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Sports Physical Therapy: A Rehab Approach for High Performance

April 11, 2023 · In: Pain Science and Healing, Science-Backed Education

Sports physical therapy is a specialty in the world of physical therapy. It covers everything from rehabilitation after surgery, recovery from an injury, injury prevention, rest and recovery, and fine tuning peak athletic performance. So what separates the sports population from the general population when it comes to physical therapy? This post will share about what sports physical therapy is all about.

**This is not medical advice. Please consult your medical provider for more information.

sports physical therapy

Treatment in Sports Physical Therapy

Physical therapists have lots of experience treating many different types of injuries and surgical interventions. Some of these include:

Conservative treatment

  • ankle sprains
  • torn rotator cuff
  • meniscus tear
  • muscle strains and ligament sprains
  • tennis elbow
  • golfer’s elbow
  • overuse injuries
  • other injuries of the shoulder, elbow, knee, ankle, etc.

postsurgical rehabilitation

  • achilles tendon repair
  • SLAP tear
  • rotator cuff repair
  • ACL, MCL, LCL, and PCL repairs
  • meniscus repair
  • UCL reconstruction (aka “Tommy John” surgery)

So if physical therapists treat the same thing with both the general population and with athletes, then why is the treatment different?

Function Vs. Performance

When recovering from injury or surgery, the general population needs to get back to functioning at their prior level. This can be anything from walking to the mailbox, walking without an assistive device, cycling, or being able to go up and down the stairs in their home.

For an athlete to return to sport after an injury or surgery, their prior level of function requires high loads of stress and peak fitness and performance levels. Based on the sport they are returning to, an athlete needs to be able to jump and land, react at a moments notice, change direction quickly, sprint, throw, etc. The body and injured area needs to be able to withstand these intense loads, absorb impact, and function at much higher levels. Strength is very important in this stage, but form is also key. Form can also be addressed in performance training (see below).

Performance Training for the Athlete

This would be the final stage of treatment for the athlete after an injury or post surgery. However, athletes may still come to a physical therapist for performance training looking to take their performance to the next level. Physical therapists are movement experts and can break down the finer details in movement that may be hindering an athlete. This is when movement analysis can be performed.

Performance specific training can take any sport specific task and break down its components to find where an issue might lie. A detailed movement analysis can look at the golf swing of a golfer, a pitcher throwing a pitch, a volleyball player jumping for a spike, or a soccer player cutting around another player.

Performance specific training may also be viewed as preventative training. Physical therapy doesn’t just treat those who are injured, but can also fine tune movements based on observation of form and transfer of power. For example, overhead athletes require an immense amount of core strength to properly transfer power from their lower body to their upper body. Physical therapists can help facilitate sport-specific training based on what the athlete is looking for and what the therapist observes in their movement and form. At top levels of performance, the finer details make a big impact.

Interested in more about sports and sports physical therapy? Leave a comment down below about what you are interested in reading about!

More Sports Related Articles

  • ACL Stability: How to Improve Strength for Return to Sport
  • 5 Reasons Why Balance Exercises are Important for Runners
  • Weak Ankles Running? Stabilization and Strengthening for Pain Free Running

TL;DR

This post addresses the differences between training an athlete to return to sport from the general population. Form, physical performance, and sport-specific training are extremely important to an athlete returning to sport.

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Tera Sandona
Tera Sandona

Tera Sandona is a licensed Doctor of Physical Therapy (DPT) and the founder of PT Complete. She helps high-achieving women break out of cycles of chronic pain, stress, and burnout through her Regulate and Rebuild Method, a sequenced approach that addresses the nervous system first and builds strength second. Her work focuses on helping women finally understand their bodies, rebuild strength, and create lasting resilience that fits real life.

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By: Tera Sandona · In: Pain Science and Healing, Science-Backed Education · Tagged: confidence with movement, functional movement, injury recovery, strength training, sustainable healing

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I'm a practicing physical therapist based out of sunny SoCal who loves to educate others and share information and knowledge. You can typically find me hard at work trying to manage normal life or cuddled up under a blanket enjoying coffee or desserts I can never seem to get away from!

