The 5 stages of on-field rehab after long term injuries with Filippo Picinini
Nov 2, 2023
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Head of late stage rehab & sports science at Isokinetic Medical Group, London, Filippo Picinini discusses the stages of on-field rehabilitation after long-term injuries, emphasizing the importance of movement quality and gradual progression. He highlights the use of GPS technology to monitor players and informs the progression through the rehabilitation stages.
The stages of on-field rehabilitation progress from linear movements to multi-directional drills and specific football drills, gradually increasing intensity and complexity.
Assessing progression criteria during each stage of rehabilitation is crucial, using objective metrics such as strength, running mechanics, and movement quality, along with monitoring workload and recovery using GPS data.
The psychological component of rehabilitation is vital, requiring a supportive environment, gradual exposure to context-specific drills, and addressing psychological barriers to regain confidence and readiness.
Deep dives
The Six Sport-Type Movements
The podcast episode discusses the six sport-type movements that are important in rehabilitating athletes. These movements include single-leg quad drop jump deceleration, lateral shuffle with a lateral stop, 90-degree change of direction, and single-leg hop. It is emphasized that if the player can handle these six movements, their foundations are automatised enough to progress them on the pitch.
Stages of On-Field Rehabilitation
The podcast episode outlines the different stages of on-field rehabilitation. Stage one focuses on linear movements and basic technical drills, while stage two progresses to multi-directional drills and gradually increases intensity and complexity. In stage three, specific football drills are introduced in a reactive and pre-planned manner. Stage four provides modified team training simulations, replicating the demands of the club without reaching pre-injury workload levels. Stage five involves transitioning back to full team training with a focus on physical preparation and psychological readiness.
Assessing Progression Criteria
The podcast episode highlights the importance of assessing progression criteria during each stage of rehabilitation. Objective metrics such as strength, running mechanics, and movement quality are used to determine if a player is ready to progress. The player's ability to tolerate workload and recover between sessions is also monitored using GPS data. The internal response to the workload, such as joint reactions and muscle soreness, is considered alongside the external metrics.
Psychological Readiness
The podcast episode emphasizes the psychological component of rehabilitation, particularly in long-term injuries. Building a relationship with the player and creating a supportive environment is crucial for their psychological readiness. Gradually exposing the player to context-specific drills and replicating team training situations helps them regain confidence. Additionally, addressing any psychological barriers, such as fear of contact or specific movements, contributes to the player's overall readiness.
Benefits of On-Field Rehabilitation
The podcast episode highlights the benefits of on-field rehabilitation. It allows players to progress from controlled indoor environments to more dynamic and context-specific on-field drills, replicating game situations. On-field rehab helps establish a connection between physical and psychological readiness, preparing players for the demands of team training and ensuring a smoother transition back to the club. The podcast also emphasizes the importance of maintaining a balance between physical preparation and technical/tactical components during the on-field rehab process.
This episode of the Pacey Performance Podcast sees Rob speaking to Head of late stage rehab & sports science at Isokinetic Medical Group, London, Filippo Picinini.
The discussion delves into the stages of on-field rehabilitation. Stage one focuses on linear movements, helping players restore confidence and familiarize themselves with the environment. The emphasis is on separating conditioning drills from basic technical drills. The transition from stage one to two is based on criteria like restored strength, normalized running mechanics on a treadmill, and movement quality. Filippo emphasizes the importance of movement quality, noting that players often struggle with basic movements, especially after long-term injuries.
Later in the episode, Filippo details how he progresses athletes into stage two and then through to three, four and five. Throughout the rehabilitation process, Filippo highlights the importance of monitoring players using GPS technology to track metrics like total distance, moderate and high-speed running, and accelerations. This data, combined with the players' physical responses, informs the progression through the rehabilitation stages.
Filippo Piccinini provides valuable insights into late-stage rehabilitation for athletes, emphasizing the importance of movement quality, gradual progression, and the use of technology to monitor and guide the rehabilitation process. If you are managing any athlete through the rehabilitation of a long term injury, this episode is for you.
Main talking points:
Emphasis on restoring player confidence
Transition criteria: strength and running mechanics
Challenges in basic movements post-injury
Volume prioritization over intensity
Micro dosing high-speed running
Rehabilitation's gradual and monitored approach
GPS technology for monitoring
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