Getting more aggressive with hamstring injury rehab with Luke Sewell

Feb 19, 2025

Luke Sewell, first team rehab coach at Ipswich Town, shares his innovative strategies for aggressive hamstring injury rehabilitation. He emphasizes early loading and neuromuscular control to enhance recovery while minimizing reinjury risks. Sewell discusses the importance of tailoring rehab intensity using match data and establishing clear rehabilitation goals. His approach focuses on collaboration among medical staff, coaches, and players, ensuring effective communication and psychological support throughout the recovery process.

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ANECDOTE

Origins of Aggressive Rehab

Luke Sewell discusses the impetus for a more aggressive approach to hamstring rehab at Ipswich Town.
It stemmed from the need to accelerate player return to support the team's promotion push, prioritizing player availability.

INSIGHT

Defining Aggressive Rehab

"Aggressive" rehab doesn't mean disregarding tissue healing principles.
It means maximizing progress within those constraints by hitting objective markers earlier.

ADVICE

Tailoring Approach to Injury Severity

Consider injury severity and location when deciding how aggressive to be.
Some injuries, like proximal avulsions, necessitate surgery and conservative approaches, while less severe ones can be pushed.

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In this episode of the Pacey Performance Podcast, Luke Sewell discusses his aggressive yet structured approach to hamstring injury rehabilitation, emphasizing early loading, objective monitoring, and collaboration, that can accelerate recovery and minimize reinjury risk while maintaining player confidence and performance. His approach emphasizes a collaborative, aggressive rehabilitation strategy developed over several years, aiming to accelerate recovery while minimizing reinjury risk.

A key component of this approach is early loading, neuromuscular control, and gradual exposure to high-speed movements. Understanding injury severity is crucial, as less severe tendon injuries can be treated more aggressively, whereas complete avulsions require surgery and a conservative approach. Progression is guided by clear rehabilitation goals, objective markers, and emotional support to ensure player confidence.

Luke highlights the importance of using maximal aerobic speed and match output data to tailor rehab intensity, progressing players through sprint work, change of direction drills, and controlled overload. The approach prioritizes communication between medical staff, coaches, and athletes to align rehab strategies with team performance needs.

Strength-building activities, monitored performance markers, and training logs ensure players safely return to full match fitness. The podcast emphasizes that aggressive rehab doesn’t mean reckless; it means structured, progressive, and well-communicated rehabilitation that gets players back faster and stronger.

Key Points:

• Early loading and neuromuscular control are essential.
• Injury severity determines aggressive vs. conservative rehab approaches.
• Maximal aerobic speed guides sprint progressions.
• Match output data tailors individualized rehab programs.
• Communication between staff and players ensures rehab alignment.
• Progressive overload is key but must be monitored carefully.
• Players must meet specific speed and volume targets before return.