With winter sport in full swing, colder weather and heavier grounds, here in the clinic we are starting to see an uptick in injuries from weekend sports. These may include injuries to the ankles, knees, soft tissue and muscular injuries, both contact and non-contact in nature. Thus, it is important to get these injuries assessed promptly to establish an accurate diagnosis and commence your management plan. However, many times we see athletes return to play within a few weeks only to wind up back on the injury list, which begs the question – are you ready to return to play? Have you met all the relevant criteria to be able to perform at the highest level? It’s important to consider all these aspects and variables prior to returning to the training environment as opposed to just returning to the field when you are ‘feeling’ good.
So, what does it mean to be game-ready? An absence of pain? An ability to generate equal force between the unaffected and affected side?
While this is a good start, it is not sufficient for successful return to play. All factors must be considered such as the capacity of the tissue to withstand the demands of the game. Does the muscle/joint have the ability to perform at a high intensity repeatedly? During the middle phase of an injury, while physiological healing is still occurring, it is paramount that the athlete continues to build strength, maintain and restore their neuromuscular control and are psychologically confident to enter the competitive environment again. This helps remodel the damaged muscle/ligament that will allow a successful return to play when the time is right. Without adequate capacity developed in this stage, athletes will lack their physical capacity to generate the force required, the endurance to perform repeated efforts and are setting themselves up for failure if they return to the field once everything is “quiet”.
At CSSM, we are introducing new services utilising state of the art VALD equipment that will allow our practitioners to gather more data, more metrics to guide the rehabilitation programs and make informed, evidence-based decisions on the return to play timeline.
– VALD Force Decks measure force through the ground
– Force frames measure a variety of muscular strength and power outputs
– Handheld dynamometry measure muscular capacity and output.
These devices will allow CSSM to expand our services to perform specific muscular assessments, undertake pre/in-season movement and capacity screens to set up plans to reduce injury risk and maximise performance / player availability.
Once strength and healing has commenced and is progressing into it’s maturation phase, the significance of a structured late-stage rehab and return to play preparation is paramount. Your rehab program should now start focusing more on movements to prepare you for your sport. This is often the stage that gets missed. The later stages of rehabilitation tend to focus less on the strength work and focus more on the movement patterns, the functional requirements and also the implementation back onto the field/court. Ensuring good trunk, pelvic and joint control allows us to perform our return to running programs with good technique to achieve optimal results. Progressing through an ease into running, followed by straight line speed, off-line work, sharper change of direction and reactivity ensures we are exposing ourselves to all the necessary variables we will encounter in a game-setting. As most field/court sports are intermittent in nature, having consideration of our work:rest ratios will also allow further specialisation and readiness to perform. These drills may include, sprint training, MAS Running and agility drills that work both the aerobic and anaerobic/lactic systems to develop capacity in both energy systems.
The final stage of return to play involves team work across all levels. This includes the coaching staff, athlete and performance/medical staff to collaborate and develop an appropriate re-integration plan that will minimise spikes in load. As we have previously discussed, when loads spike, our risk of injury / re-injury is exacerbated. Thus, in conclusion, late, end-stage rehabilitation is not optional, it is often missed and is a key component into a successful return to play. The ability to close the gap between clinical signs and assessments to field-based return to performance will improve not only outcomes, and re-injury statistics, but will allow us to play harder for longer and minimise time off the field.
Senior physiotherapist Peter Stath relishes the opportunity to help his clients return to the things that mean the most to them, whether that’s sport, work or family. “A strong and healthy body maintains a healthy mind, which allows us to perform and work to the best of our ability.”
Peter promotes an active approach to rehab and has a passion for treating sports injuries such as new and recurrent muscle strains and injuries of the shoulders, hips, knees and ankles.
With a unique understanding of the demands of high level competition, Peter has worked with Melbourne Victory FC Academy as well as with the A League Men’s team. He is currently the Head Physiotherapist for Bentleigh Greens Soccer Club in the National Premier League Victoria competition and also part of the Football Victoria program as a physiotherapist for their state and representative teams.
Peter is also a great advocate for the involvement of children and adolescents in sport, helping them develop healthy habits as they grow. He has a particular clinical interest in working with adolescent athletes.
“It’s so important to stay at the forefront of the industry in terms of latest techniques, advancements, patient care and rehabilitation and use this information to continue to play a key role in patients’ recovery.”
Peter has valuable experience in pre- and post-operative care and has developed expertise in using Clinical Pilates to facilitate optimal recovery and performance.
Whether it’s an acute injury or simply wanting to optimise performance, Peter has the expertise to diagnose and prescribe a program to get you back on track to achieving your goals. His unique combination of physiotherapy and high level coaching skills is a valuable asset in both the prevention and rehabilitation of injury – particularly in the areas of sports performance in the younger athlete.
Book in with Peter here.
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