Rehabilitation in Sport. There is no ‘One size fits all’

Tanya Bell-Jenje

There are so many different sports, so many different levels of competency, skill sets and competition. Also, each individual athlete can respond profoundly differently both to a specific injury, both physically and psychologically, as well as to the prescribed rehabilitation. For these reasons, and many others, there is no ‘one size fits all’ approach.

So how do we tailor our prescriptive rehabilitation to meet such variations and demands?
The answer is that we can’t. But there are some key points to structure the best management and prescriptive rehabilitation program for each specific athlete.
Based on all these considerations this presentation expands on my top 11 tips.

  1. Know the Sport. Read about it, watch it, and better yet, get involved.
  2. Get to understand the athlete in front of you. Improve the athletes ‘buy-in’ to complete the prescribed rehab program.
  3. Conduct a thorough and detailed subjective assessment (interview). By the end of the assessment, you need to be able to visualise the problem as well as its significance to the athlete.
  4. Keep objective tests to a minimum. ‘Less is More’. Understand the value of each test, including the significance of a composite of positive tests.
  5. Use specific biomechanical loading tests especially if the injury is persistent or has developed over time. This guides in finding the ‘Source’ of the problem and not focusing on the ‘Site’ of pain. It directs us to specify rehabilitation that focuses on individual movement dysfunctions.
  6. Clinically reason your findings and develop a working hypothesis. This includes a provisional diagnosis and a management plan for short to long term outcome goals.
  7. Prescribe a rehabilitation program that is specific to the time in the season (pre-season, competition, post-season).
  8. Prescribe a rehabilitation program that is relevant to that specific athlete as well as to that stage and severity of the injury. From pain management and protection, the therapist must be cognitive of multiple areas requiring attention. The entry point to rehabilitation is individual specific.
  9. Advice, reassurance, and education are paramount. Educating and including the athlete in decision making as well as goal-setting all increase the athlete’s motivation and focus.
  10. Utilise the help of experts in their fields. Where possible, utilise the combined skills of a multi-disciplinary team. Although not ideal, the reality is that for many of us, budgetary limitations demand that we wear many hats and have a workable knowledge of many roles.
  11. Listen. Be flexible and adaptive. Modify your program & management based on changes on injury behaviour as well as the athlete’s response.

In this presentation I look forward to expanding on these ‘tips’, as well as suggesting various entry points into different stages of rehabilitation, all with specific exercises and loading principles.

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