Return to sport after injury: Rehab Program

Question 1

What are the stages of rehab and return to sport?

Answer 1

• Early stage: Maintaining cardiovascular fitness and sports performance whilst injured
• Mid stage: Specifics of sport specific rehabilitation program to facilitate return to sport
• Late stage: How do we know if our athlete is ready to return to sport

Start with specific, individualized exercises, progress to complex task/sport specific exercises

Question 2

Who are the stakeholders in rehab?

Answer 2

• Team
• Coach
• Physio
• Doctor
• Parents

ATHLETE

Question 3

What are factors influencing functional performance before return to sport?

Answer 3

• Physical factors
• Psychological factors
• Social/contextual factors

Question 4

What are the focuses during early stages of rehab?

Answer 4

• Managing pain and swelling
• Improving or maintaining ROM
• Maintaining muscle strength
• Maintaining CV fitness
• Keep them moving, exercising and an active decision-maker in their RTS planning

Question 5

What are factors to consider in rehab return to a specific sport?

Answer 5

• Demands of sport
• Type of injury
• Time of injury (pre-season, mid-season, late-season)
• Goals of athlete
• Weight gain/loss requirements

Question 6

What are other general health items to take care of when injured?

Answer 6

• infections
• other injuries
• cuts/wounds
• other surgeries

Question 7

What are post injury psychological considerations

Answer 7

• Reinjury anxiety:
• Inability to perform to pre-injury standards
• Feelings of isolation, lack of athletic identity and social support
• Pressures to return to sport
• Appearance concerns in RTS from injury: appearing unfit, unskilled

Question 8

What are sport specific components that occur during mid stage RTS?

Answer 8

• Proprioception
• Strength
• Flexibility

Question 9

What are aspects of muscle conditioning?

Answer 9

• Muscle control
• Muscle strength
• Muscle power
• Muscle endurance

Question 10

What are flexibility aspects of RTS?

Answer 10

• ROM

- Musculotendinous flexibility

Question 11

What may be causes of technical errors?

Answer 11

o Overuse injuries
o Increase risk for future injuries
o Decrease in performance
o Lack of fitness/ strength/ ROM

Question 12

What are ways to analyse technique?

Answer 12

• Video, digital, analysis programs

Question 13

What is the correction process with a technique?

Answer 13

• Identify error
• Instruct player on correct and incorrect technique
• Find correction method that works for player
• Structure training to reinforce new technique
• Consider athlete history

Question 14

What determines RTS?

Answer 14

o	ROM 
o	Effusion
o	Strength and endurance
o	Flexibility
o	Proprioception
o	CV fitness
o	Functional sport specific skills
o	Biomechanically sound
o	Psychological

Question 15

What is the StARRT framework?

Answer 15

Strategic assessment of risk and risk tolerance

Question 16

What are the steps involved with StARRT?

Answer 16

Step 1: Assessment of Health (tissue health/physiological signs) - risk
Step 2: Assessment of activity (risk analysis of activity)
Step 3: Assessment of risk tolerance: Other factors to risk it

Question 17

What are open and closed skills

Answer 17

Closed skills: hop test figure 8

Open: Have a reactive element

Question 18

Running after ACL-r Whats the criteria to return to running?

Answer 18

• No joint swelling
• Full ROM
• Pain <2/10
• Gradual walk run
• 70% knee ext strength
• 70% hop tests

Question 19

What are ways to assess psychology for RTS?

Answer 19

• Injury psychological readiness to RTS scale

Advancement through the rehab process must be criteria based not time based