In this blog I will aim to outline a pragmatic and in-depth approach to rehab programming in active populations. My hope is that this will act as a guide for physiotherapists and other rehab professionals to direct clinical reasoning throughout the rehab journey. I will outline what we need to see in each phase of rehab to ensure we can accurately assess functional capacity and mitigate risk to the patient while they are still training. This will also allow us to communicate the important things that stakeholders (athlete, coach, S&C) actually want / need to know or do. For a more thorough look at the S&C coaches perspective on rehab, see here (1).
I believe the physiotherapy model actually outperforms the traditional S&C model in its approach to clinical reasoning in rehab. Physiotherapy uses a session to session approach, with constant assessments to dictate exercise prescription (bottom up approach). S&C commonly use a periodisation approach (top down approach). Top down approaches break training into set blocks of time that progressively build into the next set block (2). Doing things the more “physio way” with rehab allows you to adjust your programming on a session by session basis along the continuum I will outline below. This can help avoid situations of conflict with stakeholders, when things don’t go exactly to a pre-planned program.