Return to Performance Series Rest is Not the Answer

As a PT at Evolution Healthcare and Fitness I would like to introduce you to my blog series: Return to Performance. I would like to share a few blog posts looking at what I consider are important yet often missed elements of Physical Therapy that hamper athlete’s progression in the weeks, months and years after injury.

              Being able to return to sport after injury is rarely returning to performance. 

 One of my most used phrases in PT is

                           ‘if you are my 100 million dollar athlete…..’

 The reason I use this phase is to begin to  emphasize that there is more to PT than taking symptoms away. Most people’s relationship with PT is a service that is only available in the presence of pain, and only focuses on taking that pain away. This may work perfectly well for many people as they just want to return to daily life without pain. But for an athlete at any level, how they manage this period of time can have a significant effect on their future performance. 

The vast majority of non-contact injuries are because your body has been unable to tolerate a certain level of load. You are now faced with a scenario where when you load this tissue there is pain. We are all conditioned from years of medical interaction to think rest is appropriate. Even to this day the most consistent advice you will receive from a medical practitioner away from a sports physical therapist is to rest. But this is one of the worst things you can do for your sport and your future success. Firstly, yes, we may need to change activity appropriately to ensure your tissue has a chance to recover. This may mean decreasing intensity or unfortunately avoiding your sport/activity for a period of time.

This does not mean rest! When I have worked directly with professional sports teams rehabilitation is one of the most intense periods of work that athlete will face, because if you were my 100 million dollar athlete we are making sure we continue to load your tissues with the most appropriate stimulus to avoid any deconditioning and atrophy, while also looking for opportunities to make you a better and more robust athlete. The more your fitness declines the more vulnerable you are to future loads and the more vulnerable you are to injury. The more your fitness declines the more work you have to put in to get back to your previous level of performance. So when my 100 million dollar athlete gets injured we are looking to get them loading again as soon as possible, and also looking at what opportunities there are to improve the athlete away from direct competition. Being an athlete is more than just completing your sport, there are the strengthening sessions, mobility and flexibility sessions and skills sessions, which enable you to compete at your best for as long as possible. An injury is a perfect time to optimize these areas without the periodic limitations of peaking for and recovering from performance. 

I believe that one of the biggest missed opportunities during rehabilitation is detailed conversations around athlete conditioning. Return to sport testing looks to determine if an athlete is strong and if their hopping and landing technique looks good, but let’s see how that athlete performs after 20 mins of sport specific conditioning, because if an athlete has not been adequately conditioned they will not be able to produce strong, efficient and safe movement patterns (Verschueren et al. 2020)

So if you are my 100 million dollar athlete in nearly all circumstances of a musculoskeletal injury we are looking to maintain a sport specific levels of fitness, strength and looking at the fine details to give you the opportunity to come back a better athlete. Here at Evolution Healthcare and Fitness we have a host of equipment to optimize this process from anti-gravity treadmills, altitude room, blood flow restriction training, variety of cardio and strength equipment. An injury as an opportunity to be a better athlete in the future. Too many athletes except returning to 80-90% of the athlete they were before injury or accept lingering low level symptoms as they return to sport.

 

 For more questions on returning to performance please reach out via the email below. 

 

Nathan Evans

MPT, CSCS, Xps

nathane@evolutionhealthcareandfitness.com