Sports rehabilitation can be split into 3-4 phases, early, intermediate, late, and return to play. Different aspects of performance are focused on in each phase and different criteria need to be met before moving on to the next stage.
Early
In the early phase of rehabilitation, the main focus is increasing the range of motion (ROM), and reducing pain. This can be done using the soft tissue treatments mentioned before with the addition of isometric and eccentric exercises. It is also important to remember that cardiovascular fitness should be maintained or built upon throughout the rehabilitation process. Before progressing to the intermediate stage, a full, pain-free, range of motion is optimal.
Intermediate
The intermediate phase of rehabilitation can be split again into early intermediate and late intermediate. The early intermediate phase of rehabilitation focuses more on compound movements. An early intermediate phase plan may look similar to a basic resistance training program. The ranges of motion achieved in the early phase need to be applied to the compound lifts taught in this phase. It then needs to be ensured that these compound lifts can be performed with a full range of motion, pain-free, and with the correct form. This then needs to be repeatable to show a level of muscular endurance and with external load to show muscular strength. Once endurance and strength are adequate, the transition can be made to the late intermediate phase. This part of the intermediate phase resembles a more advanced resistance training program. The exercises developed in the early intermediate phase can be modified to develop and improve more sport-specific movement patterns including basic plyometrics ability and unilateral strength and endurance. This is also where proprioceptive work is integrated to build awareness and control of the body in space.
Late and RTP
The last two stages of rehabilitation are the late phase and the “return to play” phase. The aim of the late phase is to improve sport-specific movement mechanics in recreated sporting scenarios and contact scenarios. This is to make sure that there are as few biomechanical weaknesses as possible when taken out of a controlled environment. The drills performed in the late phase should aim to put together all of the aspects developed in the intermediate phase at a higher intensity. Once the athlete has the ability to perform at, or as close as possible to, their pre-injury level they will be ready to enter the return to play phase. In this phase, the athlete’s confidence is accessed to ensure the athlete is confident in all aspects of their sport and feels mentally ready to return to playing their sport.
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