How to find the right sports medicine professional for return to sport.

Contributed by Dr. Jon Herting, PT, DPT, CSCS, HF/S

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If you are reading this blog you may already know that not all rehab professionals, physicians or strength coaches are created equal and this begins with the life experiences and education that each of us have been subjected to.

As sport medicine professionals we all have separate but equally influential life experiences that shape how we practice.

If you have followed us on twitter and read our past blogs you know that the number 1 predictor of future injury is past injury, so not only is the return to sport rehab process about ensuring pain free range of motion and maximum strength, but it is also about ensuring proper neuromuscular control patterns and muscle endurance to promote good body mechanics during random and unpredictable sporting events.

When seeking out qualified individuals to manage your return to sport progressions you should seek out individuals who have experience dealing with athletes. Some designations and certifications to look for in each field are as follows:

Physicians

-MD  or DO – these are essential to being able to practice as a physician

-Board Certification

-Specialties – Most physician’s have specific interests and specialties. Find a physician with a sports medicine focus and an interest in treating your particular injury.

board_certification1

 

Therapists

-SCS (Sports Certified Specialist)

-OCS (Orthopedic Certified Specialist)

-NSCA-CSCS

-NASM-CES or PES

-ACSM – Health Fitness Specialist

Strength Coach/Personal Trainer

-SCCC (Collegiate Strength and Conditioning Coaches Association (CSCCa))

-MSCC (Collegiate Strength and Conditioning Coaches Association (CSCCa))

-NSCA- CSCS

-NASM-CES or PES

-ACSM – Health Fitness Specialist

It is important to note however that there are numerous certifications not listed in each of these fields. This is a short list of some of the most respected certifications. It is also very important to recognize that certifications do not always equal competence and you should do your due diligence in asking physicians, therapists and trainers what type of continuing education course they have taken. This will help you to determine which professionals will best be able to coordinate your athlete’s plan of care. You may also ask other athletes and their parents about who they may have used to rehab their past injuries and how they felt their rehab professional prepared them for return to sport.

When seeking out individuals who may have experience training and rehabilitating athletes there are specific questions that you should ask in order to ensure the best standard of care and optimal return to sport; while preventing future injury.

Below are 5 questions you should ask each specialty to ensure success for your athlete. By no means is this an all-encompassing list.

questions

 

When choosing a sports medicine physician you should ask:

-What is the overall plan for safe return to sport?

-What type of outcome can I expect?

-Do you have therapists and strength coaches/personal trainers that you are familiar with and comfortable making referrals to?

-When can I expect to return to practice and then full competition?

-Will you communicate regularly with the other healthcare professionals in the continuum of care to ensure you are all on the same page regarding my recovery and return to sport?

 

When choosing a therapist some questions to ask are as follows:

-What experience have you had rehabbing this type of injury to prepare them for return to sport?

- What have your outcomes been when rehabilitating this type of injury?

-Do you work with this level/age of athlete regularly?

-What philosophy do you subscribe to when rehabilitating an athlete?

-Do you have strength coaches/personal trainers that you are familiar and comfortable with to continue the athletes’ progression toward return to sport upon discharge?

 

When choosing a strength coach you should ask these questions:

-Do you individualize each athlete’s program and how do you assess individual strengths and weaknesses?

-Are you familiar with the injury and specific protocols that may need to be followed?

-Have you worked with this type of injury and athlete in the past?

-What philosophies do you subscribe to when rehabbing an athlete?

-Do you have references?

The most important question that you should ask each individual is what is their plan to properly progress you toward return to sport?  Every profession as part of the continuity of care should be on the same page and have your best interest at the forefront of the process. Each medical professional should regularly update each other on your progress to ensure optimal and expedient recovery.

When progressing through the rehab process it is important to remember that the only thing that can replicate game speed and game conditions is actually playing in a game; though this does not mean that you should immediately transition from squatting or controlled running in rehab to running, cutting and jumping in a game under random and unpredictable conditions. The proper evidence based progressions should be followed to properly prepare for you return to sport and prevent future injury.

In doing your research you may find that some physical therapy and strength and conditioning facilities offer programs to ease the transition between the two. There is only so much that can be replicated in the rehab setting and a properly set up program between a therapist and knowledgeable strength coach may help to further bridge the gap between injury and return to sport.  right-running-pace

It is important to note that each athlete will progress at their own pace and if your athlete does not progress as expected it may not necessarily be someone’s fault. Asking the above questions will ensure that you pick the right individuals to guide your athlete through a comprehensive and individualized program.

Consider yourself more educated than the average “consumer” at this point as we often do not realize that there is a choice when it comes to choosing physicians, therapists and strength coaches. Though insurance may dictate these choices to a degree sometimes it is worth shelling out the extra money short term to prevent future injury or further complications.

Physicians, strength coaches/personal trainers and physicians please share with your athletes and feel free to add anything below in the comments section.

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