after an illness can be challenging, especially in the midst of the COVID-19 pandemic. However, even with simpler illnesses like colds or stomach bugs, athletes often struggle to determine when it’s safe to get back in the game. In this article, we will explore the signs, symptoms, and factors that athletes, parents, and coaches should consider when deciding when to return to sport.

The Importance of Comfort and Engagement

Returning to play isn’t just about being medically cleared. It’s crucial to understand that an athlete’s comfort and ability to fully engage with the sport are equally important. For example, even after being cleared to play, an athlete with an ear infection may still experience too much pain to fully focus on the game. In such cases, returning to play prematurely may put them at risk of injury. An athlete should feel well enough to perform effectively before getting back on the field.

Guidelines for Specific Illnesses

Asymptomatic COVID-19

When it comes to returning to sports after asymptomatic COVID-19, it’s important to consult with a primary care provider once symptoms have completely resolved. They will assess the athlete’s overall health and provide guidance on when it’s safe to return. It’s advisable to follow a stepwise approach, gradually increasing activity over a period of five to seven days.

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Symptomatic COVID-19

For athletes with moderate symptoms of COVID-19, it’s recommended to see a primary care provider before returning to play. Additional tests, such as an EKG, may be necessary to assess heart health. Athletes with severe symptoms, indicating myocarditis, should wait for three to six months and obtain clearance from a cardiologist before resuming sports.


The “neck rule” is a helpful guideline for dealing with colds and flus. If symptoms are isolated above the neck, such as an earache, runny nose, or sore throat, athletes can usually return to sports safely, provided they feel okay. However, symptoms below the neck, such as fever, vomiting, diarrhea, lung symptoms, or a significant cough, should be addressed before resuming sports. Athletes with fevers should be fever-free for 24 hours before returning to play. It’s important to monitor temperatures accurately using a digital thermometer. Athletes on antibiotics for conditions like ear infections or strep throat can return to training once the fever is gone and they feel well. However, antibiotics may cause gut issues, in which case it’s advisable to wait until those issues resolve.


For athletes recovering from mononucleosis, it’s essential to wait until they feel better and have regained their energy before considering a return to play. Regardless of fever or spleen status, athletes should wait for three weeks before resuming sports, as splenic rupture is a concern during this period. Low-impact activities like walking or yoga can be gradually introduced once symptoms subside, even if energy levels are still low. This period can also be used for rehabilitation and mental preparation.

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Gut Issues

For stomach bugs, food poisoning, and other gastrointestinal illnesses involving vomiting, diarrhea, or stomach pain, it’s important to stay away from practice until symptoms resolve. These illnesses can easily spread among athletes, especially in high-contact sports or those with shared equipment. It’s crucial to practice good hand hygiene and be cautious about returning to play to prevent transmission and dehydration.


Q: Can athletes return to sports immediately after their symptoms have resolved?

A: No, athletes should follow a stepwise approach, gradually increasing activity over several days, based on their energy and performance levels.

Q: Should athletes wait until they complete antibiotics before returning to training?

A: No, once the fever is gone, and athletes feel well, they can resume training even while on antibiotics. However, athletes may want to wait for gut issues caused by antibiotics to resolve before returning to intense training.

Q: Is it necessary for athletes to see a cardiologist after recovering from COVID-19?

A: For athletes with severe symptoms of COVID-19, clearance from a cardiologist is recommended before returning to sports. It’s crucial to ensure the heart is healthy and fully recovered from inflammation.


Returning to sports after illness requires careful consideration of an athlete’s comfort, engagement, and overall health. Whether it’s asymptomatic or symptomatic COVID-19, colds, mononucleosis, or gut issues, each illness has specific guidelines for safe return to play. By following medical advice and prioritizing the athlete’s well-being, parents, coaches, and athletes can make informed decisions and ensure a safe return to sports. Remember, it’s always essential to consult with a healthcare professional for personalized guidance.

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For more information and expert advice on returning to sports after illness, visit