Today, I was in my NHS clinic and saw one of my patients in the review clinic. What happens here is I review the progress a patient is making with them present. So this patient a 32 year old female netball player had sprained her ankle about 3 months ago, although the symptoms had resolved a lot over this period there still remained some tenderness around the ligaments at the front of the ankle. I tested the muscles adjacent the ankle for their strength. They were weak as might be expected because of the ongoing pain. I told her that we would need to create a programme for her to target these muscles. Then , it suddenly dawned on me that if she was weak there, where else might she be weak, so I then proceeded to test the quadriceps and gluteal muscles for strength. The relevance of these muscles is that they are are important anti gravity muscles involved in walking , standing and jumping "the activities needed for netball" and Guess what they were all weak!
32 year old female netball player had sprained her ankle about 3 months ago
I asked her what she did in the gym and she explained that she had been going to the gym diligently for over 9 months using the bike and doing weights. I gave her a 8kg weight and asked her to do 8 repetitions of a split squat (lunge) slowly. By the time she had done 6 reps she needed to stop because of fatigue in her quadriceps.
8kg is not heavy! But for this patient it was clearly too much fo her weak muscles . So if 6 reps was enough to fatigue her in the very simple and controlled environment that I had created ..... she would have no chance in a game of netball where she would need to fend off players , jump, hop and decelerate her momentum after landing from jumps until she was strong! So the moral of the story is that you can not expect to perform complex activities safely until you have an effective foundation of strength.
Don't expect to perform complex activities safely until you have an effective foundation of strength.
All to often patients want to return to their sport or their preferred physical training activity before they have a baseline of strength , hoping that the activity or sport will get them strong again. This is mis-guided and often leads to re-injury because they have built a foundation on sticks or just not built one at all.
Don't, rush back to sport... Strength First!