The majority of us will not get through life without sustaining some degree of injury. The joints of the back, shoulder, hips, knees and ankles are all very common injury sites for not just athletes, but the general fitness population as well.
Most injuries that develop over time tend to have one thing in common, a breakdown in the human movement system. Meaning it could be that you are performing specific movements with sub-optimal technique or perhaps muscle imbalances are responsible for your symptom presentation. Regardless of the reason for injury, the goal is the same; to make movement more efficient to ensure that once training or competition resumes, the chance of re-injury is minimal.
Efficiency of movement is rarely a goal achieved in therapy. Incomplete rehabilitation in athletes and the general fitness population has lead to a re-injury epidemic. The problem is rooted in either the push to return athletes to the field as quickly as possible or rushing patients through the rehabilitative process.
With the ever changing landscaped of health insurance, the overwhelming majority of athletes and patients deal with increasing out-of-pocket expenses and limited number of therapy visits. Ultimately, many patients never complete their rehabilitation process.
This may be for a number of reasons, but in most cases athletes or patients are discharged once specific objective and ADL (activities of daily living) measures are satisfied. Sure you may have minimal to no pain, full range of motion and seemingly adequate strength resorted, and basic activities are easy to perform, but this does not ensure you are ready to resume training and competition.
And this is exactly where most get stuck.
They are lead to believe they are ready to resume sport training or their exercise program, but soon after resuming they realize they aren't as ready as they thought they were.
The transitional period between rehabilitation and performance-based training is the most critical period to ensure complete rehabilitation and that the transition back into training and competition carries minimal risk of re-injury. Sadly, due to points made previously about the state of healthcare, many personal trainers and strength coaches are finishing off the rehab process.
Why do I say sadly?
Frankly, the majority of personal trainers aren’t educated enough to be overseeing such a delicate process, yet many position themselves as psedo-therapists. I’ve lost count of how many personal trainers I’ve seen giving “massage” or performing “joint mobilization” during their training sessions. They have no training or qualifications to perform such work and ultimately the person at most risk is the individual they are working on. Word to the wise: if your personal trainer is performing such work on you and has no license to perform such work, run the other way and seek out a qualified professional. Within the fitness industry, there has been a large growth in facilities that blend rehabilitation with prevention strategies within strength and performance based training programs. Done well and overseen by qualified professionals, this is a great way to manage what is seen both in a rehab and training setting. This process should not be handled improperly. Implementing “corrective” or therapeutic exercises strategies into a performance-based training program should be lead by qualified professional(s). There used to be a gap between the professionals in the therapy and strength & performance world. Progressively though, that gap is slowly closing as more therapists crossover into the world of strength & conditioning.
Returning from injury isn’t and shouldn’t be a quick process. It’s far better to train smarter through the process. Improving on the function of the body while adding qualities such as endurance, strength, reactivity, power, etc. will help ensure successful outcomes. It’s less about isolation and more about training systematically to re-groove movement patterns. For anyone who has suffered an injury, they all want to get back to their previous level of function while also building the confidence they will not re-injure themselves. It can and will be a detailed process that involves rest, manual therapy directed at specific joints and soft tissues, as well proper exercise progressions. And yes, this means regressing, substituting, and even just slowing down exercises until they are owned.
Once movement and exercises are owned, it opens the door to further progressions in a performance-based setting to help ensure a more complete rehabilitation resulting in reduced risk of re-injury. This has become a huge part of what we do at Gallagher Performance as we successfully help our athletes and patients resume an active, pain-free lifestyle.