Sports Medicine Broadcast
Soccer Specific RTP with Tyler Knight
Tyler Knight shares some Soccer Specific Return To Play or RTP tips and tricks. With nearly a decade of soccer experience, he has seen a lot of growth in sport-specific rehab plans.
What is the least soccer specific rehab exercise you have seen?
- Almost everything we do…discuss the importance of understanding the ‘why’ of what we do, as well as never forgetting components of movement.
- Isometrics because the patient can’t perform much more
- Eccentrics once able
- Stretch-shortening cycle
- Unloaded → supported → unsupported
“Train movement not muscles”
What do we need to consider in on-field RTP?
- In order to get to the field, you have to get out of the Athletic Training room first.
- Treat the person, not the athlete or the injury (reference all that people have going on in their lives). Ron Corson-ism
- Good communication, setting expectations, and appropriate planning are MUSTs.
- Individualization (based on person, position, and injury)
- Consider our two biggest protective capacities and build upon those early: strength and endurance
- Consider our two biggest protective capacities and build upon those early: strength and endurance
- Programming based upon working zones (importance of ESD)
- Quantifying internal vs. external load
- Individualization (based on person, position, and injury)
- To do that, we have a few basic rules at Charlotte FC:
1. Create a safe environment.
2. Don’t hurt the person.
3. Be aggressive without breaking rules 1 and 2.
- KPIs to provide direction and accountability to the process
- Additional principles of rehab to accelerate and enhance what we do on the field:
- Move early, move often.
- Highlight BFR and isometrics.
- Highlight BFR and isometrics.
- Don’t mess it up.
- Consider tissue healing times.
- Periodize manual therapies, incorporate things the person believes in
- Periodize manual therapies, incorporate things the person believes in
- Break down the phases of healing (acute, subacute, remodeling), as well as the places of healing: table, Athletic Training room, gym, field, and everything in between.
- Create time for mental or psychological recovery
- Move early, move often.
- KPIs
- Mobility
- Stability
- Function
- Power
- Mobility
- On-Field
- Consider position, individual needs, team tactics, and demands of the sport…and MAKE IT FUN
- Players have the ball only 3% of the time, a good reason to emphasize the incorporation of the ball and fitness/drill exercises that place focus on getting into the right spaces
- In 2019/2020 EPL season, the highest average number of passes per game was 688 (Man City; approx 62. per player) and the least was Burnley at 333 (approx. 30 per player).
- Paul Bradley research
- Players have the ball only 3% of the time, a good reason to emphasize the incorporation of the ball and fitness/drill exercises that place focus on getting into the right spaces
- Consider control – chaos continuum
- Reverse engineer and use the prospective loading document
- When we have elevated AC ratios, did the majority of that come from a more controlled environment or chaotic environment
- By using fatigue, you can increase chaos (for those athletes limited in what they can perform)
- Reverse engineer and use the prospective loading document
- How are you going to account for one of the most unique facts of the game: limited substitutions and, potentially like many other sports, the pace of the game is only increasing
- Actual loading
- Link load with the context of how it happens in a session/match
- TD, HSR, sprint, ACC/DEC, HMLD or explosive efforts
- Intensive vs. extensive days (can you match what the player is doing with you to what the team is doing; team schedule, RPExduration)
- Density of high intensity actions (repeated sprint ability and repeated high intensity efforts in 1, 3, and 5 min blocks)
- Link load with the context of how it happens in a session/match
- Consider position, individual needs, team tactics, and demands of the sport…and MAKE IT FUN
- “It takes a village.” Educate, incorporate, and empower those around you. If we all understand the why, we will know how to do it, and what we need to use to get there. Trust is a major factor here.
- Create a PowerPoint document, have illustrations, don’t be afraid to do the math ahead of time, use a stopwatch.
Let’s talk through a RTP plan you use and why:
- The war is won and lost in the mind
- Briefly recap where we are and where we’re going
- What can we do to prepare, potentiate, desensitize, or address other movement qualities before we hit the pitch; build time and trust with people
- Briefly recap where we are and where we’re going
- Individualization:
- Needs assessment to construct rehab or movement plan:
- Current injury
- Previous hx of injury
- Quality of movement (identify areas to fine-tune)
- Training history (gym)
- Current injury
- Movement and ability restoration
- Major proponent of push-pull movements or complex training (plyo-like), also appreciate avenues to incorporate lumbopelvic hip stability (core transferring F)
- Major proponent of push-pull movements or complex training (plyo-like), also appreciate avenues to incorporate lumbopelvic hip stability (core transferring F)
- External load
- Average weekly load in training
- Average match load
- These are BUDGETS, it’s science AND art
- If they aren’t close to being on the field, what are we going to do to reduce that gap (RPE x duration; off legs conditioning, gym, etc.)
- Average weekly load in training
- Needs assessment to construct rehab or movement plan:
- On-Field
- 4 levels
- 1: high control
- Band 1 ACC/DEC, no HSR/sprint
- Band 1 ACC/DEC, no HSR/sprint
- 2: medium control
- Band 2 ACC/DEC, add HSR, no sprint
- Band 2 ACC/DEC, add HSR, no sprint
- 3: low control to low chaos
- Band 3 ACC/DEC; add sprint
- Band 3 ACC/DEC; add sprint
- 4: medium to high chaos
- Add density to exposures
- Add density to exposures
- 1: high control
- Drill selection
- Technical
- Tactical/passing
- Position specific
- **all interspersed with position specific running**
- MAS, ASR, or loading focused
- MAS, ASR, or loading focused
- Technical
- 4 levels
- How can we get players out of rehab the same care and joy others get from playing the game
- Revisit the plan often to show progress
- Change the setting
- Make it fun, do what you can with them
- Revisit the plan often to show progress
- Week
- Monday: introductory day
- Tuesday: small to medium space
- Wednesday: large space
- Thursday: treatment only
- Friday: small to medium space day, slightly more than re-intro
- Saturday: super-Saturday
- Sunday: OFF
- Monday: introductory day
Contact Us:
Tyler – tknightatc@gmail.com
Jeremy – @MrJeremyJackson
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