S&C Rehab/Reconditioning - An honest article...

The reconditioning and preventative injury side, of strength and conditioning (S&C), has been a growing area over the last decade, one which many of us find? interesting, and has huge potential benefit on the performance areas we are responsible for. So how well are we doing?

Every few months comments online arise, such as ‘why are injuries getting worse despite developments in sport science and S&C?’.? A quick search shows a couple of important answers…

In a UEFA study over 18 years in Europe’s top clubs, injury rates slowly and significantly reduced, and player availability to train/play increased (Ekstand et al. 2021).? That said, the same group more recently found when looking at 21 seasons and into specifics like hamstring injuries, these had approximately doubled in regards to occurrence and days lost to the injury (Ekstrand et al. 2023).

You and me know so many factors influence such findings, for example, footballers can be exposed to greater forces in greater frequencies nowadays, due to the growing intensity of match-play.? But, I’m not going to split hairs over these uncontrollable factors, but rather, focus in on practical ways we can stack the odds greatest, in our favour, to recondition those we support back from injuries, in the best way to minimise further missed days. And being honest as promised in the title, its important to say...

Please turn away now if you’re expecting me to share an exciting new piece of technology which can achieve this. Or, if you are unwilling to challenge your own capabilities as coach, not just in knowledge, but also your human coaching skills.

The last 10 years of my professional S&C career, through growing Coalition Performance, following my prior years in professional rugby S&C, have exposed me and my team, to the most wide array of injuries and reconditioning challenges imaginable. All of which have helped identify common trends and pillars of effective reconditioning, as we have not been restricted or institutionalised to only working with a specific demographic or in a certain way. Equally this has been through our own openness to not think we are the bee's knee's, and when we needed to be better, accepting it, not throwing the toys out the pram and trying to get better.

So no one gets muddled up, I’m not calling anyone out -? I have no idea what you, your department and others get up to. But what I do know, is that exceptional coaches and practitioners are still open to challenge themselves and others, by reflecting on such things like I’m about to reveal…

You Don’t Train a Firefighter by Watering Plants with a Garden Hose

When you jog, you encounter loading around 1.5 times body mass, and muscles such as the calf complex, have around 250 m.s to recruit. So what?

If you stood at your workplace entrance, pulled a gun from your pocket, and fired it down a sports pitch in front of you, 250 m.s is approximately the time it takes the bullet to travel that distance.

This demonstrates how even during low demand exercise, the demands on your body are much greater than we often perceive. A common pitfall with reconditioning is to:

• Not fully appreciate the true physical demands an athlete/person is having returning to, but maybe more so…
• Not fully understand the demands that exercises you use, place on the body, in relation to this.

Bodyweight proprioceptive exercises may have logic during early stages of reconditioning, but can lose rational logic further on, as the loading of joints/muscles and recruitment of muscles, is an eternity off what many need to get back to (you can’t train a firefighter by having them water plants with a garden hose).

Eccentric exercises used in later stages, can easily be submaximal and not anywhere close enough to the loading muscles experience when lengthening during performance (is that calf eccentric really a true high load eccentric contraction like they experience on the field?)

Compound strength exercises or plyo’s utilising lack lustre intent, are light years away from the high threshold recruitment used when sprinting, leaping or cutting.

Beyond this, further improvements in avoiding this noted pitfall, come from logically and accurately progressing the exercises/tools you use towards the true demands of the end performance goal.? It’s easy for exercises which have now served their purpose to remain in a programme. That said, this can also lead to another challenge we can conquer…

Patience – Don’t Make Progressive Overload any Harder to Achieve

Progression can easily be seen as changing an exercise, although every time this occurs you have to recalibrate and determine the new loading, to ensure progressive overload from the prior session.? It’s a core reason why a staple of strength training is consistency, as if you stick with an exercise for a sufficient period, it’s much easier to get true progressive overload.

