When delivering rehabilitation programs, it is my anecdotal experience that establishes proper rehabilitation milestones often correlates with a higher motivation, attendance and outcomes. The progression of the rehabilitation program should be judged by clinical reasoning with objective exit criteria. These criteria serve to minimize inappropriate rehabilitation and avoiding that the patient does not fall behind. Furthermore, creating a clear roadmap of recovery can help to optimize the communication, so all involved partners of the team (athlete, coach, physio, surgeon, S&C coach, nutritionist and so on) are aware of what is going to happen, and when it expected to occur.
The achievement of milestones also helps the athlete to follow his journey and see the progress which hopefully engenders confidence.
However, importantly no road is without bums. Therefore preparing the athlete to falls will happen at any path, but reaching the Milestone before continue to next rehab phases can help to navigate around the bums.
For me, the three A’s, Attendance, adherence and adapt, is a good rule of thumb for a good training program. Our patient have to attend the rehabilitation, they have to be consistent and stick to the plan. To optimize attendance and adherence, collecting objective, subjective feedback and data can boost any program to make a more optimized adaptation. (the three A’s is originally from a highly recommended course with Nick Grantham)
Every program should be simple, but on the other hand, not so simple, that the patient will become an external hard-driver to the rehabilitation and just do for example 3 set of 10 reps, and when you unplugged them, they can’t train on their own. The athlete needs to have autonomy and we have to be careful not trying to make the patient fit into a rigid protocol.
We have to give our patient the small wins to let them feels motivated (the progress principle) and help them to a belief that they are successful in reaching their goals. This can be done with establish testday or continues testing the athlete throughout the rehabilitation.
The above picture is my humble attempt to visualize the currently ACLR roadmap I using for my ACLR patient at the moment. I would like to hear other practical examples of how to visualizing rehab plan.
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