Module 3: Motor Learning - Return to Sport
The decision of when an injured athlete can return to sport is difficult and challenging one. Despite the development of return to sports (RTS) guidelines, there are still more questions than answers regarding specific criteria. In various publications, return to sport is considered a continuum. In reality, we first have to take a step back to the moment of the injury before we actually start talking about RTS.
In the acute phase, for example after ACL reconstruction, it may be useful for patients to use a motor program aimed at protecting the knee by taking small steps, reducing the range of motion of the knee and limiting the load on the operated leg. This strategy also keeps the pain within acceptable limits and can therefore be seen as meaningful. Gradually, one would expect that improvement and restoration of movement patterns occurs. However, that is often not the case. An ACL injury, in addition to being a biomechanical lesion of the knee, can also be considered a central neurophysiological lesion.
This is the opportunity to implement motor learning in the rehabilitation of the patient. The aim is to achieve optimal neuroplasticity. The principles are applied in the pre-habilitation from the onset of the injury. After the operation, additional principles are worked on, contingent on the basis of time and criteria. The importance is that direct relationships were found between abnormal movement patterns at the beginning of rehabilitation and later performed RTS tests. Therefore, it is important to ensure optimal recovery from exercise from the start of the rehabilitation.
During this course, we will critically assess the current RTS after ACL reconstruction. Possibilities for optimization based on current trends in the literature are presented. The students work out a case in groups and present this. Special attention is given to neuroplasticity and how to facilitate this with principles of motor learning. In addition, we will discuss indicators for the psychological willingness of the athlete with regard to RTS and the role of the physiotherapist within a multi-disciplinary shared decision making process.
At the end of the course:
- You have gained insight that RTS is a continuum instead of a fixed moment in time
- You will be familiarized with an extensive spectrum of sensorimotor and biomechanical assessments required for RTS decision making
- You will be able to recognize the psychological willingness of the athlete for RTS
- You have insight about your contribution to RTS decision making