What does a good rehabilitation program looks like?
If you’ve ever been injured, you know that it’s going to be important to do some kind of rehabilitation to help heal the injury and return back to sport. Injuries suck but are a part of playing competitive sport, even with the best training and diligence you can still get injured. Once your injured you have a few choices, 1) Feel sorry for yourself and end your sporting career 2) Look back at why it may have occurred and use your rehabilitation as an opportunity to get better, I know which one I would choose.
Get help and have a plan
If you choose option 2) then the first thing you want to do is seek help from a good Physiotherapist (Physio) and good Strength and Conditioning Coach (S&C). The combination of the two is the absolute best for your rehabilitation plan, between the two working together, they can devise a thorough plan. This is the same as how you would plan a training program if you wanted to improve speed, fitness or strength. The best way to plan for a rehabilitation program is to start from the finish (returning to full sport) and working your way back from there. This can help you determine how long it will take to return to play, and sets your timeline.
It’s important to set targets to know when you are ready to progress in your rehabilitation and when you’re ready to return to play. The Physio and S&C should set metrics for you so you know if your fit enough, fast enough, strong enough, resilient enough, to return back to sport. For example, you need to be able to complete atleast 2-3 high speed running sessions, then you need to complete a fitness test made up of speed, agility and conditioning, then you need to complete 1-2 full training sessions with out restiction before you can return to play. Having a plan and targets is really important because it helps you stayed motivated. There’s going to be tough times in particular in long term rehab where it feels like it’s really dragging out. Although, if you’ve got these small little steps and targets in place, it can really help you stay on track and be consistent. Everytime you complete a session your one step closer to your next target, every time you hit a target your one step closer to your end goal – returning to sport. If you’re starting to lose motivation and missing sessions here and there, you’re really only holding yourself back and you’re prolonging your return to sport.
The phases of rehab
A good rehab program should be broken up into phases. Each phase will build on the previous one and have different target to be met.
Phase 1 – Recovery
The first phase is the acute phase, this is where your Physio kicks off the rehabilitation process. The goal of this phase is to promote recovery and tissue repair/healing but it also allows you to work on the other non affected limbs. You can use this phase to train the non-injured limbs hard.
Phase 2 – Building
The next phase will involve more specific training of the injured limb (the limb should be mostly healed by now), now you’re trying to build it back up. Body tissues whether it’s ligament, tendon or muscle, become weaker after injury, they will repair but not with the same load tolerance (strength) as before. The good thing is that rehabilitation can help strength these tissues even beyong their previous strength. You should still be working on the rest of your body because when you return to sport you don’t want any weak links. You don’t want to have done all this hard work on one area, for another area to break.
Phase 3 – Integration
Next, you’re going to integrate back into training. Now this is a really important step. If you skip it and go straight back to full training, your going to be at a high risk of re-injury or another injury. You would’ve missed a large portion of sports specific training so you need to slowly build up your tolerance to training again before you return to play. Remember you can determine your readiness to progress using the targets your Physio has set. If you’re meeting them, you can progress.
Phase 4 – Return to play
If you and your Physio/S&C coach are confident and you’ve hit your targets then you are ready to return to play. Ideally, you’re trying to return to performance as well, coming back better than before you got injured.
Rehabilitation is essentially a continuum, being injured on one end and performance on the other. Rehab is just working through that continuum.