Return to Sports Training

Getting back to the best you can

What is Return to Sport?

Return to sport refers to a multifactorial process returning to your sport at the same or better level of performance prior to the injury. This is especially important if you’re returning from a major injury or a surgery. The process of returning to sport is not as straightforward as starting to play soccer 3 months after your ACL reconstruction surgery, for example.

Much thought, work, trial-an-error on what is suitable for you and what your body is able to cope with will determine the process and success of your eventual return to sport. Returning to sport is hard work and shouldn’t be taken lightly. It involves you, being engaged at each session and putting in the hard work between your therapy sessions so that you will be able to benefit from and progress in each session.

Return to sport builds on what your Physiotherapist, Hand Therapist or Podiatrist has already addressed for you in terms of any problem areas. Thereafter, you will be pushed to your limit, while respecting and considering the injury or surgery you’re recovering from and how we are able to reduce the risk of a re-injury and yet help you gain confidence in returning to the sport that you love.

Who needs to return to sport training?

The return to sport does not only apply to competitive athletes, but also to anyone who wishes to return to their daily sporting activities or to improve their overall physical wellbeing and performance after injury.

Return to sport training is essential for a spectrum of people. If you’re recovering from an ankle sprain or learning to walk and potentially walk after a major surgery (and anyone in between!) and you’re keen to return to your sport, you’re eligible for the return to sport training.

If you’re keen on returning to soccer after an ankle sprain, basketball after a shoulder dislocation or rugby after an ACL reconstruction, return to sport training is something that you need to consider. Do no attempt to return to sport without having gone through any return to sport training. You will increase the risk of a re-injury.

Why is return to sport training important?

It is extremely important for everyone returning from injury to have appropriate Return to Sport Training. Sporting too soon without proper rehabilitation and conditioning could increase your risk of re-injury and delay your return.

Return to sport training includes drills and conditioning activities that are specific to your sport. If you play volleyball, the physical demands would be quite different from another who plays rugby who will be different from another who is keen to return to dancing. Therefore, the understanding of the sport is vital to a successful return to sport.

Return to sport training includes, but is not limited to, strengthening, plyometrics i.e. jumping, landing, agility, coordination, balance, reaction time etc. It will differ vastly based on the sport that you’re keen to return to.

What are some factors to consider when returning to sport?

In order for you to be able to return to your specific sport, it is recommended that you be proficient in these aspects.

Joint Range of Motion & Flexibility

It is the ability of a joint or a series of joints to go through its complete spectrum of movements. An injury or recovery from surgery may result in a reduction in range of motion and flexibility. As a result, the joints’ range of motion would be reduced, which would affect & change the person’s movement pattern. Flexibility and range of motion can contribute to good balance, allow you to perform movements without restriction, and reduce the risk of injury. To prevent a reduction in range of motion, mobility exercises and stretching are crucial. Various stretching techniques could be used, such as:

Proprioceptive Neuromuscular Facilitation
Ballistic stretches
Static stretches

Strength and Endurance

Musculoskeletal injuries may cause significant skeletal muscle deterioration and will have a negative impact on an individual’s cardiovascular endurance and muscular strength. Why is strength important? Building strength of the structures such as the ligaments, tendons and muscles around the affected body part will aid in supporting and take the load and pressure off the injury during recovery. This is important for all sports and daily activities. Having a lack of muscular strength causes higher fatigue and the ability to stabilise the joints is reduced which will alter movement patterns and will put stress on parts of the body which are not used to the movements, which increases the chances of getting injured. What are some ways to improve your strength?

Machine-based exercises
Free-weight exercises
Banded exercises
Bodyweight exercises

Endurance, whether muscular or cardiorespiratory, is extremely important, especially in endurance sports. For example, long-distance running or cycling is also important in sports such as football and rugby which involve repeated bursts of exercise (called interval exercise). Individuals with lower levels of muscular or cardiorespiratory endurance are more susceptible to injury due to muscular compensation and altered movement patterns caused by fatigue. Having good endurance is important for you as this will reduce fatigue and allow you to perform at your optimal performance and reduce compensation. What are some ways to improve your endurance? Exercises that involve low impact can help to improve your endurance without re-aggravating your injuries, could include, but not limited to:

Stationary cycling
Swimming
Walking
Running

Remember, the type of endurance exercise will need to resemble your sport as closely as possible.

Double leg knee extension

Leg press

Medicine ball wood chop

Shoulder strength and stability

Coordination

Coordination involves selecting the right muscle at the right time and intensifying it appropriately to accomplish the desired effect. It is characterised by the appropriate speed, distance, and direction. Injuries to the muscles will affect the individual’s neuromuscular control, which will impact their coordination. What are the benefits of having good coordination? Good coordination enhances your ability in sport such as agility and flexibility and it lowers the risk of injury/ re-injury. Are there any exercises you can do to improve your coordination? There are multiple methods which could be used to improve coordination such as:

Pilates
Balance exercises
Coordination exercises for the development of neuromuscular function
Ladder/ Cone drills

Proprioception & Balance

Proprioception is the ability of your body to recognise motion, movement, and position. This is a result of sensory receptors in your neural system. You can find them in your tendons, muscles, and joints. The sensors will communicate your position and movements to your brain as you move. A body with good proprioception is able to perform simultaneous actions without stopping to think about each separately, such as running while dribbling a basketball.

Balance refers to the capacity of a person to keep their equilibrium or line of gravity inside of their base of support. Vision, the vestibular system (motion sense), and proprioception(touch) are the three sensory systems that make up the central nervous system that regulates balance. Thus, proprioception and balance are directly related to one another.

Injuries will have a negative impact on an individual’s proprioception and balance. For example, an injury such an ACL tear or a achilles tendon strain damages soft tissues where the proprioceptors are being located, the damaged tissues are unable to function as per normal, which therefore will result in the loss of proprioception and will have a carry-on effect to an individual’s balance.

Proprioception & balance is important for precision and fluid movement, which is beneficial to both athletes and non-athletes. Your overall coordination and balance would improve with good proprioception as well as neuromuscular functions which will allow you to perform better. What can you do to improve your proprioception and balance?