LEC13: Strength Conditioning in the Rehab Process

Question 1

What are the three elements of the return to sport (RTS) continuum?

Answer 1

1. Return to participation
2. Return to sport
3. Return to performance

Question 2

Resistance Training Program Decision: medical

Answer 2

1. Sports physician
2. Physical therapist
3. Soft tissue specialist
4. Athletic trainer

Question 3

Resistance Training Program Decision: performance

Answer 3

1. Strength and conditioning coach
2. Nutrition
3. Psychologist
4. Sport scientist
5. Sport coach

Question 4

Which aspect does medical focus on in the return to sport (RTS) continuum?

Answer 4

Major: return to participation
Minor: return to sport

Question 5

Which aspect does performance focus on in the return to sport (RTS) continuum?

Answer 5

Major: return to performance
Middle: return to sport
Minor: return to participation

Question 6

What can strength and conditioning get from medical?

Answer 6

Knowledge specific to the injury
- tissue involved and severity
Healing timelines
Special considerations for exercise prescription

Resistance training program framework and expected benchmarks
- Clinical clearance requirements

Ongoing feedback throughout progressions
- Circumstance dependent

Question 7

What are the stages of return to sport (RTS)?

Answer 7

1. Early clinical
2. Introductory
3. Building capacity
4. Specialization
5. Continued monitoring

Question 8

Stages of RTS: early clinical

Answer 8

Goal: respect the injury, care for the body

• Respect the injury (do no harm)
• Follow the guidelines of the managing therapist
• Consider: other body parts/well limb, cardiovascular system, flexibility/mobility, deficiencies

Question 9

Stages of RTS: introductory

Answer 9

Goal: integrate the affected structure into movement

• Beginning to work directly with the injured site
• Still need to consider the healing state of the injured structure
• Constant monitoring for pain and swelling, changes in range of motion
  
  • Ongoing communication
  • Respect the parameters outlined
  • Workouts vs Programming

Question 10

Stages of RTS: building capacity

Answer 10

Goal: condition the athlete

• More autonomy in strength and conditioning
• Return to ‘normal’ programming (may still need to consider modifications for the injury)
• Monitoring workload across all domains (acute: chronic workload ratio)

Question 11

What is the ‘sweet spot’?

Answer 11

Low injury risk

Question 12

What is the ‘danger zone’?

Answer 12

Increased injury risk

Question 13

Stages of RTS: specialization

Answer 13

What do you need to be able to do to return to pre-injury performance?
- Key performance indicators
Programming considerations:
- Amplitude and Direction of movement
- Dynamics of Effort & Accentuated Regions of Force
- Speed / Agility / Plyometrics

Question 14

Stages of RTS: continued monitoring

Answer 14

• Done by all members of the integrated support team (risk of re-injury is still present)
• Athletes often return with the minimum required
• Strength and conditioning programming should continue to change to reflect their changing sport participation (sport coach shift in perception of the athlete ‘out rehabbing’ to ‘doing extra’ to catch up
• Ensure athlete doesn’t slip between the cracks

Question 15

Athlete Perceived Readiness

Answer 15

Roles from all IST to help ensure athlete perceives readiness
- Medical/ Therapy: Clearly identifying their current status/risk
- Sport Psych: Confidence, visualization, positive self talk
- S&C
- Objective testing scores
- Subjective movement evaluation
- Sport Coach: putting them in scenarios to allow them to succeed