One question I have is what is the line with corrective exercise? I think every athlete should do a little self care, and some coaches can sprinkle in therapeutic exercise, but we need to have limits. I like some of what Dean says, but he is not a podiatrist and some of his statements are not valid. The posterior tib is important, but it’s a strip of bacon and can’t fix structures that are frankly are designed differently. Similar to lordosis with athletes with lumbar structures that increase anterior tilt, you can only do so much stretching and core work. Track warm-ups need to look like exercise, not rehab. Otherwise finish your rehab and comeback or do something light until you are ready to train. It’s ok to do a few week of light running and circuit work to stay fit while doing rehab, so one doesn’t need to have the little quick fixes of activation and mobility tricks to keep going. Park the ferrari in the garage and get repaired.
I have been blessed and cursed by soft tissue therapist cleaning up my mistakes. Since the errors were small, I didn’t notice the patterns of overload or restriction, and the athletes felt good overall. Now with documentation I can better see what is too much and what is not executed right. I am halfway there, since it takes decades to see what is going on. Many, assume they have cracked the code and can see things with warm-ups and movement screens but the body is so complicated we need to be humble. I have seen world champion athletes in track and field get rehabbed by the best, and when the best fail and athletes go elsewhere with success, it shows that we are human. No way can youtube do everything since experience can’t be summarized in a few minutes. Here are some things I feel strongly about.
The average athlete in track and field can improve 1-3% per year if they improve at all. Trying to do too much backfires. It has taken me 15 years to be patient, and now I may be too conservative, but at least I know the spectrum. The issues I have is that 98% attendance healthy with a simple program beats the Super Dynamo Russian Block Phase periodization program. Medical Maximum. Creativity is needed to challenge the body without creating injury. We all know that. I think we need to collaborate more about this.
Assessments need to be more complete. How many times do we see therapists seeing something and after six weeks it doesn’t hold up? Then unfortunately a change of coaching (with a change in medical support) finds out the problems are deeper and more specific. Jumping the gun happens more than just the short sprints, we are plagued by confirmation bias.
Successful therapy is defined by no limitations in training and no lingering problems. Otherwise what can we say here? Constantly doing self fix therapy or stuff to keep going is not successful, it’s just pain management. This is very hard to do when athletes are competing and want to get back, but an injury that is 4 weeks should maximize the 4 weeks and not rush back too soon.