“Player X was injured in the game or practice” are the words every sports fan hate to hear. Even before the athlete is evaluated by the medical and training staff fans are wondering if an athlete will be able to return to pre-injury performance levels. In other words, will the athlete still be able to do their job? Often you will hear percentages thrown around and everyone has an idea what they think this all means, but what does it actually mean?
When an athlete comes into their teams facilities for the first time they undergo a physical which includes performance function testing. This testing includes a series of standardized tasks to evaluate mental and physical abilities to obtain a baseline score on each of these tasks for each athlete.
This testing takes place at the start of each new season to access the athletes performance relative to their baseline and/or the baseline of others with similar physical demands on the playing field. This testing also occurs as an athlete works to get back on the playing field following an injury, as well as part of the physical evaluation when a player is traded and has to pass a physical. If initial baseline is considered to be 100% then when someone says he is at 75% you don’t have to ask – 75% of what?
When an athlete is injured, a continuous process starts which involves several members of the medical and coaching staff.
- Step 1 – Medical treatment. This is shared by the treating physician who examines, diagnoses and performs any corrective procedures to facilitate recovery. It also includes athletic trainers and physical therapists who work with the physician to manage pain, limit swelling and protect injured tissues.
- Step 2 – Initial Rehabilitation. This is the job of the athletic trainers and the physical therapists. This stage is designed to restore motion and neuromuscular control of muscles and muscle groups. It is not designed to build additional muscle, just to stabilize and strengthen the muscle already traumatized by the injury
- Step 3 – End Stage Rehabilitation. The athletic trainers and physical therapists are joined by the strength and conditioning staff in managing this stage of the recovery process. In this stage the athletes must balance stability and strength. Endurance is maximized as the athlete continues to progress toward a return to the playing field.
- Step 4 – Generic Specific Development and Rehabilitation. Once the athlete has been deemed ready to begin to work back to the playing field, he is ready to start working with the strength and conditioning staff in a more concentrated capacity to restore basic physical performance functions of the athletes body. Steps 1-4 are basically the same steps that anyone who sustains an injury go thru as they recover from their injury. Athlete or Joe fan, the recovery process is very similar.
- Step 5 – Sports Specific Development. The final stage of the recovery process is when the athlete is permitted to return to practice and begin working with the position coaches and strength and conditioning staff to restore competitive performance functions. These are the tasks that an athlete does to show they can handle the rigors of the position they play. Running, jumping, pushing pulling etc. This is dictated by the necessary functional ability dictated by their specific role on the field.
While player and fans alike would like to think this is a simple very organized process, it often gets messy because of setbacks from day to day in the recovery period. Another problem occurs when the process is tried to be sped along, which generally just results in further injury and rather than a faster return to the playing field it actually results in a prolonged recovery period. All along the way in this process, the athletes performance and functional testing is evaluated and measured, to get a sense of how the athlete is doing in their recovery.
Each time a player is injured it impacts their ability to recover from the injury and also increases the possibility of re-injury or further injury. Most of the time an athlete is able to return to their pre-injury level of performance. However, occasionally that is not the case.
Sometimes the level of performance is decreased so little that except for the training staff who do the performance evaluations and have statistics to look at, it isn’t really discernible. Over time and a multi-season playing career, these slight decreases begin to buildup to a point where a player is determined to no longer fulfill the demands of the job, or the cost to retain the player is deemed to be too great to the long term goals of the team.
I explain this to people as the ‘used-car’ effect. A new car has a value when you get it, but as soon as you leave the dealer the value begins to drop, eventually the cost of maintaining and repairing the car becomes less cost effective than trading the car in on a new model. Exactly what happens when an athlete is either traded, released or decides to retire.
Editor’s babble: We are honored to have Dr. Beth Sullivan (D.O.,Doctor of Osteopathic Medicine) join us and contribute to our blog. Dr. Sullivan is interested in sharing her vast knowledge about injuries and other medical conditions that are relevant to playing NFL football. You can follow Beth on Twitter at @GAPeachPolymer.