Football Rehab – part 4

The game of football is the starting point. This counts for both fit players and players coming back from an injury. When an injury occurs the coach starts to plan a football rehabilitation periodisation. Within this football rehab periodisation the coach plans the expected first game after the injury. This first game is the starting point from which you start planning the process. The coach starts counting backwards from this game and divides the rehabilitation process into several phases. He has to estimate how many weeks the player needs to prepare him for his first game. He has to think about how many weeks the player needs to return to group training. What does he need to be able to do to go from one phase to another? Where do we start? A football rehabilitation program should therefore contain certain criteria. These criteria are goals that should be met before introducing the next phase. When a player starts his rehab, after a surgery for example, he will start in phase 1. Criteria that should be met at the end of this phase could contain information about, ROM, effusion, pain and the ability to execute a certain exercise, for example. Criteria must be realistic in relation to the phase a player is in and the natural healing time of the injured structure. Running with changes of direction is not a good criteria belonging to phase 1.

The duration (days/weeks) used in each phase is highly dependent on the type of injury. A sprained ankle normally takes less time to recover from than a ruptured ACL. The time in each phase, in regards to the ankle injury, will therefore be much shorter. Another aspect is that every individual reacts differently to a certain workload. This could mean that player A goes to the next phase before player B does. It doesn’t necessarily mean that player A returns to play earlier than player B. A rehab process must therefore be an individual process. 

Most rehabilitation programs use building blocks to gradually improve the players fitness. These building blocks ensure a safe and structured build-up, towards return to play, over time. Walking on a treadmill precedes running outside for example. Some of these building blocks are more relevant in certain phases then in other phases. The player will, most probably, also work on specific exercises from previous phases during his rehab. Exercises from phase 1 can still be necessary in phase 5. Each phase must therefore not be seen as a separate piece of a puzzle. They are intertwined.

A player coming back from an ACL surgery will go through all the phases and will use all the building blocks within a football rehabilitation protocol. Treatment by the medical staff, movement training, walking/jogging on a treadmill, running protocols outside, return to team training and finally game minutes are just some of the building blocks used by the coaching staff to get the player back where he thrives best. On the pitch with his teammates. 

The game is the starting point and from there the rehab coach starts planning. Can a football rehabilitation protocol start in the final phase(s) or do we have to start from scratch? Can we start running right away or do we start on the treatment table? When do we introduce changes of direction? Many questions must be answered to be able to plan the most ideal individual football rehabilitation periodisation. But as we all know the ideal world does not exist. However, as long as we can explain why we are doing what we are doing we can come a long way.

Thanks for sharing.