Beyond Outputs: Improve Confidence in Return to Sport
Returning to Sport from Athlete Perspective
Returning to sport after an injury involves a multifaceted approach that addresses both physical and cognitive components. For many athletes, the transition back to sport after an injury can feel overwhelming. This apprehension surrounding returning to gameplay highlights a key opportunity for physical therapists and performance coaches to intervene and close the gap between rehabilitation, training, and the actual game.
In order to return to the field, physical outputs, such as strength, power, speed, range of motion requirements, and work capacity are prerequisites to reintroduction to sport. However, these physical outputs require top-down control to be effectively implemented on the field. Cognitive components like motivation, confidence, reactions, and decision-making have a direct effect on how athleticism is expressed by athletes. Clinicians often focus on physical outputs, but cognitive components are crucial for a holistic approach to team sport performance, as emphasized by Fergus Connolly in “Game Changers.”
Determining Limiting Factors in Returning to Performance
Injuries can be attributed to various factors, which can be identified through comprehensive testing. These factors may include:
Perception of Environment: How an athlete perceives their surroundings can influence their reactions and decision-making processes.
Deficit in Output: Physical deficits, such as strength, speed or power, can also contribute to injuries.
Output Prerequisites
To ensure a successful return to sport, athletes must meet certain physical output prerequisites as determined relative to their specific injury. These might include:
Force: Strength relative to body weight is critical.
Reactive Strength Index (RSI): Measures explosive strength.
Max Deceleration: Tests like the 5-0-5, T drill and 5-10-5 assess an athlete’s ability to decelerate quickly.
Testing and Training Methods
Hop Testing: Evaluates lower limb strength and stability.
Multidirectional Jumping: Assesses an athlete’s ability to generate force in different directions.
Change of Direction (COD): Understanding the difference between COD mechanics and reactive agility mechanics is vital for developing targeted training programs. COD capacity provides the base for reactive agility later.
Addressing physical outputs within return to sport (RTS) requires a thorough needs analysis, considering the athlete’s injury history, current training and rehabilitation status, unique strengths, and pain experience. Targeted training should address specific deficiencies, with objective testing to ensure improvements.
Applying Physical Outputs to Sport Specific Environments
Understanding the OODA Loop (Observe, Orient, Decide, Act) provides us with the process by which athletes process information and react in real-time. Physical capacity is a prerequisite for effective skill execution, with objective metrics described above being crucial for peak on-field performance. The OODA loop is certainly an over-simplified model, but it provides a simple framework for analyzing on-field decisions and performance.
OODA in Detail
The OODA Loop, developed by military strategist John Boyd, is a decision-making framework that stands for Observe, Orient, Decide, and Act. It is particularly useful in dynamic and fast-paced environments, such as sports. Here’s a detailed look at each step:
Observe: In this initial phase, the athlete collects all relevant sensory information from their environment. This includes visual cues, auditory signals, and any other pertinent sensory stimuli. The goal is to maintain situational awareness, understanding the current state of play, the positions of teammates and opponents, and any other factors that might influence skill execution.
Orient: Once situational awareness is established, the athlete must process and interpret it. This involves assessing the data in the context of biopsychosocial factors, which include the athlete’s physical condition, psychological state, and social environment. Tactical reasoning also plays a crucial role here, as the athlete must understand the strategic implications of the observed stimuli. This step is about making sense of sensory stimuli and determining its relevance to the current situation.
Decide: Based on the orientation phase, the athlete then decides on the best course of action. This involves selecting the appropriate technical skill. The decision must be quick and efficient, taking into account the athlete’s capabilities, the demands of the situation, and the potential outcomes of different actions. The goal is to choose the action that maximizes the chances of success.
Act: The athlete must execute the chosen skill. This step requires precision, coordination, and confidence. The execution phase is where the athlete’s physical and technical training comes into play, as they must perform the selected action effectively and efficiently.
Feedback: After executing the action, the athlete must evaluate the outcome and gather feedback. This feedback is crucial for learning and improvement, as it helps the athlete understand what worked, what didn’t, and why. By analyzing the results and incorporating this feedback into future observations and decisions, the athlete can continuously refine their skills and decision-making processes.
