Getting Back From Injury

“An emotion that lives with me is a sense of ‘what might have been’ had injuries not robbed me of my most lethal weapon – speed.” Michael Owen 

It’s been almost 10 years since qualifying as a physiotherapist, and in that time I have came to a pretty solid conclusion…athletes aren’t always the best at managing their injuries! Some are lucky enough to have professional help from start to end, others may be ill-advised or have bad management along the way, but for the most part let me illustrate what typically happens.

Look familiar??? Typically this cycle continues, the athlete begins to compensate for their injury by over loading the joint and tissues above or below. For example, joints that are meant to stabilize, begin to act as a prime mover and become more mobile, and vice versa (see Michael Boyle’s book ‘Advances in Functional Training: Training Techniques for Coaches, Personal Trainers and Athletes’ for more detail on this). In essence, what started as a smaller problem, often becomes much more complex, with other structures getting involved.
Ok, so what should you do if you get injured? Here is ESP’s guide to getting back to full fitness.
Find Out What’s Wrong
Stop hobbling around the pitch at thirty percent fitness and go get a diagnosis! Go and see a chartered physiotherapist  who is registered with the HPC, for an assessment and diagnosis. If the physiotherapist can’t give you a diagnosis, then move on and find someone who can. Second opinions are always worthwhile and remember, always be wary of going under the knife!
Start Fixing It
Get treatment for your injury. The core of any treatment should always be graded rehabilitation. By this I mean that it should include: stretching exercises to improve muscle and joint flexibility; strengthening exercises; power exercises; balance and co-ordination exercises; conditioning exercises; sport specific and agility drills. By all means, it’s great if your therapist includes massage for soft tissue issues, mobilisation for stiff joints or uses acupuncture for your pain. But if your treatment consists of no rehabilitation exercises whatsoever, and only involves lying on your back for 30 mins and getting ‘zapped’ for months on end, then move on and find someone else who isn’t just after your money.
Make sure you get evidence based treatment
Positive Mindset
Stop thinking “I’m Injured” and start thinking “I’m in Rehab”. Keeping a positive mind set has a major benefit to your recovery, so work hard and get fit again!
Embrace The Pain
With guidance from your therapist, once you become pain free with normal activity,  progress the rehabilitation into functional/sports specific work. At this stage you may well encounter some degree of post rehabilitation soreness. Do not confuse this with your original pain! Some pain after rehab is to be expected, especially in tendon rehabilitation, but it will usually present more like Delayed Onset Muscle Soreness and often passes in a day or two.

Your Only As Strong As Your Weakest Link
Once you have built up strength and range of motion at the joint; agility and quickness; power; endurance; co-ordination and balance then you can progress to skill work. This may involve going back to basics with the football, for instance passing, crossing, shooting, dribbling etc. Once you can complete these drills pain free, then you can begin with some light non-contact training. Gradually and sensibly progress this until you are back playing for the 1st team, and remember to start with graded exposure to competitive sport. For example, twenty minutes in the first game, forty minutes the next match, up until you can perform for the full match. Be guided by your body here and leave pride at the door. If your body can’t play for thirty minutes, then don’t force it!  Don’t stress if your not confident about when your ready for the next stage, your therapist will guide you through all of the stages.
Plyometric box jumps for power: be sure to build a strong athletic foundation in rehab
The Journey’s End 
If you follow the above plan then you’ll return to your sport focusing on winning and performing, rather than worrying about your injury re-occurring or breaking down. Graded rehabilitation is crucial in recovering from any injury. Remember, you don’t play sport to get fit…you get fit to play sport!

The best footballers and sports people get to the top by constantly developing their skills. They do this by not getting injured in the first instance. For advice on avoiding injury see ESP’s August blog on warming up.

Stay strong!

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