By Jim Zouch
As a physiotherapist it’s a common story I hear at the start of every sporting season. Typically, it involves a client presenting with a ‘pull’ in one of their lower leg muscles upon returning to training or within the first few matches of the season. More often than not, it’s the second or third ‘pull’ the client has experienced in a matter of weeks as they have tried to navigate their way through the injury, often resting until the pain disappears then returning back to sport.
One such client presented last week having felt a ‘pull’ in her quadriceps while sprinting during a training session. She rested the leg for a week and upon feeling no pain with her day-to-day activities returned to training only to have a recurrence of the same sensation. She was visibly frustrated having had a season off sport due to covid and was extremely enthusiastic to get back into the game she loved.
She was aware that she had likely injured one of her quadriceps muscles but wasn’t sure of how to go from her current state, back to sport without the same thing occurring. At the time of presentation, the client was able to perform most functional activities I threw at her without pain or discomfort. As part of our assessment, we used a hand-held dynamometer to assess her ability to generate power in a kicking motion, testing both legs individually. We observed a 30% difference in strength between sides. The client found this extremely interesting and it helped us frame why returning to sport prior to regaining strength might leave her at an increased risk of another injury. It also serves as our ‘baseline’ measurement that we will use for upcoming sessions to test her improvement in strength that occurs as a result of both natural healing alongside an appropriate strength programme.
The testing opened a really nice line of questioning from the patient about ‘how strong should she be’ and ‘how long will it take to get these numbers higher’. We discussed setting some goals over the coming weeks and establishing a minimum score (within 10% of her other side) that she should achieve, before we discussed higher intensity return to sport activities. The strength testing also gave us some information about what of training was likely to be safe during her upcoming training sessions without comprising her healing.
I’m looking forward to seeing the improvements in strength over the next few weeks!