Return to Sport

Question 1

How does return to sport fit into physio mgmt?

Answer 1

1. Pt present for physio ax and rx
2. Early stage mgmt (decrease pain, commence strengthening)
3. Progress exercises (load, function)
4. Incorporate into sports-specific tasks: gradual return to training

Question 2

Return to sport continuum?

Answer 2

Return to

Participation –> Sport –> Performance

Question 3

What are the models to guide return to sport?

Answer 3

1. StARRT Framework: Strategic Assessment of Risk and Risk Tolerance
2. Biopsychosocial model
3. Optimal loading – the ‘Goldilocks’ approach (acute:chronic workload - load during current week VS. average of preceding 4wks) (useful to plan load progressions)

Question 4

How can we optimise RTS?

Answer 4

• Make it priority from Day 1
• make sure all rehab goals logically lead to RTS
• maintain clear communication with athlete and all stakeholders
• have understanding of evidence for RTS for specific injuries/pt populations

Question 5

Phases of recovery post ACL reconstruction?

Answer 5

Pre-OP
1 Recovery from surgery
2 strength and neuromuscular control
3 running, agility, landings
4 return to sport
5 prevent re-injury

Question 6

What are some structured injury prevention programs?

Answer 6

FIFA 11+ (soccer)
Footy First (AFL)
Powerstep (rugby)
KNEE (netball)

Question 7

FIFA 11+ structure?

Answer 7

1. Running exercises (8 min)
2. Strength, plyometrics, balance (10 min)
3. Running exercises (2 min)

20 mins total

Question 8

KNEE stands for?

Answer 8

Knee injury prevention for Netballers to Enhance performance and Extend play

Question 9

KNEE structure?

Answer 9

1. Warm up, footwork
2. Strength
3. Balance, landing
4. Agility

10-12 mins total

Question 10

What percent of athletes RTS after ACLR?

Answer 10

85%

But only half return to previous level of performance

Question 11

What’s the facts like for sustaining another ACL tear after RTS after ACLR?

Answer 11

1/3 of young athletes who return to cutting/pivoting sports after ACLR will sustain another ACL tear within 2 years

Question 12

What are the 2 main things to consider for RTS?

Answer 12

1. Physical readiness

2. Psychological readiness

Question 13

What is a predictive of ability to run after a TBI?

Answer 13

Self-selected walking speed (>1m/s)

Question 14

What are some factors that may affect running after TBI?

Answer 14

1. Higher risk of falling and subsequent injury
2. Awareness of safety / judgement due to potential cognitive deficits
3. Associated deficits e.g. spasticity, ROM, motor control
4. Comorbidities e.g. orthopaedic injuries, visual deficits
5. Cardiovascular fitness

Question 15

What does HiMAT stand for?

Answer 15

High Level Mobility Ax Tool (for TBI)

Question 16

What are the HiMAT items?

Answer 16

ascend stairs - dependent
descend stairs - dependent
walk
walk backward
walk over obstacle
walk on toes
bounding
ascend stairs - independent
descend stairs - independent
run
skip
hop

–> Foot placement, strength, balance

Question 17

Things to consider about running post-pregnancy?

Answer 17

1. Pelvic floor disorders (and rectus diastasis)
2. Type of delivery & recovery timeline
3. Risk of pelvic organ prolapse
4. Urinary and faecal incontinence
5. Time required for complete repair of abdominal fascia after caesarean section
6. Pain
7. Significant CV and muscle impairments post-partum

Question 18

3 part program for return to running post-partum?

Answer 18

1. Walk/run program
2. Strengthening
3. Pelvic floor