Medical Jurisdiction Throughout. Performance Clearance Through KPIs and Exit Markers
If there is one rule that must anchor the entire Return to Play (RTP) landscape, it is this:
Medical professionals govern progression. Performance professionals validate readiness.
When this line gets blurred, athletes get hurt—not because anyone had bad intentions, but because the system lost its structure.
At Aruka, this principle is non-negotiable.
Medical Jurisdiction Is Continuous, Not a Phase
One of the most common misconceptions in RTP is that medical oversight ends once the athlete “leaves rehab.” In reality, medical jurisdiction does not stop—it simply evolves.
Medical professionals (licensed physical therapists and certified athletic trainers) retain authority:
- To determine RTP entry point
- To advance an athlete through phases and stages
- To hold, regress, or modify progression when red flags appear
This ensures that tissue healing, symptom response, and biological readiness are never overridden by urgency, competition schedules, or subjective optimism.
RTP is not a handoff—it is a collaborative continuum.
Performance Clearance Is Earned, Not Assumed
Performance professionals play a critical role—but not by making medical decisions. Their responsibility is to stress the system intelligently and measure the response.
Performance clearance is achieved when the athlete:
- Meets defined KPIs (Key Performance Indicators)
- Demonstrates repeatable outputs under increasing complexity
- Satisfies clear exit markers at each phase or stage
This removes guesswork. The athlete doesn’t advance because they “look good” or “feel ready.” They advance because they prove readiness through objective and observable performance criteria.
Why KPIs Matter
KPIs translate preparation into evidence. They answer the question:
“Can this athlete tolerate and express the demands of the next environment?”
Examples include:
- Strength symmetry and rate-of-force development
- Balance and movement competency under load
- Multi-plane control and deceleration capacity
- Fatigue resilience across repeated exposures
- Sport-specific execution at required speeds
KPIs create a shared language between medical and performance teams—one rooted in data, observation, and consistency.
Exit Markers Create Accountability
Exit markers define the minimum standard required to progress. They prevent premature exposure and protect athletes from subjective bias.
In the Aruka R6 Model:
- Every phase and stage has non-negotiable exit markers
- Advancement without meeting them is not permitted
- Regression is a decision governed by medical authority
Exit markers ensure RTP remains criterion-based, not time-based.
The Aruka Standard
The strength of the R6 Model is not just in its structure—it’s in its governance.
- Medical professionals determine when progression is allowed
- Performance professionals demonstrate why progression is deserved
- Athletes earn advancement through execution, not pressure
This preserves trust, protects tissue, and aligns everyone around the same objective truth.
The Takeaway
RTP fails when authority is unclear and standards are undefined.
RTP succeeds when:
- Medical jurisdiction remains intact throughout
- Performance clearance is earned through KPIs
- Exit markers govern progression—not emotion or urgency
That is the fundamental rule of the RTP landscape.
And when it’s respected, athletes don’t just return.
They return prepared, protected, and positioned to stay healthy.
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