At NDPT, our mission is to uncover the root cause of your problems, not just treat the symptoms. Take, for example, a basketball player who came to us with anterior knee pain triggered by running and basketball activities such as deceleration and change of direction (COD). Our approach to rehabilitation involves four phases: Foundation, Function, Fitness, and Performance, using a variety of tools to achieve the best outcomes.
For this athlete, we began by assessing their movement health, utilizing a basic general assessment called the SFMA. We identified limitations in single-leg stance (SLS), multisegmental flexion, multisegmental rotation, and an arms-down deep squat. These findings indicated issues with hip flexion mobility and ankle dorsiflexion (DF), common in basketball players. Despite these limitations, the athlete did not report pain during this initial examination.
To dig deeper, we employed the Functional Movement Screen (FMS).
The FMS helps us evaluate movement competency, which is crucial before jumping into sport-specific activities. During the inline lunge test, the athlete reproduced their knee pain on the left side. This pain correlated with some of the previous patterns observed in the first assessment: arms down deep squat and single leg balance tests. Now back to the FMS, the athlete displayed a lead foot heel lift, difficulty touching the left knee to the middle of the board, loss of postural control, and a spine flexion compensation evident by the dowel rod movement. Additionally, the athlete exhibited proprioception challenges, as seen in the difficulty and lateral deviations during the movement.
These observations provided valuable insights: we identified a maximum point to avoid loading in a lunge or split squat position, ensuring we train the athlete within their pain-free capacity. Our goal is to progress this athlete through the phase of movement competency, then transition to enhancing movement work capacity, which means weight room and loading the athlete, which includes postural control testing, jump testing, and movement control upper and lower extremity. As my mentor and friend Lance Walker would say, “If I take a piece of cardboard and I push on both ends. Where does it break? It breaks in the middle!” If we do not have trunk control then everything else will fall apart and if we are looking at muscles we typically will miss this important area. Ultimately, we aim to return the athlete to basketball skill activities, minimizing the risk of reinjury by focusing on comprehensive movement patterns rather than just the muscles.
We hope this article sheds light on our approach. If you found it helpful, please reach out to us. Our focus is on providing personalized, one-on-one care tailored to your specific needs. We are committed to helping you improve so you can continue to enjoy your sport or recreational activities without pain or limitation. Let us help you play your best for as long as possible!