The athletic development community has recently looked more at physical education and how it can assist athletes. Much of the discussion centers around the coordinative development of movement and how to develop higher levels of trainability/physical literacy/physical competency. But physical education is more than just doing, it is also understanding. This cognitive aspect of physical education is central in the reconditioning process. Athletes that are educated about the cause of injury, healing process, and training in general will generally have better outcomes.
I am not a physical education teacher, but I have had the pleasure to learn from some masters of the craft via the GAIN community. They have taught be the value of physically and cognitively educating our children, athletes, and patients. In this article I’m going to dig into a few aspects of the human form and function that I think should be explicitly and implicitly taught as an athlete navigates the path from injury to competing at their best again.
Education about the cause of injury
When an athlete gets injured, it is important that their medical professionals help educate them how it happened. This is valuable in helping define the path back to the field, but also in preventing the same thing from happening again. Not all education is created equal and how we explain this can lead to different outcomes.
Last month Craig Pickering delineating some of the injury models currently being debated in the sports science world. As rehab professionals it is our job to teach the athlete the relevant parts of these theories without creating a sense of fragility or lowered self confidence. We must frame the reasons they got injured in a light that creates a challenge – a navigable pathway back to resilience. We can teach them about tissue strength, movement efficiency, joint range of motion without discussing Ruffini corpuscles or Golgi tendon organs. We can discuss the effects of life stress, heat and equipment on our injury risk without overloading them with talk of acute:chronic workload, sodium concentration or the friction coefficient of different footwear.
We must be able to simplify and present logical science in a way that empowers them to face the challenge of reconditioning viewing their body in a positive light. We want them nurturing a growing sense of resilience rather than a fear of being forever fragile. There are depths to the injury models that may be overkill with regards to how much an athlete needs to be thinking about. But an understanding of modifiable risk is paramount to an appropriate mindset while embarking on a reconditioning journey.
Education about healing
Healing is complex, but basic understanding of the physiology of how we heal ourselves can be very useful when teaching an athlete why their body is reacting in certain ways. Swelling as a sign of acute overload, pain as a protective mechanism, the phenomenon of muscle inhibition. All of these, however simplified, allows the athlete to make sense of what they are experiencing. During the process it can be worrying for an athlete to see muscle atrophy or pain to return without a general understanding of why. Research has shown stress can prolong the recovery process.
It is our job to support an athlete through these changes. Provided we are talking in lay terms and in a conversational style then the issue isn’t medicalized and scary, it is merely teaching.
Education about training
Most HMMR Media readers will be familiar with the concept that reconditioning is just training with a few constraints. Well, what if the injured athlete has a poor level of trainability and has no understanding of the training process? Is this not where physical education is most urgently called for? Should all rehab professionals not be able to teach the basic principles of the training process in a way that empowers the most vulnerable, injured athlete? I would argue yes. We can start by asking athletes to answer a few basic questions, and form better answers:
- Do they know how to train? Warming up, lifting technique, basic physical literacy?
- Do they understand progression and regression?
- Are they familiar with the need for overload?
- What are their beliefs about the training process?
- Are they demonstrating any harmful beliefs or practices?
The gift of injury
There is a gift in injury sometimes. It gives an athlete time to take stock. In that time the rehab professional can either empower or disillusion. We have a duty to provide accurate, simple and tempering science to assist us in the provision of a progressive reconditioning plan. In the reconditioning process itself there may be quite a few sacred cows to slay:
- “Why aren’t you doing any hands on treatment?”
- “Can I not just get surgery?”
- “I thought physio was all theraband and wobble cushions.”
- “My dad said I should be doing more calf raises.”
We must be respectful but firm in our stance against these. Educate the person entrusting you with their care. The longer inaccurate beliefs exist the more likely they are to create animosity in the future. You are the one educated in the profession, if you have kept up to date with science then you must show authority – but not be authoritarian. Reconditioning is a partnership, we must learn how to converse and connect with each athlete. It is never helpful to lecture and dictate, we must seek to understand their stance or beliefs. We can learn so much of how to deal with issues in the future if we listen in the present and enquire about the past.
Education in reconditioning sets the tone for the therapeutic alliance. It must start, progress and end with camaraderie, respect and care. Ask questions about their understanding regularly to find the gap that might be hindering progress.