As a sports physiotherapist and strength and conditioning coach, ultimately my primary aim is to guide an individual safely and thoroughly through the rehabilitation process and back to playing sport.

My approach to rehabilitation and performance has constantly evolved over the past 15 years and it also varies between individuals. Ultimately, I believe that a successful return to sport must consist of a multi-factorial approach. From a physiotherapy perspective, understanding and respecting tissue healing are important during the early stages of injury management, with a knowledge of exercise principles and prescription vital throughout the entire return to sport process. Other factors are equally as important in creating an efficient rehabilitation process however, such as communication, motivation and accountability.

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I have found that what works for one person, may not work for the next. Each individual that attends the clinic brings with them a unique personality, varied beliefs and different learning styles. Therefore, to achieve the ultimate goal of a successful return to sport, tailoring the rehabilitation programme to each person is essential. This is not to say that each individual should receive a completely different exercise programme or repetition-set scheme. It is important to have a system in place, whereby a structured rehabilitation process is followed. However, this system should allow for both adaptability and variation. Following a set recipe-approach in rehabilitation rarely has a positive outcome. For example, I understand that most people aren’t elite athletes, therefore they often can’t spend two hours at the gym every day. The best exercise programme is the one that is actually completed, therefore communication with clients regarding what they are willing and able to commit to is essential. 

I would argue that communication is the cornerstone of any successful rehabilitation programme. Following an injury, the athlete or individual should know what the top of the mountain looks like for them. Specifically, this involves understanding what they need to perform in order to be deemed fit to return to sport again. An individual’s pain will often have resolved well before they are fit to return to sport. Therefore, educating the individual about the criteria that they must pass can pay dividends later in rehabilitation. This can also help to reduce the risk of returning too quickly and ultimately unsuccessfully to sport. It is important to address the athlete’s expectations from day one, in order to avoid any confusion later in rehabilitation. Setting short term goals is beneficial throughout rehabilitation to help keep the individual motivated. This is especially the case following injuries that require more extensive rehabilitation periods.

Rehabilitation can be tough, both physically and psychologically. This is especially true for longer-term injuries such as lower limb fractures, anterior cruciate ligament (ACL) surgery and achilles tendon ruptures. I was once told that there are approximately four occasions during ACL rehabilitation where the individual struggles and gets fed up with rehabilitation and training. Being injured often means being unable to train with your peers, and therefore missing out on the social aspect that sport offers. It is always much easier to have prior knowledge of these motivational dips, that are inevitable during rehabilitation. Rehabbing any injury for 12 months is understandably challenging. In these situations, regular short-term goal setting and appropriate alterations in training programmes can help to reduce training monotony. 

Another aspect that I place emphasis on is accountability. Asking individuals to record completed rehab and/or gym sessions, can help to ensure that the work is actually being accomplished. Many of the individuals that I see are either students or they have full time jobs, so life can get in the way sometimes. If I know exactly how many sessions that they have completed, I can confidently programme more challenging exercise progressions. Conversely, there may be weeks where individuals have examinations or they are sick, and therefore are unable to complete the desired number of training sessions. Ignoring this information and progressing an exercise programme, will probably lead to undesirable results. I also believe that it is essential to receive feedback from individuals after they have commenced a new resistance training programme. I have found that new or updated programmes will nearly always need to be adjusted for various reasons.