For most people, regaining full range-of-motion and full strength are enough to return comfortably to their daily work and activities. However, athletes require additional sport-specific rehabilitation to be able to regain their explosive power and functional ability to return safely and effectively back to sport.
While many physicians and orthopedic surgeons may release patients back to full activity when their patients have regained their full range-of-motion and strength after an injury, strength alone is not good enough to safely return athletes back to the playing field.. Although this may be enough recovery to walk around or complete daily activities, it is not enough recovery to return an athlete to sports.
It is important for athletes recovering from serious injuries to complete a full rehabilitation program including functional sport-specific exercises with a sports medicine professional before returning back to the practicing/playing field. These exercises are uniquely designed for each athlete and are designed to mimic the skills the athlete will need to perform when he/she returns to sport.
Defining Functional Sport-Specific Exercises
Once the athlete has achieved full range-of-motion and full strength in their injured area, the athlete is then ready to move to sport-specific training exercises. The type of exercises in these programs should be tailor-made to the athlete with a direct correlation to the athlete’s sport and position (where applicable).
In order to design a successful program for the athlete, the sports medicine specialist needs to fully understand the demands of the sport as well as the specific demands of the position. Once these are known, the professional can then analyze the position for specific offensive and/or defensive motor skills. The functional program is then progressively developed from these basic motor skills.
For example, a defensive motor skill breakdown for a catcher in softball might include the following skills:
- Catching a pitch and throwing back to pitcher from a crouched position
- Jumping to a standing position from a crouched position to throw
- Catching a pitch and throwing to first, second, and third base
- Blocking balls from a crouched position
- Jumping to feet from crouched position to catch foul balls in all directions
Once the motor skills have been analyzed, drills need to be created to effectively take the athlete through the motor skills beginning at a low intensity. As the athlete’s confidence and comfort builds, the intensity of the drills can be gradually increased until the athlete is performing full out.
Many of the drills that can be used for functional sport-specific exercises can be taken from warm-up drills used in the athlete’s sport. This is where a coach can be very helpful in either creating functional exercises or providing them to a sports medicine professional as these types of drills are second-nature for most coaches.
For example, an athlete returning to basketball after a serious injury may include the following basic warm-up drills as part of his/her sport-specific functional exercises:
- Individual shooting drills
- Lay-up drills
- Three person weave
- Passing and shooting drills
- Defensive slides
Purpose of Functional Sport-Specific Exercises
The purposes of these types of exercises are twofold. The first purpose is to gradually increase the load on the injured extremity to ensure that the injured limb has completely healed and is strong enough for the demands of the athlete's sport. The second is to provide an opportunity for the athlete to regain confidence in their injured extremity.
While the first purpose is important, more often, building confidence is the key to safely returning an athlete to sport. It is common for athletes who have been critically injured while competing in sports to be anxious about returning to the sport that caused the initial injury.
This anxiety can alter the focus of the athlete and actually place the athlete more at risk for another injury. If the athlete’s attention is focused on their knee, shoulder, or ankle rather than on attending to important cues in their sport, the loss of focus itself can set the athlete up for another injury.
Safely Progressing Functional Exercises
Starting at low intensity and gradually allowing the athlete to progressively move through all of the basic skills of his/her sport will give the athlete time to mentally become comfortable and confident with returning to sports. Once the athlete is comfortable with individual motor skills, the athlete can then progress to scrimmage type situations and then finally to full competition.
Depending on the severity of the injury and the competitive level of the athlete, the time frame for functional sport-specific training can take from several days to several months. Athletes competing in sports that require more power and dynamic movement skills may also take longer.
Regardless of the level of the athlete, some type of sport-specific training should be undertaken at the end of every rehabilitation program prior to returning an athlete to full competition. This training will ensure that the injured extremity is strong enough to handle the demands of the sport and that the athlete is confident and mentally ready to safely return.
Reference
Irvin, R., Iversen, D., & Roy, S. (1998). Sports Medicine: Prevention, Assessment, Management, and Rehabilitation of Athletic Injuries. (2nd Ed.). Allyn & Bacon: Needham Heights, MA.
Terry Zeigler - Educating through writing with over twenty-five years of experience as a Kinesiology Professor and Certified Athletic Trainer.
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