{"id":11118,"date":"2024-05-31T06:00:19","date_gmt":"2024-05-31T05:00:19","guid":{"rendered":"https:\/\/blogs.bmj.com\/bjsm\/?p=11118"},"modified":"2024-05-27T16:44:49","modified_gmt":"2024-05-27T15:44:49","slug":"strength-in-collaboration-the-collaborative-power-of-physiotherapy-and-strength-coaching-part-2","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bjsm\/2024\/05\/31\/strength-in-collaboration-the-collaborative-power-of-physiotherapy-and-strength-coaching-part-2\/","title":{"rendered":"Strength in collaboration – the collaborative power of physiotherapy and strength coaching Part 2"},"content":{"rendered":"

A collaborative rehabilitation framework involving the dual-discipline support of physiotherapy and strength & conditioning (S&C). To assist the athlete\u2019s journey from injury to performance. <\/span><\/b><\/p>\n

Keywords: Exercise selection; rehabilitation programming; strength and conditioning<\/span><\/b><\/p>\n

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Introduction:<\/b><\/p>\n

Part one<\/span><\/a> of this blog series established factors involved in the working relationship of an S&C coach and physiotherapist when supporting an athlete’s return to performance (RTP), specifically in relation to the assessment and planning aspects of rehabilitation.\u00a0<\/span><\/p>\n

This is part two of this blog series which explores how S&C and physiotherapy practitioners effectively apply their collective skill sets, break down and analyse movement tasks, applying exercise prescription knowledge to achieve the desired outcome.<\/span>\u00a0<\/span><\/p>\n

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Figure 1:<\/b> Prioritise and programme (Dyer, C., 2020) (2)\u00a0<\/span><\/p>\n

Prioritise and programme \u2013 performance task breakdown:<\/b><\/p>\n

The \u2018prioritise and programme\u2019 aspect of this process requires robust foundation knowledge of the task the athlete is returning to, breaking this down to its constituent parts anatomically and physiologically.<\/span><\/p>\n

S&C coaches and physiotherapists are well placed in problem solving this collaboratively. By reverse engineering the task it is possible to jointly agree on the areas of adaptation required. This can be done by firstly looking at the performance demand and then the performance actions. Subsequently, it is important to establish the biomechanical factors involved in completing the performance task and therefore identify the adaptation requirements to achieve this.<\/span>\u00a0<\/span><\/p>\n

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Figure 2:<\/b>\u00a0 Performance task breakdown (Dorn et al., 2012) (1), (Lenhart et al., 2014) (4)<\/span><\/p>\n

Prioritise and programme \u2013 achieving the targeted adaptation:<\/b><\/p>\n

A lack of clarity on the specific physical outcomes results in programmes that may be inappropriately aligned to the needs of the athlete. Examples include a lack of preparation for exercise programme progressions and an overly general and vague <\/span>programme with<\/span> not enough specific content to drive an adaptive response physically. Recognising what type of adaptation is needed to bridge the gap between the athletes current anatomical and physiological capabilities and the performance task requirements, can help effectively prioritise and programme the rehabilitation. S&C and physiotherapy clinicians should jointly discuss what to target.<\/span><\/p>\n

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Figure 3:<\/b> Example areas for targeted adaptation (Wolf, A., 2020) (6)<\/span><\/p>\n

Prioritise and programme \u2013 exercise selection:<\/b><\/p>\n

There are endless choices of exercises, drills and activities that can be used during rehabilitation to obtain adaptive responses to the human body. Once clarity is gained regarding the adaptive priorities required, the selection of exercises can become clearer through a \u2018funnelling\u2019 process. This allows S&C and physiotherapy practitioners to determine the appropriateness and importance of an exercise within a rehabilitation programme. <\/span><\/p>\n

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Figure 4:<\/b> Funnelling system for exercise selection (MacPartlin, F., 2020) (5)<\/span><\/p>\n

The exercise selected can be progressed and regressed across the parameters depicted below to work towards tasks that resemble to demands of the sporting actions (see Figure 5). <\/span>It also involves selecting tasks suitable for the stage of the athlete\u2019s injury and ensuring the removal of any unsafe tasks from the <\/span>programme. Collaborative discussions between the S&C coach, physiotherapist practitioners and the athlete should occur to agree on the programme, covering the athlete\u2019s performance priorities and ensuring engagement and buy-in across all stakeholders.<\/span>\u00a0<\/span><\/p>\n

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Figure 5:<\/b> Exercise progression and regression stream<\/span><\/p>\n

Conclusions:<\/b><\/p>\n