An injury-free return to sport

How does an online Physical Therapy consultation work?
March 13, 2020

An injury-free return to sport

In any team sport, the team is only as good as the squad. It is very rare nowadays that the same group of players that start a game, finish it. There is a heavy emphasis on the substitutes made throughout the game and everyone who comes on needs to make an impact. This is the main difference between a highly successful team and the teams that are not quite at the level required to really compete. Every team will have its key players and every sport has a number of key positions. So, what happens when injury strikes and you lose a few key players or are left wondering how you are going to fill those key positions? What if your squad is plagued with injury?

Avoidable injuries make up a high percentage of the pre-season injury profile, these are injuries like Hamstring, Calf, Groin, Glute, Quad tightness/strains/tears, Shin Splints, Low Back pain/tightness, etc.… We generally find that these soft-tissue injuries happen mainly at the start of a season, but they can become an issue at other times throughout the season also, mostly after a break from play and/or training, or during a period of high loading (a number of high-intensity games in a short period). I call these injuries “avoidable injuries” because we have control over them.

After periods of inactivity or when introducing new movement patterns to the body, the nervous system needs time to be able to react to the unfamiliar loads that we are putting on the various joints, ligaments, tendons, and muscles. If we go straight to high speed and high load the nervous system will perceive a threat to the body and it will go into “protection mode” by tightening up or contracting the muscles or tendons that it feels are most at risk (normally the ones that need to take the most load in the movement). Once that “protection mode” is activated the “protected structure” is at high risk of being injured or damaged. A graded exposure system will allow those structures to accept the load in a very controlled way and by slowly building the load over a period of time the nervous system will not feel the need to place the structures in “protection mode”.

The key concepts of a successful graded exposure system are:
  • Planning:
  • Plan at least 4 sessions in advance, this allows all coaches to prepare and not have any surprises on the night of a session.
  • Communication:
  • is vital between coaches, management, medical, and players.
  • it’s important that everyone buys into the plan and knows the importance of the system.
  • RPE (rate of perceived exertion) can be useful in getting info from players. However, just asking them how they felt the session went as they leave the pitch also works.
  • take this feedback on board when planning your sessions.
  • Graded exposure:
  • everyone will turn up on the first night at various levels of fitness and conditioning, whilst you don’t have to pitch the sessions at the lowest level in the squad, you shouldn’t be pitching it to the highest level either
  • have some extras available to those few who didn’t feel fully challenged by the session, tempo runs etc.
  • try to avoid extreme cutting and turning in the first few sessions back
  • for more info on various graded exposure sessions please get in contact.
  • Recovery:
  • emphasis has to be on planning the sessions, sleep, and nutrition/hydration.

    Following a COVID-19 lockdown, depending on the sport that you are in, there may be a very short lead into games and this makes balancing graded exposure and being game ready a difficult juggling act. But personally, I feel that it’s better to be slightly under-cooked in the first game than showing up missing your key players or being unable to fill those key positions due to injury. However, if you need to have your team humming from the start (you may have an important championship or knockout game to start with) get in contact and I’ll guide you through the possibility of speeding up the process slightly. Getting up to the speed of the game will happen much quicker if you don’t have a large number of players rehabbing injuries. Everyone is in the same boat, it’s the team that weathers the storm best that will come out on top. If you would like to get any further information in relation to anything discussed in this blog or if you would like to find out how I might be able to help your team, or you as an individual player, weather the storm, please don’t hesitate to get in contact.
  • Comments are closed.