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Go to Return to Sport Functional Tests

Random Thoughts on Coming Back from Injury & Brian's 3 tips for training/rehab of athletes

3/15/2015

1 Comment

 
Picture
I wanted to share this article with you all today for a couple of reasons.  Primarily, I wanted to talk about Patrick's point number 3:  Rehab needs to progress and not be soft.  I couldn't agree more.  Too often I see therapists who work with athletes that do not truly get them ready for their return to sport.  Rehabilitation for an athlete MUST be different because their demands are different.  Basics may be similar and time needs to be spent on them but when an athlete is ready to go back to sport they must have performed enough demands in rehab to practice their skill.  Below are a few points I feel should be considered when rehabbing athletes.  


1.  Sports are Reactive, train accordingly.  
     - What I mean by this is that we must not only go spend the time on the basics but then evolve the rehab.  For example, when training lateral movements, the motor control & strength needs to be there at slower speeds but then progressed to faster speeds.  Once the athlete can do this MULTIPLE times then they NEED to be progressed again.  How do we do this?  Reactive training.  Forget the cones and the mirror, we use these way to much.  Instead point and direct or use verbal commands for a specific direction.  Observe movement and/or videotape for the athlete and yourself.  See the differences between the reactive movements and planned movements.  Are they consistent?  If not, find out why and re-train/re-assess.

2.  Perform a needs analysis and train accordingly.
     -  Are they a baseball player or basketball player?  Pitcher or Point Guard.  Again, could the basics be the same? Yes, they very well might be and they need to be well done before progressing them.  But once they are ready to progress make sure you look at the biomechanics of their sport.  Training a point guard vs a power forward is going to be very different.  Make sure you understand this from day 1 of rehab.  Then make it the goal to rehab them so they can perform their specific position activities.  Not the skill of the sport because thats not our job.  Our job is to make sure they can move well within the context of their sport & position.  To make sure they have adequate stability and mobility to perform their skill (shooting, dribbling, etc).  

3.  Be individualized and objective
     -  This one is really easy to fall out of.  When craziness occurs its easy to lose track of objective measures and individualization.  But this is so important.  Just because you have two baseball pitchers coming back from Tommy Johns does not mean they should get the same rehab program.  Again, basics may be the same.  But maybe one of them has underlying shoulder or hip issues while the other does not.  Therefore, rehab will be different for each.  Lastly, objective measures must be used.  How do you measure progress?  This goes back to Patrick's point number 4 where he talks about monitoring.  If you are rehabbing a jumping athlete's right ankle then make sure you are objectively measuring things.  Measure both ankles height with jumps for example.  Measure ROM, strength, and a Y-balance.  Something needs to be measured to properly monitor progress.  At the same time don't get too hell bent on measurements.  An athlete could have the same jump height side to side but look horrible on one side.  See if your athlete is taking off and landing similarly to the opposite leg.  Be objective but don't lose sight of movement.  

- Brian

1 Comment
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  • Home
  • About Us
  • Insider Access
    • About Insider Access
  • Online Courses
    • Hooper's Knee
    • Physical Therapist Entrepreneur Course
    • Physical Therapist Consultant Course
    • Orthopedic Management of the Cervical Spine
    • Return to Sport Essentials Course
  • Resources
    • Newsletter
    • Business Minded Sports Physio Podcast
    • Day in the Life of a Sports PT
    • Residency Corner
    • Special Tests >
      • Cervical Spine >
        • Alar Ligament Test
        • Bakody's Sign
        • Cervical Distraction Test
        • Cervical Rotation Lateral Flexion Test
        • Craniocervical Flexion Test (CCFT)
        • Deep Neck Flexor Endurance Test
        • Posterior-Anterior Segmental Mobility
        • Segmental Mobility
        • Sharp-Purser Test
        • Spurling's Maneuver
        • Transverse Ligament Test
        • ULNT - Median
        • ULNT - Radial
        • ULNT - Ulnar
        • Vertebral Artery Test
      • Thoracic Spine >
        • Adam's Forward Bend Test
        • Passive Neck Flexion Test
        • Thoracic Compression Test
        • Thoracic Distraction Test
        • Thoracic Foraminal Closure Test
      • Lumbar Spine/Sacroiliac Joint >
        • Active Sit-Up Test
        • Alternate Gillet Test
        • Crossed Straight Leg Raise Test
        • Extensor Endurance Test
        • FABER Test
        • Fortin's Sign
        • Gaenslen Test
        • Gillet Test
        • Gower's Sign
        • Lumbar Quadrant Test
        • POSH Test
        • Posteroanterior Mobility
        • Prone Knee Bend Test
        • Prone Instability Test
        • Resisted Abduction Test
        • Sacral Clearing Test
        • Seated Forward Flexion Test
        • SIJ Compression/Distraction Test
        • Slump Test
        • Sphinx Test
        • Spine Rotators & Multifidus Test
        • Squish Test
        • Standing Forward Flexion Test
        • Straight Leg Raise Test
        • Supine to Long Sit Test
      • Shoulder >
        • Active Compression Test
        • Anterior Apprehension
        • Biceps Load Test II
        • Drop Arm Sign
        • External Rotation Lag Sign
        • Hawkins-Kennedy Impingement Sign
        • Horizontal Adduction Test
        • Internal Rotation Lag Sign
        • Jobe Test
        • Ludington's Test
        • Neer Test
        • Painful Arc Sign
        • Pronated Load Test
        • Resisted Supination External Rotation Test
        • Speed's Test
        • Posterior Apprehension
        • Sulcus Sign
        • Thoracic Outlet Tests >
          • Adson's Test
          • Costoclavicular Brace
          • Hyperabduction Test
          • Roos (EAST)
        • Yergason's Test
      • Elbow >
        • Biceps Squeeze Test
        • Chair Sign
        • Cozen's Test
        • Elbow Extension Test
        • Medial Epicondylalgia Test
        • Mill's Test
        • Moving Valgus Stress Test
        • Push-up Sign
        • Ulnar Nerve Compression Test
        • Valgus Stress Test
        • Varus Stress Test
      • Wrist/Hand >
        • Allen's Test
        • Carpal Compression Test
        • Finkelstein Test
        • Phalen's Test
        • Reverse Phalen's Test
      • Hip >
        • Craig's Test
        • Dial Test
        • FABER Test
        • FAIR Test
        • Fitzgerald's Test
        • Hip Quadrant Test
        • Hop Test
        • Labral Anterior Impingement Test
        • Labral Posterior Impingement Test
        • Long-Axis Femoral Distraction Test
        • Noble Compression Test
        • Percussion Test
        • Sign of the Buttock
        • Trendelenburg Test
      • Knee >
        • Anterior Drawer Test
        • Dial Test (Tibial Rotation Test)
        • Joint Line Tenderness
        • Lachman Test
        • McMurray Test
        • Noble Compression Test
        • Pivot-Shift Test
        • Posterior Drawer Test
        • Posterior Sag Sign
        • Quad Active Test
        • Thessaly Test
        • Valgus Stress Test
        • Varus Stress Test
      • Foot/Ankle >
        • Anterior Drawer
        • Calf Squeeze Test
        • External Rotation Test
        • Fracture Screening Tests
        • Impingement Sign
        • Navicular Drop Test
        • Squeeze Test
        • Talar Tilt
        • Tarsal Tunnel Syndrome Test
        • Test for Interdigital Neuroma
        • Windlass Test