When are you ready to return to sport after injury? Suffering an injury is not only painful, it can also be frustrating and time-consuming. It can make you impatient and want to return to your favourite sport as soon as possible. Yet, the single biggest risk factor predicting a future injury is a having a history of the same injury. In other words, once you have an injury – despite overcoming your symptoms and pain – and regaining your full strength and mobility – you are between two and four times more likely to have another injury in the future. Scientists in kinesiology and physical therapy continue to examine the reasons behind this statistic; however, from experience I’d like to share some important tips that will help you to return to sport after injury and lower your risk of injury in the future:
Tip #1: Don’t rush it.
Many people see the end of therapy as if they were climbing out of a dark hole. Seeing the proverbial light, they charge back to their sport workout schedule as if nothing ever happened, blind to the reality that the time spent recovering has also left them out of shape. Unless addressed this loss of conditioning leaves you prone to re-injury or to new injuries.
Unfortunately, the line between fitness and injury is not only invisible, but also moves depending on where you are in your recovery process. Complete recovery follows a path that continues well after discharge from therapy to ensure you have restored all elements needed for your sport. As you return to your normal fitness routine, remember to build off of the progress made in therapy. That means slowly progressing as your abilities allow until you reach, and then exceed, your pre-injury fitness levels.
Tip #2: Incorporate recovery time in your workouts
Most often, what goes unnoticed is that exercise actually makes you weaker (in the short term) and that your progress is highly determined by the amount and quality of rest you receive between training sessions. This means there is a window of time within which you will make the best gains. Clients who are are highly motivated to get back onto the court or course are often delayed by their eagerness to speed their return to sport. Cutting into rest time means incomplete recovery, and can lead to an injury when the tissues are no longer able to manage the relentless stresses. However, this is not a license to sit on the couch for two days with a bag of Doritos and wait for your next scheduled workout. Recovery not only includes rest, but also changes in your routine. For example, attending a stretch class, going for hike or bicycle ride, or swimming are all strategies that can boost your recovery and help you to return to sport quickly and safely.
Tip #3: There are no magic exercises.
Many people who are serious about their performance think they must only do sport-specific exercises, otherwise their workouts are a waste time and effort. This fitness myth can greatly increase your risk of suffering another, and potentially even more damaging, injury; or lead to early plateaus by leaving out important capacities in your fitness.
The term “sport-specific program” is a fairy tale that just does not fulfil the promise of performance. Neither is there a list of exercises that can develop you into a champion. Even elite athletes work on their general fitness capacities and vary them as needed. Having worked with many elite athletes over the years, including Olympian Heather Bansley (who competed for Canada in Beach Volleyball at the 2016 Rio Olympics), sports specific exercises actually make up a smaller part of the total conditioning program than you would think.
A major problem with the “sport-specific program” approach is that it can cause the person to hit a plateau too soon. The cause is known as “overspecialization”, which occurs when important elements of a conditioning program are left out. Highly-specific exercises are focused on one, or only a few, attributes of a sports skill (such as speed and agility.) Adding these exercises too soon is like throwing a grade-schooler into college. Not only are general fitness qualities overlooked, but also the speeds and stresses when performing these exercises may easily become overwhelming and send your performance in the wrong direction fast.
Although out of pain, most people are not quite back to one-hundred percent at the end of therapy. To make the most efficient gains onward, your conditioning program should always start out general in nature. The first step is to address fundamental requirements such as mobility, general strength and muscular endurance. Exercises that involve multiple joints at the same time will help improve the functional movements that are essential building blocks to performance. Before adding specialized exercises, it is important to build a strong fitness base that will lead to the best results in your sports conditioning program. You need to find a balance without pushing too hard too fast.
If you would like to learn more about general and specific exercises, please read this article, in which Strength Coach Nick Tumminello references a research paper I helped conduct when at UW to outline the implications for choosing exercises for your conditioning program. Please stay tuned for part 2 of this article where I will discuss additional factors to improve your fitness, and return to your sport after injury in a safe and effective manner. This information is for educational purposes only and does not constitute medical advice for any condition. Reasonable and appropriate care should always be performed by a qualified health professional after a comprehensive evaluation to identify treatment goals.
John Gray is a Registered Kinesiologist and Certified Strength and Conditioning Specialist practicing in downtown Toronto at the Orthopaedic Therapy Clinic and throughout Metro Toronto. His clients include athletes ranging from recreational to Olympic calibre level.