December 1, 2025

Cleared Isn’t Always Ready: What  Girls are Taught to Accept vs What their Bodies are Actually Asking For

By Lylah Ruparel

There is a moment every injured athlete waits for.

It usually comes in a small room, fluorescent lights, paper-covered exam table. A doctor or trainer looks up and says the words that feel like permission: You’re cleared. Cleared to return. Cleared to compete. Cleared to stop worrying.

For many girls, that word carries relief of proof they didn’t fall behind, didn’t lose their place, didn’t let their team down. But for far too many female athletes, being “cleared” marks the start of something harder. Because cleared doesn’t mean ready. And their bodies know it before anyone else does.

The Space No One Trains For

Medical clearance is often based on thresholds: range of motion restored, swelling down, strength approaching baseline. These are important milestones but they don’t reflect how sports actually work.

Sports are unpredictable. Injuries, particularly those involving soft tissue, happen under fatigue, pressure, and split-second decision-making. Sports ask bodies to absorb force at awkward angles, to react without thinking, to trust themselves fully.

Soft tissues like ligaments, tendons, cartilage, don’t heal like bones. They’re slower to recover and especially vulnerable to repeated stress. Research in Sports Medicine and the British Journal of Sports Medicine shows that even when athletes meet strength benchmarks after injuries like ACL tears, neuromuscular control and movement confidence often lag behind, sometimes for months.

That gap matters. One large meta-analysis found that athletes who returned to their sport without meeting broader readiness criteria were significantly more likely to reinjure themselves within the first year. Girls, in particular, face higher reinjury rates, not because they’re fragile, but because the systems around them rarely account for how their bodies adapt under load.

As orthopedic surgeon Dr. Fury put it during our interview, “Passing a test doesn’t mean the body knows how to protect itself yet.”

What Girls Learn to Ignore

From a young age, girls in sports are taught powerful lessons, often without anyone saying them out loud. Push through. Don’t complain. Pain is part of it. Rest is for later.

By the time many girls reach high school, they’re exceptionally skilled at overriding discomfort. They know how to minimize pain, how to keep going even when something feels off, especially if stopping might disappoint a coach or cost playing time. But pain is not a weakness signal. It’s information. Biomechanics research shows that fatigue, pain, and fear subtly change movement patterns. A landing becomes stiffer. A cut shifts load to the opposite side. Timing changes by milliseconds, just enough to increase injury risk. Over time, small compensations become big problems.

During our interview, Dr Livesay, professor of Applied Biology and Biomedical Engineering described it perfectly: “Most injuries don’t happen because something suddenly goes wrong. They happen because the body has been quietly adapting for a long time.”

The Brain Hasn’t Caught Up Yet

Even when tissue has healed, the nervous system may still perceive threat. This is where fear, hesitation, and lack of trust show up; not as thoughts, but as movement. Medical clearance is often based on thresholds: range of motion restored, swelling down, strength approaching baseline. These are important milestones but they don’t reflect how sports actually work. Studies on return-to-sport psychology consistently show that athletes who feel uncertain or anxious about reinjury move differently, even when they are physically strong. Their bodies brace instead of flow. They hesitate instead of react.

For gymnasts, this might look like avoiding a certain landing. For soccer players, a delayed cut late in the game. For many girls, it feels like something they can’t quite explain like “I’m fine, but I don’t feel like myself yet.” Neuro-performance coach, Ms Sugiura, explained it this way during our interview: “If the brain still thinks something isn’t safe, it will change how you move no matter what the scan says.” Yet mental readiness is rarely treated as readiness at all.

Why “Return to Sport” Is a Misleading Finish Line

The phrase return to sport suggests it's like a box to check or a moment to celebrate. But recovery isn’t linear, and it definitely isn’t binary. True readiness lives in capacity: Can the athlete maintain form under fatigue? Can she react instinctively, not cautiously? Does she trust her body again and not just hope it holds?

Research increasingly supports this shift. Performance-based return criteria including hop symmetry, movement quality, and psychological readiness are associated with lower reinjury rates than time-based clearance alone. And yet, calendar timelines still dominate. Dr Fury put it bluntly: “We’re very good at saying when someone can play again. We’re much worse at helping them rebuild confidence and capacity once they do.”

What Girls Actually Need

Girls don’t need to be tougher. They’re already tough. They need systems that recognize recovery as a process, not a moment. They need education about the difference between soreness and injury, about why fatigue changes mechanics, about why fear isn’t a flaw but a signal. They need coaches who ask, “How does that landing feel?” and not just “Are you cleared?” They need permission to say, I’m healed, but I’m still rebuilding.

Because readiness isn’t weakness. It’s awareness. It’s longevity. It’s respect for a body that wants to keep going long-term, not just get through today. And when girls are given that respect, they don’t just return to sports. They stay.

Sources & Further Reading

• Ardern CL et al. (2014). Return to sport following ACL reconstruction: a systematic review and meta-analysis. British Journal of Sports Medicine.

• Grindem H et al. (2016). Simple decision rules can reduce reinjury risk after ACL reconstruction. British Journal of Sports Medicine.

• Gokeler A et al. (2017). Neuromuscular control and return to sport after ACL injury. Sports Medicine.

• Bahr R & Krosshaug T. (2005). Understanding injury mechanisms: a key to injury prevention. British Journal of Sports Medicine.

• Wiese-Bjornstal DM. (2010). Psychology and socioculture affect injury risk, response, and recovery. Sports Medicine.

• HERcovery Project — In Converstation... Series (2026)