Physiotherapy and Return to Sport after injuries

Tips for return to sport

Bismillahirahmanirahim..

Return to sport is both the ultimate goal of rehab

A source of doubt and worry about the uncertainty of injured athlete’s abilities to return to a level at or above where they performed prior to the injury

Approaches

It can be threat

·         Low confidence

·         Decreased adherence to rehab

·         Increase in pain

·         Display avoidance behaviors

·         Increases anxiety

·         Reduced motivation

It can be challenge

·         Positive attitude

·         High motivation

·         Excitement

·         Increased effort in rehab

·         Greater desire to return to sport

·         Over adherence to rehab

·         Greater risk of reinjured due to premature return

Stages of Return to Sport

1.      Initial Return to Sport

2.      Recovery confirmation

3.      Return of Physical & Technical Abilities

4.      High Intensity Training

5.      Return to Competition

Initial Stage

·         Considered to be the most difficult

·         Athlete quickly determines the effectiveness of the rehabilitation

·         Entire stage should include a series of tests of the healed area

·         Athlete’s expectation are:

·         They will perform at the same level as prior to the injury

·         Pain will not be present

·         Discussion with the athlete are needed to examine their expectations.

·         A concern of AT is that athlete become “overzealous” in their approach to train and compete.

   

Recovery Confirmation

·         More psychological than physical

·         Involves the athletes’ obtaining evidence from initial stage that the injury is healed and ready to face the demands of the sport participation

·         This is considered the make or break period

·         Athlete’s initial play will confirm their attitudes and approaches

·         Success will lead to higher levels of self-confidence and motivation

·         Injury does not swell, no pain, full range of motion,

·         Self-confident and motivated

·         Not being successful will lead to doubt if they will be able to return.

·         Swelling occurs, unexpected pain, little range of motion, decrease strength

·         Highly anxious and depressed

Return of Physical & Technical Skills

·         High intensity training marks the absolute conclusion of athlete’s identification that they are fully healed.

·         Re-establishment of their regimen of physical conditioning and technical training

·         Major psychological concern is their level of perceived preparedness:

-                      Provide a safe,

-                      progressive conditioning program developed by the AT or physical trainer

Return to Competition

·         First post-injury competition is key concern:

·         Athlete is usually more anxious than at any other time

·         Initial uncertainty

·         Athlete may have a distorted perception of the probability of the injury occurring again.

·         Need to discuss with the athlete’s their attitude and feeling about the upcoming competition

·         Athlete should not be thinking negatively

·         Athlete needs to redirect their focus to their skills, game strategy, and goals.

Fear of Injury: A Major Concern

·         Perception that recovery is incomplete,

·         returning to sport to soon,

·         impatient in returning to sport,

·         lack of acceptance of the risk of the sport,

·         low confidence,

·         highly anxious,

·         and preoccupied with being re-injured

  

Prevention of Fear of Reinjury

·         Continue involving in the sport during rehab

·         View rehab as a form of athlete performance

·         Becoming involved with a coping model

·         Performance imagery

·         Give the athlete time to progressively regain their physical, psychological, and technical skills.

Treatment of Fear of Injury

·         Need to take a proactive approach to alleviate the fear

·         Athlete needs to face a similar situation as when the injured occurred.

·         Rational self-talk helps the athlete refocus

·         Simulation practice

·         Relaxation techniques

·         Athlete establish pre-competition and competition routines

Self-Determination Model & Return to Sport

Ryan & Deci (2000) focused on:

·         Competence,

·         Autonomy, and

·         Relatedness in explaining the athlete’s return to sport.

·         From the self-determination perspective, the success of an athlete’s return to sport from injury is related to meeting these psychological needs

Competency Issues

·         Athlete’s fear and concerns of returning to sport

·         Loss of enjoyment because they could not participate in the sport

·         Injury blocked their short & long term goals

·         Letting down others, teammates, and coaches          

Issues

Competence Issues

  -  Fear related to returning to sport

  -  Injury blocked  their sport goals

  -  Overcoming their fear of reinjury

Relatedness Issues

 -  Feels of separation from team

 -  Support in re-entry into sport

 -  Having role models

Autonomy Issues

 Sense of personal control

- Pressure to return to sport

Implications

Regarding the assistance and management of athletes returning to sport following an injury:

Rehab environments meet these three basic needs of the athlete by:

1.      Implementing goal-setting

2.      Giving the athlete choices when to return to sport

3.      Provide role models

4.      Rehab progress should be safe and successful

wallahuaklam

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