Topic 07

Sports rehabilitation

If an area injured during sports keeps hurting, or your performance isn't the same after returning, your movement patterns may not have recovered even though the pain is gone. Sports rehabilitation generally assesses movement and sport-specific actions, progresses in stages, and returns to sport after return criteria are met. An accurate assessment should come from a qualified healthcare professional.

Do you have these symptoms?

You keep injuring the same area
It hurts only during or after exercise
There is no pain, but movements aren't as smooth as before
After the neck was bent sideways, the arm briefly tingled and went weak
After returning, the knee feels unstable when changing direction or jumping

A previous injury is known to be one of the main risk factors for injury. Movement can be poor even without pain, and movement can be good even with pain.

Causes and understanding

Movement pattern problems: If basic movement has flaws, the skills and strength built on top of it also carry injury risk. That said, good movement does not guarantee injury prevention; strength, endurance, and coordination also play a role.
Pain is an alarm signal: Pain signals inflammation or problems with alignment or muscle control. Masking the pain leaves the cause in place.
Shoulder: Impingement and instability in weight training, swimming, and throwing sports
Knee: Cruciate ligament injuries when changing direction or landing, collateral ligament injuries on contact, meniscus injuries with rotation. Patellar tendinitis in basketball, volleyball, and soccer
Neck, low back, and hip: Neck nerve injuries (burners) in contact sports, spinal stress fractures in sports with repeated back bending, and hip stress fractures in running and ballet

Assessment from a chiropractic perspective

Movement pattern testsThe 7 movements of the Functional Movement Screen (FMS) are commonly used. If there is pain, the principle is to stop screening and move to clinical assessment.
Region-specific testsAssessment typically includes orthopedic tests for the shoulder, knee, neck, and low back.
Functional testsFunctional tests such as single-leg hops are used to look at left-right differences.

How it's managed

1. Acute phasePain and swelling management, relative rest, and movement within a pain-free range are generally recommended.

2. StabilizationCore stabilization exercises, including the abdominals, pelvic floor, and diaphragm, are used.

3. Sensory & balanceJoint position sense training and balance board exercises are used.

4. Functional strengtheningAdding strength training once flexibility has recovered is the usual order.

5. ReturnA gradual return after confirming no pain, normal movement, and passing functional tests is the general criterion. Recovery time depends on the extent of the injury and the individual.

Exercise within a pain-free range, and stop if pain starts.

When to see a doctor first

A suspected fracture
Headache, dizziness, vomiting, or changes in consciousness after a head injury
Arm symptoms after a neck injury that last more than 24 hours or appear on both sides
A suspected cruciate ligament tear or locked knee → orthopedic specialist
A suspected spinal stress fracture → orthopedic specialist

Related columns

Field notesNo Pain, All Healed? What to Check Before You Return to Sport

Coming soonWhy you keep injuring the same spot: movement screening

Coming soonFrom a knee ligament injury back to running

Coming soonIf your arm tingled after your neck was bent

This article is for general health information. Everyone's condition is different, so an accurate assessment requires consulting a professional.