A Speed-Based Approach to Soft Tissue Rehab –

Different ways to implement speed into your rehab training

“Rehab is an opportunity to get better” – This catchy phrase holds true in many regards. Let me show you a few concepts, that are certainly not new but I rarely see implemented in soft tissue rehabilitation.

In my daily work with professional athletes I have found that there is quite a big gap between what is happening on the physio bed in terms of rehab and what the athlete needs in order to return to competition while minimizing the risk of re-injury. There is a lack of exposure to high speed movements in rehab.

 The reasons for this gap are diverse but I believe that next to time and location constraints, many practitioners are afraid to make mistakes when getting athletes ready to return to the field or the track. Maybe some don’t know better.

If any of them would be asked if they think that a sprinter can safely return to full training without actually moving at high speeds prior to being medically cleared, most of them would certainly answer “No!” - I would agree.

Now this blog post is not meant to bash any practitioners, so instead I will show you some concepts that can help to return athletes safely and well-prepared to their respective sport if that sport involves some kind of fast running.

 The Short-to-Long-Approach

This concept is as simple as it sounds, start short and progress to longer distances. But what does it mean exactly?

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By restricting the distance, we can manipulate the intensity of the movement, while still working with high intent.

If an athlete can get back to running at 95-100% intent over 5 meters early throughout the rehab (i.e. week 1-2 during hamstring rehab), this presents several benefits:

1.     Boosting the athlete’s confidence

2.     Actually training speed

3.     Minimizing decrease in performance measures

4.     Great screening tool

5.     Minimizing muscle atrophy

If you have seen the graphic above, you most likely noticed that the increase in intensity does not happen linearly. Especially looking at the first 5m and realizing that athletes reach roughly 60% of their maxV in such a short distance, is important to understand when looking for speed exposure in rehab.

Practically speaking I like to make sure that the run doesn’t end right after reaching 5 meters, instead I choose to let athletes run for 30-40m each run, limiting the acceleration distance to 5m (progressing to 10m,15m etc. over time), thus managing the running speed and intensity. Once they hit the targeted acceleration distance, I am asking them to float and maintain speed, rather than continuing to accelerate – this is a very important aspect.

Make sure to keep the overall volume low, 2-4 reps can do the job.

Use these accelerations as a movement screen. It’s harder to hide movement deficiencies at higher speeds and intents.

Limiting Range of Motion (ROM) through Dribbles

This concept should be well known for progressing strength exercises like the Romanian Deadlift by restricting ROM with the help of blocks, lowering the restriction over time, allowing for larger ranges of motion.

It’s also not new in terms of speed training during rehab but I rarely see it being implemented into rehab programs.

An easy way to introduce athletes to upright sprinting are “dribbles”.

The varieties of dribbles are endless, before I will dive deeper into the practical application it is important to know the three basic categories of dribbles.

1.     Ankle Dribbles

2.     Shin/ Calf Dribbles

3.     Knee Dribbles

These categories differ in ranges of motion limiting amplitude, impact and speed and can be introduced as early as week 2 for hamstring rehabilitation, pretty much as soon as the athlete can walk pain free.

The main benefits of dribbles to me are:

1.     Building athlete’s confidence

2.     Similar posture to maxV running

3.     Neurally very similar to maxV running

4.     Great screening tool

5.     Less demanding than actual sprinting

Here’s I how you can implement and progress dribbles

As mentioned, you can start implementing ankle dribbles as early as week 2, depending on the grade of the soft tissue injury. If the athlete’s awareness is low and you can spot major deficiencies, you can safely progress to Shin and even Knee Dribbles.

You will notice that the bigger the ROM, the closer the athlete will get to completing a proper sprint stride, that’s exactly the point. Make sure to extend the distance according to the movement progression. Ankle Dribbles will need less space while knee dribbles will take up to 30m to properly execute and get up to speed.

I mentioned that the varieties are endless, however I will list a few versions that I like to use during rehab or active recovery days.

A.    Flying Dribbles – 5-10m jogging approach + 20m high frequency dribbles

B.    Dribble Bleed – Progress from ankle to knee dribble into a sprint (ca. 30m dribbling + 10-20m sprinting)

C.   Flying Dribbles + Run-Off – 10m jogging approach +20m high frequency dribbles + 10-20m Run-Off (Sprint)

Unlike accelerations, dribbles are great for developing tissue tolerance through conditioning. A great example is the 10/30 Protocol as used by overall good guy and Rehab Expert Alan Murdoch (@elevate_speed_rehab)

Here the athlete is asked to complete 10 reps of 30m dribbles with walk back rest.

I hope this article was able to give a better understanding of how to properly (and easily) implement speed training early on into a well-structured rehab program. Speed is certainly not everything, but it is crucial when wanting to safely return athletes to sports like soccer, football, field hockey, track& field etc.

Please contact me either through e-mail: eric.franke@live.com or on Instagram @b.eric if you have any questions or want to discuss some concepts further.