By applying the OODA Loop, athletes can enhance their ability to make quick, effective decisions in chaotic environments, ultimately improving their performance and confidence in return to sport scenarios. In our job as sport physical therapists, we aim to set our athletes up for success. By incorporating elements of the OODA loop, we are able to develop an athlete’s ability to make effective decisions on the field and streamline their reintegration back into their team/organization. How do we do this practically?
Programming Progressions for RTS
As an athlete gets closer to returning to sport, the therapist and/or performance coach should focus on manipulating variables to increase cognitive load and challenge the athlete to perform in game-like scenarios. Each of these 3 variables exists on a spectrum that allows a therapist/coach to adjust the demand based on the athlete’s needs analysis.
Task Representativeness: Transitioning from structured drills (order) to more chaotic, game-like scenarios (chaos).
Planned: These are drills where the athlete’s path is fully mapped out. They know exactly what moves they are making.
Semi-Planned: Adding multiple choices or reactions to planned drills allow athletes to get more comfortable with uncertainty and expressing their athleticism within game contexts.
Unplanned: This is the progression to game scenarios with the highest level of cognitive. Small-sided games and goal-oriented drills allow for maximum athlete creativity and problem-solving.
Types of Reaction: Training different types of reactions to improve responsiveness and technical skill selection.
Simple Reaction: “Red Light, Green Light”. The most basic type of reaction to introduce low levels of uncertainty into rehab drills. This is like a true-false exam.
Complex Reaction: The athlete should progress to drills where they have multiple options or opportunities to respond to stimuli. This is like a multiple choice exam.
Stroop-type and Game-like Reactions: Stroop reactions (shown below) and game specific stimuli provide the highest cognitive load and force the athlete to be decisive in chaotic situations. This is like an open-ended essay.
Impulse: Creating a greater change of momentum during a reactive drill increases the training stimulus and prepares an athlete for sport environments
Low Impulse: Slow speed, low force, very low intent… Shuffles, jogging, balance drills, light med ball throws
Medium Impulse: Submax speeds, medium intent… Running, Jumps, Hops, Medium intensity med ball throws.
High Impulse: Maximal speed, maximal force, maximal intent… Sprinting, Plyometrics, Game-like reps, competition
There is not a one-size-fits-all protocol for returning each athlete to their sport. It requires the judgment and expertise of the therapist or strength coach in order to develop an effective plan for RTS. This is where having an in-depth needs analysis and understanding the limiting factors of the athlete pays big dividends. By manipulating the variables above to appropriately challenge an athlete, we can bridge the gap from the clinic out to the field.
Preparing athletes to return to the field requires a holistic approach that integrates both physical and cognitive elements. While physical attributes like strength, power, speed, and range of motion are crucial, they must be supported by top-down decision-making and other cognitive factors. Clinicians should address both aspects to ensure comprehensive performance enhancement. By utilizing frameworks like the OODA Loop, therapists/coaches can help to improve athletes’ decision-making and reaction times, leading to better performance and increased confidence in chaotic environments. This integrated approach ensures that athletes are not only physically prepared but also mentally ready to return to their sport.
Written by SPT: Ian Dietrich
Citations:
Connolly, F., & White, P. (2017). Game Changer: The Art of Sports Science. Victory Belt Publishing Inc
Boyd, J. R. “The Essence of Winning and Losing,” Excerpts in presentation format dated August 2010, April 2011, URL: www.dnipogo.org. (OODA image)
Gray, R. (2021). How we learn to move: A revolution in the way we coach & practice sports skills. Independently published.
Josse, C. (2024). The Four-Coactive Model of Player Preparation. SimpliFaster. Retrieved from https://simplifaster.com/articles/four-coactive-model-player-preparation/.
Miller-Dicks, Matt & Davids, Keith & Araujo, Duarte. (2008). Ecological psychology and task representativeness: Implications for the design of perceptual-motor training programmes in sport.
