The Return to Sport Continuum
Thoughts from: Dr. Michael Reinhardt, DPT, OCS: Performance Physical Therapist, Resilient Performance & PT & R2P Academy Instructor
It is easy to get a bit lost in the weeds at some point throughout a long-term return to sport process.
A rehab process that takes place over the better part of a year can at times fall victim to our own biases, expectations, and level of familiarity and confidence with progressing our athletes across the full continuum from initial injury up through full return to competition.
Clinicians and coaches enter the process with the best intentions of helping their athlete. Oftentimes, they even possess a seamless theoretical expectation of what the process should look like.
In an ideal world, we would all love to see linear improvements across all desirable criteria:
- Improve joint range of motion without pain…
- Improve local strength capacities and muscle hypertrophy…
- Start to build back in escalating rate of force components to maximum the athlete’s ability to generate and tolerate impulse…
- Reintroduce and progress the volume and intensity of relevant movements, velocities, and coordinative qualities (sprinting, cutting, jumping, change of direction, taking contact)…
- As the previous qualities are established and built upon, find safe entry points for the athlete to return to portions of practice, drills, scrimmage, play, and then competition.
Unfortunately, such a streamlined process is not the norm.
Frustrations and lack of progress may start to spring up if an appropriate amount of time, competence, confidence, or performance outputs are not established prior to progressing to higher order interventions. As coaches, we are often guilty of this as we ourselves can grow bored and weary of “doing the same things” over and over again. The reality is repetition and time are the drivers behind adaptation.
If you find your athlete struggling to progress beyond a given portion of this continuum, the first step may be to take a step back and ensure that the relevant prerequisite qualities and competencies have been established.
A narrow and inadequate foundation will lack the structural integrity to support peak performance.
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Ready 2 Level up in Sports & Performance Physical Therapy? Start with the self-paced Foundations of Sports Rehab, where Dr. Reinhardt and the team lay the ground work as you lead your clients from rehab 2 performance. Approved for up to 9 Hours of CEUs for Physical Therapists. Learn more and get started HERE
