Change of direction was incorporated into intermittent dribbling lanes while slightly increasing linear running velocities to achieve lower threshold HSR (‘zone 5’ between 5.5 ms −1 and 7 ms −1). Having set the foundation, the aim of this stage was to reduce task and environmental constraints, 10 while progressively increasing explosive distance. Moderate control: weeks 4–6 (24–26 weeks post-injury) Ex, extensive session example, RAMPs, raise elevate heart rate, Activate, activate key muscles groups involved in activity, Mobilise=mobilise key joints involved during activity, Potentiate=potentiate the neuromuscular system for activity, Specific=relevance of other acronyms in relation to the players actual sport/specific training session type n, number of sessions within each phase. TD, total distance HSR, high-speed running (>5.5 ms − 1), SPR, sprint distance (>7 ms − 1), Exp-D, explosive distance (accelerating/decelerating from 2 to 4 ms − 185% Max HR), **=gameload adjustable dependent on injury specificity/severity, SSG, small-sided games, ‘realistic’=real-life representation of the volumes (distances/durations) the player is exposed to during training/match-play. Model can be adjusted specific to injury diagnosis, estimated tissue healing times and expected return to training. Green represents high control (low intensity) moving towards high chaos (high intensity). ![]() Chaos=behaviour/actions/movement that is unpredictable as to appear random/reactive, that is, chaotic situation. Control=high influence on behaviour/actions/movement, that is, controlled situation. of sessions, technical qualities and actual session running load targets (upper, lower and actual values). BFR, blood flow restriction Con, concentric CSA, cross-sectional area CT, contact time Early, early rehabilitation phase DB, dumbbells DL, double leg Ecc, eccentric End, end rehabilitation phase hip dom, hip dominant Iso, isometric knee dom, knee dominant, Lat, lateral MB, medicine ball Med, medial MVC, maximal voluntary contraction Novel, novel load, providing a novel stimulus for bone remodelling PR, passive recovery reps, repetitions s, seconds SL, single-leg SSC, stretch-shortening cycle STR, strength >, progression.Įxample ‘control-chaos continuum’ phase progression content including conditioning emphasis, no. (C) Progression of dynamic strength exercise selection. Moving from slow SSC and in-place to fast SSC, dynamic activities. (B) Progression of jump-landing exercise selection. Overcoming=pushing/pulling against an immovable object, Yielding=holding a weight, and preventing it from moving (fixed position) that is, resistance to deformity. (A) Progression of isometric strength exercise selection. 4Įxercise selection following a tibia-fibula fracture. The qualitative aspects of movement in competition were also considered progressive variable, spontaneous and unanticipated movements, (the conditions of chaos) reflecting the unpredictable nature of sport. Using the ‘control-chaos continuum’ as a framework for RTS, 4 the goal was to return the player to pre-injury running loads using global positioning systems (GPS). ![]() In this video-supported viewpoint, we outline the on-pitch/sport-specific rehabilitation of an English Premier League footballer who suffered an open fracture of the distal tibia-fibula just above the ankle joint following an opponent’s poorly timed kick ( figure 1A). Currently, limited information exists describing the rehabilitation and the Return to Sport (RTS) following traumatic fractures (commonly to the tibia, fibula or a combination of both). While non-contact lower limb injuries are common in elite football, 1 contact from poorly timed kicks or tackles can result in severe injuries such as traumatic fracture. 10 Simon Bolivar University, Barranquilla, Colombia. ![]() 9 University of Santander (UDES), Bucaramanga, Colombia.8 Trauma and Orthopaedic Department, Aintree University Hospitals NHS Foundation Trust, Liverpool, UK.7 Medical Department, Everton Football Club, Liverpool, UK.5 Sports Surgery Clinic, Dublin, Ireland.4 Arsenal Performance and Research Team, Arsenal Football Club, London, UK.3 Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.2 School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK.1 Performance Department, Everton Football Club, Liverpool, UK.
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