Background: Lumbar disc herniation is a common injury among athletes, especially those who practice disciplines with repetitive flexion movements, twisting and axial loading on the spine, such as weightlifting, gymnastics, hockey and American football. In refractory cases to conservative treatment, microscopic discectomy or full endoscopic discectomy are used as surgical options to relieve pain and restore patient functionality. However, the ideal time for a return to sports activities remains a matter of debate due to variations in recovery times and risks of complications associated with each technique. Methods: A review was conducted, including articles published in the last 33 years (1991-2024), as it was the earliest date matching our search criteria. Clinical studies, systematic reviews, meta-analyses, and clinical guidelines were included. Results: The most common complications when returning to sport prematurely include recurrence of the hernia, persistent pain (VAS leg 7 or higher after surgery) and reduced physical performance. The return to full activity rate of patients who underwent microdiscectomy reaches up to 90%, while the endoscopic technique shows a success rate that reaches 99%. Return to play meantime was 5.19 months (range 1.00 - 8.7 months) and mean time of 4.6 months (range 2 - 8 months) with Microdiscectomy and full endoscopic discectomy respectively. Conclusions: There is no unanimous consensus on the exact timing of return to sport due to variability in recovery times and clinical outcomes. In both techniques, evidence highlights the need for a multidisciplinary approach that integrates surgeons, physical therapists and trainers to optimize recovery and ensure a safe return.
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