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The Process of Returning to Sport after an Injury

October 29, 2020

How to decide when to return to sport after sustaining an injury? Why don’t you let an expert make that decision for you here at StudioXphys! Many of our clients decide to go back too early and do more harm than good. Here is a step by step guide to get you back to playing your chosen sport after injury.

When should you return to play?

 

The term ‘Return to Play’ refers to the point in the recovery process where its deemed safe and the participant is at a reduced injury standpoint. Sustaining an injury to either the knee, hip, or ankle goes through the very similar process of recovery when a person can go back to playing sports or participate in an activity at a pre-injury level.

The ankle is the most common site of injury in 24 of 70 sports according to a study published by Sports Health 2012. Ankle sprain accounts for roughly 80% of injuries, followed by fractures of 16.3%. Soccer and Basketball have the highest proportion of ankle injuries when compared to other sports. In Soccer, the risk of injury during a game is 4 to 6 times greater when compared during training. The most significant predictor of injury is reinjury, so be sure to seek professional help here at Studioxphys to rehab the ankle right.

The lateral ankle sprain, or more commonly known as a rolled ankle, is one of the most common injuries in sport. The integrity of the anterior and posterior talofibular and calcaneofibular ligaments are compromised, these ligaments are located on the lateral (outside) aspect of the ankle most commonly damaged and where you lose the integrity of the ligaments.

Initial first aid

‘POLICE’

P= Protection
O= Optimal
L= Loading
I= Ice
C= Compression
E= Elevation

Protection; Protect emphasizes the importance of avoiding further tissue damage, e.g. the use of crutches to protect further soft-tissue structural damage. Optimal & Loading; Optimal loading is done by utilizing mechano-therapy intervention (exercising) and includes a wide range of manual techniques currently available here at StudioXphys. The use of braces may be an option in the acute stage before progressing to without the brace. Ice + Compression + Elevation; Will aid in the reduction in oedema (swelling, puffiness) in the compartment surrounding the ankle.

Phase 1

Get the injury assessed, graded and diagnosed by your health professional here at StudioXphys. Range of Motion (ROM) exercises where the focus should be placed on dorsiflexion (toes to shin), plantar flexion (pressing the toes away in the opposite direction) and these exercises to be performed in passive (assisted by a clinician) and active (alone) as tolerated in pain-free ROM.

The introduction of towel stretches and wobble board in the acute stage of rehabilitation as tolerated (no pain, but slight discomfort).

The early introduction of a stationary exercise bike can aid in the ankle’s Range of Motion (dorsiflexion and plantar flexion). Hydrotherapy is an excellent additional option here at StudioXphys where you can work the ROM of the ankle while also gaining the benefits of hydrostatic pressure from the pool.

Phase 2

Once cleared and can safely weight bear on the injured ankle, phase 2 of the rehabilitation process can begin. Balance and neuromuscular control exercises can be introduced as well as increased ROM exercises as tolerated. Balance exercises to begin with as double-limb stance and progress into single-limb stance as well as firm surfaces to be progressed into unstable surfaces.

Closing the eyes and incorporating perturbation when performing the above exercises can challenge the client and progress neuromuscular control (Brain talking to the body). Introducing activities like catching a ball or single-leg squats will challenge the client further.

Optimal loading the structures to build that much-needed strength in the structures to support the ankle. Ligaments in the body are avascular meaning that blood flow to the ligament is non-existent. Exercises like weight baring, weighted balls and performing double or single-legged squats on stable and unstable surfaces will increase blood flow to the area and result in healing of the tissues, and the integrity of the ankle structures being restored.

Phase 3

Sport-specific exercise training, e.g. a Soccer player performs; lateral running, ladder work, double and single leg squat hops and jumps.

By following these three phases of the ankle, rehabilitation will decrease the risk of fear-avoidance which may lead the athlete to alter their play and place the athlete into a higher risk category for reinjury or an additional injury in another location.

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