Strength and Conditioning in Injury Rehabilitation

Objectives:  There is an emergent body of evidence supporting exercise therapy and physical activity in the management of musculoskeletal pain. The purpose of this study was to explore potential barriers and facilitators with patients and physiotherapists with patellofemoral pain involved in a feasibility randomised controlled trial (RCT) study. The trial investigated a loaded self-managed exercise intervention, which included education and advice on physical activity versus usual physiotherapy as the control. 

Conclusions: Implementation, delivery and evaluation of the intervention in clinical settings may be challenging, but feasible with the appropriate training for physiotherapists.  Participants’ improvements in pain and function may have been mediated, in some part, by greater self-efficacy and locus of control.

Chronic musculoskeletal pain remains a huge challenge for clinicians and researchers. Exercise interventions are the cornerstone of management for musculoskeletal pain conditions, with the benefits being well-established. 

The need for pain to be avoided or alleviated as much as possible has been challenged, with a paradigm shift from traditional biomedical models of pain towards a biopsychosocial model of pain, which is particularly relevant in the context of performing therapeutic exercise.

The aim of this article is to provide an understanding on the potential mechanisms behind exercise and to build on this into discussing the additional theoretical mechanisms of painful exercises. 

This online course provides an overview of the current understanding of:

1. Musculoskeletal pain in relation to central and peripheral pain mechanisms, the immune system and affective aspects of pain. This course focuses on these three mechanisms as these systems may respond differently to painful stimulus, compared with a non-painful stimulus;

2. Then, the proposed mechanisms behind the potentially additional beneficial effect of allowing painful exercises over pain free exercises for individuals with chronic musculoskeletal pain.

Strength and power diagnosis can provide valuable insights into the different capacities of athletes.  The strength and power tests chosen should be reliable and valid and take into account the requirements of the sport and what is a meaningful change in performance.  The results of these tests need to be reported in a clear, meaningful, and timely manner for coaches if they are to have maximal impact on training programs.  The practitioner can use this evidence-based information in conjunction with the art of coaching to maximise training program effectiveness. 

In this online course, we introduce the return to sports continuum and outline each component. We define successful rehabilitation and provide reasons why the decision-making process is complex and influenced by athlete-specific biopsychosocial factors. 

In this online course, Dr Jason Tee discusses the fundamental principles of strength and conditioning.

Dr Jason Tee unpacks the Needs Analysis to determine the demands of sports to create comprehensive rehabilitation programs.   

In this online course, Dr Jason Tee discusses training prescription by influencing volume, intensity, load and the force-velocity curve. Then, he unpacks the considerations for the application of these principles in a 'performance' rehabilitation context. Finally, he outlines why specificity is vital to ensuring optimal outcomes.  

In this online course, Dr Jason Tee discusses the contextual challenges to skill execution. He considers the difference between closed and open skills and how they affect training prescription, and finally, he explores the control-to-chaos paradigm for return to performance. 

In this video, Eurico Marques physiotherapist discusses why understanding contemporary pain sciences is critical to managing the complexity of injury rehabilitation. 

In this video, Eurico Marques physiotherapist discusses how clinicians can utilize the self-determination theory to optimize compliance and motivation through the challenges of rehabilitation.

How can you, as a health care professional balance the needs of the sports team or organization that is paying your bills, the athlete’s (your patient’s) desire to perform while in pain and with injury; and the economic consequences of playing/not playing  for both the athlete and the team/organization? 

This comprehensive course examines some of the difficult legal and ethical issues, the potential consequences surrounding the decisions  sports medicine practitioners have to make in this age of professional sport.  

• confidentiality aspects of disclosure such as injury, use of drugs, alcohol or psychological issues that may impact player’s performance;
• the ethical implications of performance enhancing drugs; and
• playing or competing with an infectious disease.