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Tuesday, June 19, 2018

THE 5 R'S OF TREATMENT


The new pain science model that has been out for a few years now is simply amazing.

Local/Amateur football conditioning methods is more than 10 years behind, making pain management in football about 50 years behind.

I really believe that my ability come back at injuries at near 40 years of age is assisted by me following the new pain management model - something that I had been following anyway my entire career without even knowing it!

Ben McCormack from Cor-Kinetic has been putting out easy to understand information on this type of stuff for a few years now and this came from him.

As a coach, player or even a trainer at a L/A football club - this is pretty much must-know information.

It pertains more to chronic, re-occurring injures and pain but holds up for acute rehab as well.

#1 RED FLAGS

- Rule them out (major injuries etc)
- Remain vigilant (on alert for what else it could be)

ROLLED ANKLE EXAMPLE - No break but lets; check the foot and knee as well just in case something further up the chain has an issue

#2- REASSURE

- There's probably not anything serious going on
- Use effective analgesic measures

ROLLED ANKLE EXAMPLE - Just a rolled ankle but let's see if you can start to walk on it or again and if possible jog. I've done a heap of these from my basketball days and have always managed to go back on. Make sure to ice for 2 - 3 rounds of 20mins on/off afterwards though

#3 RECONCEPTUALISE

- Pain is simply an alarm that something has happened
- Try not to become oversensitive about it

ROLLED ANKLE EXAMPLE - Initial pain is through the roof in some cases but trying to walk on it decreases your brains sensitivity about it as it's getting positive input from loading it again.

#4 - RECALIBRATE

- Graded exposure to restore appropriate level of threat to the central nervous system

ROLLED ANKLE EXAMPLE - Progress through walk, to jog, to run to decrease the perceived threat from the acute phase

#5 - ROBUST

- Increased movement demand and build increased zone of homeostasis

ROLLED ANKLE EXAMPLE - Progress to sprint + jumping + change of direction so now all perceived threat from the acute phase can be taken away

As a trainer or treatment person you should:

- Listen to the person and their story and try find a relevant narrative

- Try to appreciate how they think and feel

- Help them think and feel differently using aspects of their narrative if required

- Watch and get a sense of how they are moving

- Help them move differently, explore movement or simply move more in ways that they are able to

- Help them perceive moving differently

- Testing does not always have to find something wrong but rather instead highlights positive movement

- Move more regularly with progressive load

I should have done a huge pain science post before now, I've got a mini book I've made up on it a year or so back that I will post at some point but hopefully gives you a slight taste of how pain is not just 1 thing that happens and it goes away without you having to do anything about it.

Let me know any questions you have on this.

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