From an injury rehabilitation perspective, there appears to be a lack of consensus with regard to optimal protocols of returning to sports. Poor guidance, peer pressure, and even one’s own desire to engage in activity can often result in a premature decision to return to play regardless of readiness from both a mental and physical standpoint. The rehabilitation process is not magically completed once physical therapy is discontinued – in fact it is just getting started!
A gap occurs when an athlete is cleared for return to sport after completing physical therapy, but functional deficits related to the current injury are still lingering. Patient education on understanding the common deficits such as decreased mobility, strength, neuromuscular control, and the physiological impact of injury must be acknowledged in order for successful sports performance. Addressing these deficits and safely returning an athlete back to play should always be the main focus.
The foundation to a customized strength and conditioning program should include
• functional movement patterns
• alignment
• motor control
• muscular strength and endurance
A gradual periodization to increasing workload, cardiovascular fitness, and sports-specific training should then be implemented. An athlete’s progression during this stage should be dictated by gaining the strength and control necessary to perform to pre-injury competition levels. Intensity and duration of sports performance can pick up once strength, power, and neuromuscular control improve. From a psychological view, confidence in performing unanticipated, multi-directional movement patterns should be fully restored. Bridging the gap from rehabilitation to sports performance training should be a coordinated effort amongst multiple healthcare professionals.
At The Micheli Center for Sports Injury Prevention, our team is well aware of what it takes to provide the missing link in the transition from rehabilitation to successful return to sports performance.