While new exercises can be progressive and are important at times, doing this in excess and too soon results a much greater risk of undercooking those you coach, wasting a week or two using a poorer stimulus, while also treating them to a new bout of DOMS.

Having fundamental exercises within your programme which you can easily adapt intensity, RoM and even subtle set up, often out perform those which contain regular exercise change which results in an unnecessary gamble. I know you’ll know this, but its so easy to still do it, and the challenge can be when having to do so, in someone who yearns variety or lacks motivation.

Novel and Functional = More Specific and Effective (really?)

I opened up Instagram the other day, my eyes were bombarded with a plethora of fruity and jazzy exercises, supposedly for football and rugby players. Now don’t get me wrong, I embrace ideas and creative thinking and I’m one of the least cynical people you will meet, but…

Many exercises used in key stages of injury reconditioning where the body can make valuable progress, can easily become elaborate ones, which don’t load and recruit key muscles, anywhere close to what you may think.

A single leg hinge into an a-hold (front foot on bench) using a load ~50% of 1RM) is not going to recruit and train musculature close to what it may appear, in relation to sprinting. Its not intense enough to develop maximal strength or structural properties of a muscle, and with no ground contact it does not have the specificity, to transfer strength increases well.

Somewhere, in someone, with some type of goal and background, you will eventually be able to rationalise any exercise, so I’m not an ageing hater of new things. But, just because it looks specific and novel, doesn’t always mean it’s the most effective tool to use. I always have fallen back on an old, but outstanding philosophy shared by Prof Rob Newton and shared by my former boss Alex Martin – transferability is best achieved via ensuring an exercise, can fundamentally match the following 3 demands of performance:

·???????? Amplitude of force

·???????? Magnitude of force

·???????? Joint angles/orientation of the body

Forgetting One of the Ultimate Variables in Successful Return to Performance

This maybe the area that on the whole, coaches could improve most, particularly if you’re already well on top of the prior discussion points. Some call it readiness, some call it confidence, it’s hard to measure and is a bit of a grey area, but it’s critical.

You could have the same reconditioning plan and process used with someone, but in one scenario it’s simply about getting the work done and growing the physical numbers and qualities. The second still values these, but on top also focus’ on communicating these in a way which relates to the athlete/person and what will yield greatest increases in confidence. This fuels the reconditioning journey with a greater likelihood of the athlete/person putting in greater effort, intent, technical quality throughout.

It's not uncommon for coaches and departments to think they are using exercises and training methods different to others, when in fact, they're scarily similar. Therefore, the art of coaching can act as a key differentiator, in the ways discussed. That said, still many S&C coaches think they have this mastered it, or are unwilling to value its important enough.

I would love it if simply ticking the physical, scientific boxes would instil the greatest confidence in anyone being reconditioned back from an injury, but it doesn’t. How you communicate via feedback, framing of information and your own coaching character, will influence how well they perceive themselves to have progressed and how confident they are to return to whatever performance is for them. Actually, I love this challenge, so I’m glad it isn’t just about the numbers.

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The Best Gym Reconditioning can be Obliterated by…

The most perfect, amazing, well coached and progressed reconditioning done by you, can be obliterated on field. While this is a shared frustration in the underbellys of many S&C coaches with technical coaching staff, it still begs the question – ‘what are you going to do about it’?

From experience, I am not going to suggest for one moment to tell you the answer to this, as the dynamics of working relationships in working environments are often complex and highly specific. But, the relations you have with others, how you present and share information is hugely impactful on this area.? It’s unlikely it will ever be perfect, but what’s the harm in at least trying to make it better?

• Use logic but explain it simply in their language
• Support everything with simple facts
• Present in a progressive way and not in a way which suggests blame/inadequacy
• Accompany these with a simple question to allow them to come up ideas which fit the framework.

Thanks for reading, I hope this provokes some positive reflection and future action, for you and others ahead.

If you liked this, please share it and/or drop my a DM, it would be massively appreciated.

Dave