My Five Guiding Principles
Since becoming a certified athletic therapist in 2017, my approach to sport injury rehab has evolved. Like many therapists, I initially followed my school teachings, but over time, I’ve learned from my experiences, colleagues, and continuing education. I’ve identified what resonates with me, guides me, and works best for me. I’ve ‘found my flow,’ as described in school.
While I aim to continuously learn and adapt, there are five principles that I believe are not only foundational to me but are likely to remain constant.
The Body is Adaptable
I think at the forefront is the idea that the body is adaptable. We know this occurs because we have concepts like Wolff’s Law (which describes how bones remodel to load), Davis’s Law (same as Wolff’s but for muscles, tendons, ligaments, etc…) and the SAID principle (specific adaptations to imposed demands- we get better at what we practice). A perfect example of this is when we workout at the gym and we do bicep curls (with progressive weight and adequate recovery), our biceps get bigger. When we stop working out, our biceps get smaller. But guess what- we can make them big again by doing curls again.
Our body can change and it responds to the loads and forces that we place (or don’t place) upon it. Obviously I like to focus on the good, but certainly if we train really hard, don’t allow for adequate recovery and experience injuries, we’re going to have a negative adaptation, ie injury. A lot of people may refer to this as “wear and tear” as if we’re a machine, but when we apply the right load and recovery throughout our training, it becomes “wear and repair”.
Load Drives Recovery
To piggyback on our adaptability, it all comes down to appropriate loads on the body, and this drives recovery from injury. Our body needs a mechanical or physical stimulus regularly and progressively in order to drive these adaptations if we want to get back to our sports and reduce our risk of reinjury. We need to prepare our body again for the demands it is going to face in our sport.
Rehab Should Be Active, Not Passive
Rest and passive treatments do play a role the role of pain management in our recovery process, but this should only be within the first few days (ie the inflammation stage of healing) and should wane and give way to progressive exercises. The problem with passive treatment is two-fold: it doesn’t load and prepare the body for physical activity, and it can make patients dependent on their therapist to get them better. Patients have better results when they are active in their recovery, literally and figuratively.
Education First
If you don’t know what you’re dealing with, how can you expect to manage it? The British physiotherapist Louis Gifford believed that patients want to know four things:
“What’s wrong with me?” They want to have an accurate diagnosis.
“How long is it going to take to get better?” Having a prognosis can help them plan their future.
“Is there anything I can do to help get better?” They want some self-management techniques.
“What can you do to help me?” This can include any number of things to help you feel better.
If I can provide an accurate diagnosis and explanation for someone’s injury, provide a timeline and idea for what recovery is going to look like, give them ways to help their own symptoms and provide a plan for a fully recovery, I am going to do a lot to help them with any anxiety and fears and help them take control and empower them throughout the process.
Resilience is the Goal
Ultimately, resiliency (the ability to adapt to stress and bounce back) is the goal. A patient should not feel broken or something is wrong with their body whenever they come into an appointment. They should not feel like they have to come in regularly in order to continue their sport. They should feel strong and confident in their body to compete after an injury. They should feel they were active and driving the recovery, and that if something does come up, they have the tools and resources to manage without feeling like they’re broken again.
