Key West Sports Medicine Sport-specific injury guidance for the Lower Keys Get evaluated

Return to sport guides for the Keys

Medically reviewed by Jason Pirozzolo, DO, sports medicine and family medicine, Key West Concierge Orthopedics. Last reviewed July 2026.

Criteria-based return means one thing: stages are earned by passing markers, not by waiting out calendar days. A calendar tells you how long you have been injured; a marker, like a 30 second single-leg balance hold or a pain-free step-down, tells you what the tissue can actually do today. Every guide in this library works that way, because the sports medicine consensus, stated formally in the 2016 British Journal of Sports Medicine consensus statement on return to sport, moved the field from time-based to criteria-based decisions for exactly this reason: bodies heal on their own schedule, and testing beats guessing.

How to use these guides

Pick the guide that matches your injury and your sport. Start at the highest stage whose markers you can honestly pass today. Then follow one rule the whole way: if pain rises above a mild level during a session or the next morning, drop back one stage for 48 hours. That single sentence prevents more re-injuries than any piece of equipment sold in a tackle shop.

The five guides

Why dropping back early beats re-injury

The setback rule feels conservative until you price the alternatives. Dropping back one stage costs 48 hours. Pushing through a failed marker and re-injuring costs the whole progression plus interest, and in the Keys the interest compounds: a charter captain who re-tears a shoulder in November has mortgaged the winter sailfish season, and a runner who re-sprains in December has donated a Half Marathon entry fee. Timelines in these guides are always ranges, never promises, because the honest answer to "how long" is "as long as the markers take."

When to skip the guide and get evaluated

These guides assume a known, uncomplicated injury. Skip straight to an evaluation when you cannot pass a guide's first stage, when a joint locks or gives way, when there is numbness or persistent weakness, or when two weeks of honest staged work moves nothing. The sports medicine overview explains how an evaluation works here, including how visiting athletes fit one inside a trip. A guide is a map; it cannot examine you, and the difference matters most exactly when progress stalls. If an athletic trainer or physical therapist is already running your rehab, the escalation and handback loop for ATs and PTs describes how a stalled case gets sent up for evaluation and sent back with a note.

Frequently asked questions

How do I know which stage to start at?

Start at the highest stage whose markers you can pass today, tested honestly. If you can walk pain-free but wobble on one leg, you start at the balance stage, not the running stage. When two stages feel arguable, start at the lower one; the cost of a too-easy week is boredom, and the cost of a too-hard week is a restart.

What do I do if I fail a stage marker?

Drop back one stage for 48 hours, then retest. Failing a marker is information, not a setback: it tells you where the tissue actually is this week. The guides are built so that dropping back early costs days while pushing through costs weeks.

Do the timelines change with age?

The ranges widen, mostly. Tissue quality, sleep, and training history matter more than the birthday itself, but a fifty-year-old tendon genuinely remodels slower than a twenty-year-old one. The markers do not change with age; only the patience between them does.

When should I get evaluated instead of following a guide?

When you cannot pass the first stage of the relevant guide, when a joint locks or gives way, when there is numbness or persistent weakness, or when two honest weeks of staged work produce no progress. The guides assume a diagnosis; if you are guessing at what is injured, the evaluation comes first.

Medically reviewed by Jason Pirozzolo, DO. Dr. Pirozzolo is dually board certified in sports medicine and family medicine and practices non-surgical orthopedics at Key West Concierge Orthopedics in Key West, Florida. Last reviewed: July 2026.

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