For many collegiate athletes, and certainly for professional athletes, sport injuries are addressed in a comprehensive manner. Sport coaches, athletic trainers, doctors, orthopedists, physical therapists, strength/conditioning coaches etc. collaborate as a team to address the athlete’s condition. An analogy is to think about rehab as a ladder: at the bottom is acute injury management (AT, MD/orthopedist), the middle is about regaining initial flexibility, strength, and proprioception (PT). At the top of the ladder (strength/conditioning) is where athletes engage in sport specific exercises at an intensity that is equal to sport participation. If the athlete can perform at the top level without pain or functional deficits they “step off” the rehab ladder, if not they go back down. The goal for everyone on this team is to return the athlete to as close to pre injury status as possible. Easier said than done.
For adult, recreational athletes addressing symptoms like decreasing pain and increasing mobility can be a relative easy task for certain injuries. Massage, therapeutic exercise, stretching, movement re education etc. are good tools in the beginning of the treatment process. Unfortunately many people stop the rehab process when they start to feel better. Using the ladder analogy, they can get can stuck in the middle. They may feel better but they haven’t done the hard work of really making their body work optimally. They return to their sport activities but their body is not prepared/conditioned to handle the stress. Continuing down this road leads to re injury, chronic pain, joint degeneration, more practitioner visits etc. Appropriate strength training is one of the most effective “treatments” for sports injuries and for long term injury prevention.
Youth sports injuries can be the most difficult to treat effectively using the team approach. They’re kids after all, they want to play sports with friends, having fun and not spending time doing rehab exercises. Some parents don’t want their kids to stop playing sports as well – often the family routine revolves around sports. I have had difficult conversations with parents of injured young athletes – what is more important the health of the child’s body or the team? Rest is often the missing component for many kids. Overuse injuries are almost always a product of fatigue and lack of adequate recovery/repair time. Middle school – high school aged athletes who are focused on sports can and should engage in strength and conditioning. The team model used for professional athletes can be adopted for youth athletes. The challenge for parents is often assembling a team – the sports medicine MD, physical therapists and personal trainers that collaborate and communicate effectively.
The importance of appropriate rehab and return to sport participation for everyone means taking the long view. It is often essential for the athlete to step away from sport participation and focus on developing their body in new ways. Getting stronger, developing better joint alignment, flexibility or joint mobility can be an essential for life long participation in sports and recreation activities.