Hi guys, this is an initial post to get the ball rolling so to speak and give you an insight into a few different debates that rage across the rehabilitation and performance based ‘worlds’.
My work encompasses the middle of these two, I’m not a physiotherapist, although trained by them to work within the MSK field as they do, I’m also not a performance coach, although I am completing my development pathway in strength and conditioning and athletics training. BUT I do work throughout the spectrum having worked with Matt our fearless team leader running head first into people and sometimes getting hurt, who then requires an assessment as to the extent of his wounds or at the latter stages of the process looking at ways and means of preventing injury and improving performance if there is a mechanical deficit.
Do the two go hand in hand? My answer could be no, but often it depends. I say no because rehabilitation involves the restoration of optimal function for the injured body, whereas performance looks to push the threshold of stress put on the body to areas right on the edge of its ability to cope and look for a reaction. I say it depends because if we are able to rehabilitate an injured individual and address deficits in their performance capability in the process that lead to their injury then they may perform better in the long term as they are less likely to recur with the same problem and spend more time being exposed to the technical aspect of their activity.
But ultimately, no, performance does not and should not come into the rehabilitation pathway, not until normal function is restored. Only then do we get to the crooks as to why it occurred in the first place and how we address this.
This leads on to my next inkling which is that most injuries outside of the traumatic ones seen in contact sports can be whittled down to a few factors.
1) Predisposition to injury – I often call this the ‘inability to dance’ factor, in that we don’t have the right mix of movement patterns in order to complete the activity we wish to undertake and often find what’s called the path of least resistance in order to compensate and get around this.
An example of this is the epidemic of ACL injuries in elite women’s football at present, this is not a new issue, Tim Hewitt and Greg Meyer from the US came across this over 10 years ago, their answer’s being that men and women post puberty develop differing landing strategies as a result of favouring differing muscle groups and differences in pelvic angle and knee anatomy – so what did they do? You might ask?
They implemented a jump based training program to develop athletes’ abilities to land, cut (change direction), accelerate and decelerate – note I said athletes and not women, because it has been shown that male athletes can and do adopt poor strategies, it’s just the fact that females are at a higher risk of at least 6x that of their male counterparts.
During my time at Manchester City Ladies FC, I did the same, with the support of the coaching staff as part of the warm up a plyometric element was introduced and we decreased the rate of knee injuries from 9 per season to just 1.
2) Training error – Please all the PT’s and S&C coaches reading this please calm down, this isn’t a pop at anyone, in fact it is well known, even noted on a recent panorama documentary about barefoot running, that training error is one of the greatest factors associated with ‘overuse’ injury. Why? Who’s fault is it? No one’s. Don’t go blasting your coach or trainer, first of all ask yourself how much rest and recovery have YOU factored into your schedule? Most often people come to me and this is the glaring hole missing from their training plan. This isn’t the trainers fault, or the coaches, most will have a plan of action right down to tables and spreadsheets with reps, sets, touchdowns for plyos etc, the issue is we often aim to please or out do, so what do we do after struggling through a hard session??
TRAIN HARDER!! Said in a Thor like voice. The end result? Fatigue, decrease in performance and pain.
Dammit! “Why didn’t I listen!?” too late. Now you’re forking out money to fix it….or not and ignore it, but that’s another issue.
I often look at and enjoy the chaos of challenging people I work with to complete ‘rubbish’ sessions, short duration, lower load, ‘technique’ sessions. They often feel empty, yet these are the ones that make the greatest difference. Why? Because they offer the opportunity to practice movements you need to address, they replenish the fried nervous system you’ve just battered with that WOD, followed by a 5k, followed by some HIIT chucked in with plyos and some max strength training, OH and some ‘rehab’ because you have niggles…..Down time is important, recovery is important, in no way am I saying don’t train hard, what I’m actually saying is train SMART. Get some guidance off someone else who knows what they’re doing, forget price because it’s your body and your life you wouldn’t buy a cap car if you had the option of a nice one, be humble and know when to listen to your body, I could sit here and say “don’t forget to stretch……But THAT is for another post, debate and another time”
Just some food for thought, bye for now!