Having worked with some of the most elite sporting teams in the world, I have interacted with some exceptional sports medicine practitioners. Their early-stage rehabilitation programs are world class. Athletic trainers and physical therapists in professional sports teams – and in rehabilitation clinics – are true experts in restoring local tissue capacity.
Despite this expertise, a challenge faced by sports medicine practitioners is the amount of time injured athletes are prepared to commit to early-stage rehabilitation. Physical therapists and athletic trainers often tell me, “We just start to manage pain and calm the tissue down, and then the patient leaves us to go straight back to sport!” The major problem with athletes choosing this course of action is that while local tissue capacity may be restored, sport-specific capacity falls well short of that required to perform the demands of competition. It is likely that the lack of a structured reconditioning phase increases the risk of subsequent injury.
But with every problem, lies a solution! In this case, additional programming skills may be the answer. And given that bridging the gap between injury and returning to peak performance requires the maintenance of global capacity, strength and conditioning programming skills is the exact tool that rehabilitation professionals should add to their toolkit!
For example, when athletes sustain an injury, local tissue capacity is reduced, due predominantly to pain. As a result, during rehabilitation, sports medicine practitioners often use microdosing – regular sub-threshold loading doses applied to the injured tissue, to restore capacity. However, when the athlete returns to sport, loading more commonly follows a “high-low” polarized model – high stress training days separated by low stress recovery days. An understanding of microdosing and polarization principles, along with a knowledge of when to implement each approach can improve athlete outcomes when returning to sport following injury.
So, what can athletic trainers and physical therapists do to improve rehabilitation outcomes for athletes?
- Complement rehabilitation skills by developing strength and conditioning skills. Additional programming skills will take your rehabilitation programs from good to great!
- Identify the key physical capacities required for successful return to sport. Prioritize these physical capacities.
- Implement a strength and conditioning program alongside the rehabilitation program. Encourage athletes to maintain global capacity by training around the injured tissue.
Rehabilitation is commonly defined as “training in the presence of injury”. Additional strength and conditioning knowledge and programming skills ensures that athletes are receiving the rehabilitation to restore capacity, and the training needed to return to peak performance.
