Case Study

For example, take a grade 2b distal bicep femoris injury sustained during a preseason training session. The player presented with a cramp sensation in limited area of his posterior lateral thigh with tenderness on palpation of 5 to 7 cm. His ranges initially with active straight leg raise (ASLR) and maximum hip flexion and knee extension (MHFAKE) was within 20% limb symmetry with awareness on isolated contraction in a long leaver prone position. Four days later the player was re-tested with his ranges and held an equivocal range with no awareness and with a 2-3cm area of tenderness on palpation. At this point he was tested in prone using a handheld dynameter where he was within 10% limb symmetry and at 5 Newtons per kg (N/kg) on his injured side. 

This gave us the green light to progress to locomotive or on feet rehab where we started with some basic speed mechanics to stress the tissue in a high functioning capacity. Due to the tissue type we had targeted hard accelerations, up right running to maximum velocity and finally decelerations as our main focus. During the players first session on the grass our aim was to give an exposure to hard accelerations and take him up to 75% of his maximum velocity during speed drills. We achieved the first objective with ease plus he managed to reach up to 80% of his max speed, which was unplanned for but gave us a further indication that he was ready for the next progressions. This is just one positive example of how objectivity can help guide us forward. 

When using this strategy within rehab, especially during short term-based injuries that when working in a sporting environment are time critical can give an opportunity to progress earlier than previously thought. However, this can go the opposite way and delay return to play but through gaining objectivity we can rely on this to back our decision that more input is required.