When we think about Sports Physiotherapy, it is common to associate it with the moment an injury occurs. A painful ankle, a muscle injury, a knee problem that prevents training, or pain that no longer allows someone to compete. However, the role of physiotherapy in sport begins long before an injury occurs and does not end when the pain disappears.
From professional athletes to those who practise sport recreationally, physiotherapy can contribute to safer participation, better recovery, and a progressive return that is appropriate to the demands of each sport.
Prevention does not mean eliminating all injuries
There is no such thing as zero risk in sport. Speed, repetitive movements, contact, fatigue, and the demands of training and competition are all part of sporting activity. Prevention should therefore be understood primarily as risk reduction.
An individualised assessment makes it possible to understand the athlete’s history, previous injuries, strength, mobility, functional capacity, and response to the specific demands of their sport. From there, modifiable factors can be identified and appropriate exercise and preparation strategies can be developed.
Scientific evidence shows that exercise programmes including components such as strength, proprioception, and neuromuscular training can reduce the occurrence of different types of sports injuries. However, there is another essential factor: training load.
Training too little may not prepare the athlete sufficiently. Increasing training demands too much or too quickly can also become a problem. Load management should consider not only the number of training sessions or competitions, but also recovery, fatigue, the competitive context, and the athlete’s individual response.
When an injury occurs, recovery means more than being pain-free
Managing symptoms is important, but the absence of pain does not necessarily mean that an athlete is ready to return to training or competition.
Sports rehabilitation should aim to progressively restore the qualities required by the sport: strength, mobility, control, endurance, speed, power, coordination, and confidence in movement, according to each individual situation.
As the athlete moves closer to returning to sport, it becomes increasingly important for rehabilitation exercises to reflect the real demands of their activity.
A tennis player needs to regain the ability to accelerate, decelerate, change direction, and repeatedly perform sport-specific movements. A football player will face different demands. The same applies to a runner, surfer, or basketball player.
For this reason, rehabilitation should be individualised and focused not only on the injury itself, but also on the person and the sport they want to return to.
Returning to sport is a process, not just a date
“When can I return?” is probably one of the first questions any athlete asks after an injury. The answer does not always depend solely on how much time has passed.
International consensus in Sports Physiotherapy suggests that returning to sport should be viewed as a continuum: first returning to participation, then returning to sport, and finally returning to the desired level of performance.
The decision should take into account physical, clinical, psychological, and sport-specific factors.
This means that being ready to start partial training is different from being ready to compete. And returning to competition does not necessarily mean that the athlete has already regained their previous level of performance.
The coach is also part of the process
An athlete’s health should not be the responsibility of a single professional. The coach understands the demands of training and competition. The physiotherapist understands the recovery process and the athlete’s functional response. Doctors, strength and conditioning professionals, and other healthcare or performance specialists may also play an important role.
At the centre of the process should always be the athlete.
Good communication between everyone involved helps support better decisions: temporarily adapting a training session, managing load progression, understanding when demands can be increased, or determining which steps are necessary before a full return to competition.
Research and international consensus on return to sport strongly support this shared approach involving the athlete, the clinical team, and the coaching and performance team.
Sports Physiotherapy is not only for professional athletes
These principles are not exclusive to elite sport.
Someone who plays tennis twice a week, runs at the weekend, practises padel, football, cycling, or is simply preparing for their first race also has a body that is exposed to training load, recovery, and adaptation.
The level of competition may change. The importance of preparing well, taking care of the body, and recovering properly does not.
At Physioclem, we believe in a Sports Physiotherapy approach that supports people beyond the injury itself: helping them understand their body, restore their capacity and confidence, and continue practising the activities they enjoy.
Because taking care of people who practise sport also means helping them keep moving.
References
Lauersen JB, Bertelsen DM, Andersen LB. The effectiveness of exercise interventions to prevent sports injuries: a systematic review and meta-analysis of randomised controlled trials. Br J Sports Med. 2014;48(11):871-7. doi:10.1136/bjsports-2013-092538.
Soligard T, Schwellnus M, Alonso JM, Bahr R, Clarsen B, Dijkstra HP, et al. How much is too much? Part 1: International Olympic Committee consensus statement on load in sport and risk of injury. Br J Sports Med. 2016;50(17):1030-41. doi:10.1136/bjsports-2016-096581.
Bourdon PC, Cardinale M, Murray A, Gastin P, Kellmann M, Varley MC, et al. Monitoring athlete training loads: consensus statement. Int J Sports Physiol Perform. 2017;12(Suppl 2). doi:10.1123/IJSPP.2017-0208.
Ardern CL, Glasgow P, Schneiders A, Witvrouw E, Clarsen B, Cools A, et al. 2016 consensus statement on return to sport from the First World Congress in Sports Physical Therapy, Bern. Br J Sports Med. 2016;50(14):853-64. doi:10.1136/bjsports-2016-096278.
