23 Aug Dr Andy Franklyn Miller Blog – Multi directional Rehabilitation
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“In an earlier blog, I discussed the benefits of a progressive neuro-muscularly challenging warm up, and work that we did with the England Age group Rugby teams to deliver this with the excellent team of Katie Davis, and the coaching staff John Fletcher, Ian Peel, Peter Walton and Neil Taylor. It is important that this is in part sport specific and to the timing of the requirements of the session and match. I commonly see in clinic patients who are a number of weeks down the line form their original soft tissue injury, typically hamstrings or groins who have almost made it back to training and then re-injure. It is here close questioning, can make the difference. If we look at the Hamstring origin, you can see that there is a multi directional pull from the ischial tuberosity and as such this needs rehabilitating in all directions.
Commonly the end stage rehabilitation involves merely progressive pace straight line running without specific strengthening such as angle change sumo dead lifts and Straight leg deadlifts with progressive change, then speed of recruitment before multi directional challenges.
This requirement for multi directional challenge applies with our athletic groin pain patients above all, where pelvic stability is the most important factor, in multi directional challenge. In the clip below you can see the stress placed on the pelvis with a side hurdle challenge, using 3D kinematics.
We have applied this stability training at a high end level using multi directional unpredictable movement as both part of our testing strategy and rehabilitation srills. We are presently filming an exercise bank for the SSC clinic profile using multi directional stimulus. We have found that in the testing process we need to add a layer of unpredictability to replicate indecision in matches and in the performance gym Crazy Catch, can help us deliver this as a means of providing this athletic sport mulidirectional work. We are still working on methods to recreate the single leg and double leg pelvic stability training with our Conditioning and Performance rehab team at SS and here are a few examples of our experimenting in the process, more to come in a polished version.”