Sometimes, life requires us to take a break from sport and exercise – whether the break was due to injury or illness, the end of the sporting season or other life commitments getting in the way.
And you have probably experienced muscle soreness, fatigue, or pain when getting back to your regular sport or activity following a period of down time. That’s why, whatever the underlying reason for time off, it’s important to have a staged approach back to activity.
Returning to pre-season training
In sport, the off-season is a chance to rest, recover and address any injuries with your physiotherapist and performance team. For some, it involves doing little to no strenuous physical activity for months and enjoying time away from routine training and competition. This leads to a relaxed and rested body and mind – but also to reduced fitness. The pre-season is a chance to build that fitness up again. Most athletes place emphasis on endurance and strength first, then on skill and patterns of play later in training.
Did you know in many sports, such as basketball, pre- and early-season training is when overuse injuries like stress reactions and fractures most often occur? This happens when the de-load adaptation from off-season down time is disrupted by a sudden increase in volume (time on feet) and magnitude (intensity) (Bell et al 2023). Which just means that a sudden spike in activity can be beyond what the body’s tissue can cope with, leading to injury. This can also be the case when you come back to sport from injury or other prolonged time off.
How do you combat this? It’s important to plan a graded return to sport, which means training with gradual increases in volume, intensity and frequency. It also highlights the need to maintain a level of conditioning in the off-season!
Returning from injury
Another reason you may have time off sport or exercise is injury. In the initial stages of injury management, your physiotherapist is focused on optimising healing. This may involve a period of unloading, such as taking weight and pressure off the injury with crutches or plaster. During this time, they will give you exercises and interventions that maintain your function and conditioning but won’t compromise your healing.
This is followed by a gradual re-introduction of load to your body and your injured tissue. Initial exercise may be very general, with focus on developing muscle mass, movement patterns and tissue tolerance.
As you improve, training may progress to sport specific, or more strenuous exercises. This could be a transition from double limb to single limb exercises, introduction of heavy weights, targeting the anaerobic energy system or power-based exercises. The goal is to prepare you to return to regular activity.
Knowing when to return to sport and training
So, how do you know when it’s time to return to your usual physical activity or training, especially after an injury? When to return and at what level to participate, is determined by how your injury responds to treatment and exercise interventions. Physiotherapists use screening tools to help assess strength, endurance, range of motion, your subjective readiness and performance. The exact nature of the screening test is determined by your injury, the physiotherapists experience and specialty, and the demands of your sport (Whatman et al 2012).
Test results provide insight into your response to rehab and help your physiotherapist refine interventions and get you back to regular activity. Screening and testing can also be used as a preventative measure during your training to help identify areas for improvement and so avoid injury.
Injury Prevention Programs
Speaking of preventative measures, if you have been involved in organised sport, you may have come across injury prevention programs. Soccer uses the FIFA 11+, Netball has the KNEE program, rugby union has Smart Rugby and the AFL has Prep-to-play.
These programs are shown to reduce in-season injury when completed regularly. The FIFA 11+ in Male Soccer players reduced injury rate up to 30% (Sadigursky et al 2017) and Netball Australia suggests that using their KNEE program can reduce the incidence of ACL injuries in players by 40-70% (Netball Australia 2015).
These programs can be implemented as part of your normal warm up. They reflect the typical demands of the sport and target strength, neuromuscular control, mobility and flexibility. They can also have different levels of difficulty, allowing for flexibility across age groups and sport participation levels.
It is important to recognise that returning to sport or exercise unprepared can lead to injury (and re-injury). To prevent this, you need to consider the demands of the activity on your body and plan for a gradual, structured return.
A sports physiotherapist will be able to help you plan this process, along with assisting with rehab, underpinned by sound testing and prevention exercises. So, if you’re looking to get back into any kind of physical activity after a long break, get in touch today to book a session with our friendly physio.
Sources
Bell L, Strafford BW, Coleman M, Androulakis Korakakis P, Nolan D., Integrating Deloading into Strength and Physique Sports Training Programmes: An International Delphi Consensus Approach, Sports Med Open, 2023
Whatman C, Hing W, Hume P, Physiotherapist agreement when visually rating movement quality during lower extremity functional screening tests, Physical Therapy in Sport, 2012
Sadigursky D, Braid JA, De Lira DNL, Machado BAB, Carneiro RJF, Colavolpe PO., The FIFA 11+ injury prevention program for soccer players: a systematic review, BMC Sports Sci Med Rehabil, 2017
Netball Australia, Netball Australia’s KNEE program, 2015