HMMR Podcast Episode 231: Rethinking rehab (with Donie Fox)

It’s easy to think about injury from a medical point of view and focus on what is broken. But you can also view it from a performance point of view: what type of plan will take the athlete is at point A to point B. Donie Fox is both a physiotherapist and athletic development coach. He joins this week’s podcast to discuss his thoughts on rehabilitation, including assessment, variation, shapes, and more.

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Notes and quotes

Donie Fox is a physiotherapist based in Dublin. In addition to helping athletes as a physiotherapist, he also is an athletic development coach for many top athletes, including Irish under-23 800-meter record holder Nadia Power, and the head coach St.Jude’s camogie team, who recently won their second Dublin championship in three years.

  • 0:00 – Introduction.
  • 4:00 – Remembering Ron McKee.
  • 12:00 – Assessment: “I’ve moved away from the hands-on assessment and now just ask what information do I need that will inform my approach. You want information that might inform a decision rather than just information to add to a spreadsheet.”
  • 14:00 – Examples of assessments: “Rather than assess ankle range of motion in terms of degrees, assess it in terms of whether it is enough to do a single leg squat, acceleration position, or something else. Assess in terms of how it relates to the sport.”
  • 17:00 – Comparing FMS and PCA assessments: “I think the best part of any screening test is that if you are doing it over time you are spending time watching the athletes move on their own, rather than in a large squad. It might not necessarily be related to the sport, but you’ll see how they start moving.”
  • 22:45 – The role of anatomy in assessment.
  • 25:45 – Frans Bosch’s concepts in the rehabilitation setting: “Fast reflexes don’t tend to get trained in rehab. Instead strength tends to be the focus. That’s where the work from Frans Bosch and others can help in the rehabilitation setting.”
  • 29:30 – The role of intent, variability, and the mind: “Traditional physiotherapy aims for pristine movements, but as Grace Golden and Frans Bosch have shown us it is not about chasing one movement, but chasing variations and challenging athletes to make a more robust athlete.”
  • 32:00 – Shapes: “There are shapes that everyone should be able to make, and then you have sports shapes. For the large majority of people I see they can’t even make basic human shapes like bending over to touch the ground. You can use that as a starting point for rehab: if there is something fundamental you cannot do, let’s start there.”
  • 36:00 – How to individualize shapes: “In the single leg squat you have a general idea of what the starting and ending shape might look like, but based on tibia length and hip strength the middle will be somewhat different. The question is how we know what variations are and are not acceptable.”
  • 43:00 – Thoughts on why so many athletes made breakthroughs in lockdown.

To hear more on these topics, listen to the full episode above. Also be sure to subscribe to our podcast and review it on iTunes.

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