Return to Play
June 02, 2018
By Alexander Germanis
There are numerous terms indicating a return to a normal state of things after a setback: to rebound, bounce back, pick up, recover. Is it any coincidence that these are all sports terms as well?
The athletic mentality of regaining a positive position is the exact same school of thought physical therapists have when it comes to helping an athlete get back to their field of play after suffering an injury or undergoing necessary surgery.
“This is somewhat of a new thing,” says Bryan Jasker, PT, DPT, Director of Rehabilitative Services at McLean County Orthopedics. A former collegiate football player holding a clinical doctorate in physical therapy from Northwestern University, Bryan has extensive experience with sports injuries both on and off the field.
“Historically, there has not been a lot of formal sports medicine or return-to-play programs,” he shares. “Recognizing the need for this, we’ve developed that post-operative reconstruction return-to-play program.” As it generally takes about seven months from surgery until an athlete is back on their respective field of play, he adds, it’s important to have this type of program.
“Traditionally, there are general protocols and guidelines from a rehab standpoint,” Bryan explains. “But historically, physical therapy would only go on for so long and at some point, the athlete is discharged and goes off into some personal training or coaching or gradual activity pattern that wasn’t really structured or monitored, and then come back to the physician for a return-to-play blessing, so to speak.”
Outlined simply, an athlete went from surgery to hospital rehab, then to an outpatient orthopedic center, to an eventual release to full return to play. “What we’ve done here at MCO is to coordinate with our other partners within the center to provide seamless transitions,” Bryan says. “We’re not wasting time; every decision is based on objective data on how to transition an athlete outside of the rehab process and into a performance environment. That piece is ongoing with weekly interdisciplinary meetings between the personal trainers, coaches, and rehab staff, along with updating the orthopedics — the medical team.”
Even with the efficiency of the departmental transitions, there is still a major component of establishing the best return-to-play program and that was by identifying the key transition points of an athlete’s recovery. The process begins with managing post-surgical trauma. “Tissue needs to heal,” Bryan states. “So, we have to ask: how are we supporting that healing process and also developing and recovering mobility and function?”
From there, the return-to-play team investigates how the athlete’s muscles are communicating with the nervous system, how to minimize the side effects of surgery, and then taking them toward recovering range of motion and normal muscle activity, and finally on into sports-specific movements. “All of those pieces tie in to how we recover you as an athlete and then recover your function as a specific athlete,” Bryan sums up.
The objective data used to establish those key transition points comes from applying the latest technology in the field of physical therapy. “How do we know when people are really ready to go from different weight-bearing environments, different loads?” Bryan asks.
In their kinematics lab, function movement screens, force plate analysis, and 3D motion analysis are used to determine when the athlete is at those transition points. “We also include the Method Sports Performance CRA (Cellular Respiration Analytics) concept early on in order to create some guidelines on how to best facilitate healing,” Bryan adds.
“While trying to highlight patient safety we also want to keep them on the path that is most efficient and most effective,” he concludes. “Our goal is to do our best with observation, data collection, and communication with the athletes and their parents before deciding for them to return to play without restrictions.”
Next month: More on how physical therapy can help patients return to work and life.
For more information on Physical Therapy, Return to Play, or any type of orthopedic problem or injury, contact McLean County Orthopedics, 309-663-6461 or visit them online at www.McleanCountyOrthopedics.com. Their new office is located at 1111 Trinity Lane in Bloomington.
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