An objective approach to rehabilitation in soccer!

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1 An objective approach to rehabilitation in soccer! Chris Barnes! West Bromwich Albion FC! CB Sports Performance

2 Stages of rehabilitation in sport Structural Return to and exercise funcional (RTE) regeneraion Return to training (RTT) Physiological regeneraion Return to Performance performance regeneraion (RTP) Physio Physio, S&C or both S&C

3 Stages of rehabilitation in sport Get him well (rebuild / remodel him)? (potenial goal conflict) Get him fit for purpose (reintegrate him) Physio Physio, S&C or both S&C

4 The perfect rehabilita.on Progress Time

5 Rehabilita.on the reality! Progress Time

6 Periods of threat to team stability.mes of tension Progress Time

7 Periods of threat to team stability.mes of tension Progress RTE RTT RTP Time

8 Recurrences S&C n=4 Physio n=4 Physio / S&C n=16

9 Mul.- disciplinary Inter- disciplinary pracice an an ineffecive team There Well is there also challenge!! is promise Physio s Art Art Science Sport Scien.sts

10 team percepion of effeciveness 6 5 Overlap (units) Low Medium High Team percep.on of effec.veness

11 An objective approach to rehabilitation in soccer!

12 An objective approach to rehabilitation in soccer! RTT!

13 Return to training (RTT) - Principles How much work has he done? VOLUME How hard has he worked? INTENSITY (combinaion of locomoive, mechanical and cardiovascular stresses monitored against targets)

14 Return to training (RTT) - Principles What will he do? Criteria Driven Entry Clinical tests FuncIonal tests FuncIonally sound under faigue Exit ObjecIve targets for each session Performance tests

15 Return to training (RTT) - Principles Requires hooks normal training acivity paberns Individual match profiles Sessions delivered by physio and/or SS/S&C staff Field sessions categorised as intensive, extensive and mixed with according goals / targets

16 Intensive AcIviIes performed in Ight areas. Result in high RZ, Acc, Dec, slow Load, Explosive distance, intensity Extensive AcIviIes performed in larger relaive areas. Result in high RZ, TD, HID, Ver=cal load (rela=ve) Mixed CombinaIon of the above. Mirrors match demands. High volume, PL and RZ

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22 day RTT - volume rela.ve to match Volume (%) Team Rehab Day Totals: Team = 375%, Rehab = 350%

23 day RTT - intensity rela.ve to match Intensity (%) Team Rehab Day Average Intensity: Team = 63%; Rehab = 64%

24 Strategy (2012 present) RTT plan implemented with all medium- long term (>2 weeks) rehab incidences DuraIon of RTT plan dictated by Ime missed and condiion of player Also implemented in cases where player under- loaded leading to minor clinical presentaion Plan delivered by performance physiotherapist and fitness coach

25 Interdisciplinary work Player returning from (recurrent) hamstring injury All staff nervous about early reintegraion Clinically sound funcionally reporing sensory weakness Passed all clinical and RTT tests Movement paberns visually ok

26 Interdisciplinary work Player returning from (recurrent) hamstring injury All staff nervous about early reintegraion Clinically sound func.onally repor.ng sensory weakness Passed all clinical and RTT tests Movement paberns visually ok

27 6- min yoyo recovery level 1 Used as iniial part of warm up every 4- weeks Assessment of fitness and freshness

28 Athlete assessed July YoYo submax run. 1 length (20m)

29 Athlete assessed July YoYo submax run. 1 length (20m)

30 Athlete assessed October weeks post h/s injury. ReporIng discomfort. No visible asymmetry

31 8 steps

32 (dis)func.onal assymetry?

33 Summary Minimise adaptaion Ime to RTT and training (Int:Ext raios) Recognise, accept and respect individual and professional differences!!! RTT should be a shared process UIlise agreed simple but objecive RTT criteria Entry Content Exit Involve the player and coach

34 Thankyou.! Chris Barnes! West Bromwich Albion FC! CB Sports Performance

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