Mark Galland, MD, Orthopaedic Surgery and Sports Medicine
Members of the sports medicine team of any busy athletic program face challenges every day. Injuries are always unexpected, but they are not the only hurdle a sports medicine provider must face. One of the most daunting scenarios is an athlete who does not want to participate in his/her current rehabilitation program. Most athletes want to get back onto the field as soon as possible, but this is not always a straightforward or purely “physical” issue.
There are several reasons why athletes decide not to continue with rehab or show lack of motivation: lack of progress, boredom with the routine, or they may feel as if their injury has already put them so far behind that their efforts in rehab are futile for return to play in the current season. Rehabilitation of lost a step” or “I will never be the same” as before the injury. Sometimes they believe the rehab process is pointless - “If I just rest, I’ll be fine in a couple of days.” Inexplicably, in this day and age, some athletes fear that the rehab could predispose to re-injury or worsen the current injury.
It is imperative that the athlete takes ownership of the recovery process. The athletic trainer can be instrumental in guiding and managing this awareness and educating the athlete. The athletic trainer, physical therapist, coaches “cheerleaders” for the athlete until the completion of rehab with return to play. Cheering is not just for the sidelines or game-day anymore: staying positive is the key component in recovery! Here are some techniques to consider:
- Give Encouragement! Some athletes simply need reassurance that they are not alone; that others are supporting their return to health and await their return to play. Also, maximum effort in rehab demonstrates desire and perseverance to the coaching staff. This may result in increased responsibility and playing time upon return.
- Mix Things Up. Avoid the same exercises every day. Provide variety. Routines can change from day to day or week to week.
- Bribes! Offer incentives/punishments. Reward participation and effort. Try anything that is reasonable and likely to achieve the desired result; offer silly Punishments are always easy to devise and can be sport specific; however, be sure that they are fair and more of a motivation than a true punishment.
- Practice Makes Perfect. Incorporate rehab with athletic practice; assign exercises that can be done at the field or in the gym with the team. Coaches are usually accommodating with this plan as this also prevents the athlete from getting behind in learning new plays.
- All For One! If many athletes from the same team are injured, schedule their rehab together. Teammates have a tendency to motivate one another.
- Play Ball! Plan sport-specific exercises. Example: a basketball player with weak quads can do wall squats with a basketball between his/her knees. This keeps them in contact with the sport even if they can not actually participate.
Consider how far to push individual athletes. Some injuries allow for more aggressive rehab than others. Listen carefully to their concerns and needs. Athletes and athletic trainers need to make sure they are on the same page. Always try to keep things exciting and new. Creativity and motivation can go a long way in aiding recovery.
The author would like to acknowledge Mandy Ryan, MS, ATC/LAT co-author of this article. Mandy is an athletic trainer specializing in injury prevention and pre-injury education.
Dr. Mark Galland is a Board Certified Orthopaedic Surgeon specializing in sports medicine, practicing in Wake Forest and North Raleigh. He serves as team physician and orthopaedic consultant to the Carolina Mudcats, AA Affiliate of the Cincinnati Reds of Major League Baseball, as well as several area high schools and colleges. Dr. Galland can be reached at (919) 562-9410 or by visiting www.orthonc.com or www.drmarkgalland.com.
Photo Caption: Trea Jones, a top-rated running back at Wake Forest-Rolesville High School, broke his ankle during the playoffs last season. He recovered from this potentially devastating injury and is currently listed on the roster of the University of Colorado football team (Photo by www.michaelmcloone.com).