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I hear this one on repeat. It started in your shou I hear this one on repeat. It started in your shoulder, now it’s crept into your shoulder blade, and maybe down toward your mid back. And the first thought is always the same: something new is wrong now or something else is breaking down.

But that’s not usually what’s happening. Pain that spreads to the region right next door isn’t a new injury announcing itself (unless you legitimately injured yourself again).

When pain spreads without a new injury behind it, it’s been part of the picture for a while, and showed up out of nowhere, it’s usually the same alarm system that’s been running in the background. It’s now been ringing long enough that the areas nearby started picking up the signal too.

Think of it less like a break and more like a smoke detector that won’t stop going off until the whole hallway of detectors starts sounding along with it. Nothing new caught fire. The system’s just been on for a long time.

If you’ve already had this checked and nothing new turned up to explain it, pay attention to that. It’s usually your best clue that this is your nervous system spreading the pain to a new area, not a new injury needing its own workup.

Comment “MINE DID THIS” if pain has crept into the area right next to where it started. I’ll send you my blog post I wrote on this exact topic that goes more in depth on what’s actually going on.
But here’s what’s actually true. You’ve probably But here’s what’s actually true.

You’ve probably been told for years that any movement counts as building strength, and in the very beginning, it kind of does. If you’re coming from little to no activity, walking, Pilates, biking, or yoga will strengthen you…at first. Your body is adapting to a demand it hasn’t had to meet before.

But that adaptation has a ceiling. Once your body reaches its load tolerance for that amount of activity, doing more of the same thing doesn’t build you past it. You’re not getting stronger anymore. You’re just maintaining the level you already reached.

This is where cardiovascular and endurance work split from strength work. Walking and biking stay focused on the cardiovascular system. They’re not increasing the load on your muscles. You’re training your heart and lungs instead.

Pilates and yoga work your muscles through holds, which builds muscular endurance and helps your muscles sustain a position under fatigue. That’s a real adaptation. It’s just not the same one as strength.

Real strength requires loading a specific muscle heavy enough, and consistently enough, that it has a reason to adapt again.

If you keep exposing your body to the exact same stimulus, no further change happens. The muscle already met that demand. It has nothing left to respond to.

Comment “MAXED OUT” if you just realized you’ve been maintaining instead of building for a while now.
Everyone sees you making it through the day just f Everyone sees you making it through the day just fine. They don’t see what it’s costing you to get there or what happens once you finally stop.

You show up. You answer the emails, sit through the meetings, keep your voice even when it needs to be, and nobody watching would ever guess anything is off.

They don’t see how tirelessly you work the second you walk back in the door, taking care of everyone else before you’ve had a single second to take care of yourself. They don’t see whatever you’re quietly carrying right now…the thing nobody’s asked about because you never said it out loud.

But your nervous system has been working the entire time to keep you looking like that. Holding the line through every part of the day you couldn’t afford to fall apart in.

And by evening, when nothing else is asking anything of you, it finally stops pretending. Not a dramatic collapse, just a flatness. It’s in the plans you cancel, the conversation you can’t hold, the two hours you lose staring at nothingwhen there’s nothing left keeping the performance up.

Nobody sees the discipline it takes to hold that together all day. They only see the version of you that’s left once it’s finally safe to stop.

If this is you, let the plans stay cancelled tonight. That’s not falling behind. You’ve already asked enough of yourself today.

Send this to someone who’s fine all day and disappears the second it’s finally safe to stop.
It’s Friday night. The week is finally behind you. It’s Friday night. The week is finally behind you. And you still don’t feel like you got anything back.

You’re not lazy. You’re using the wrong tool for the kind of tired you’re actually experiencing.

I know why you think something’s off. You slept enough. You even took the whole day off. And your mind still felt like it never turned off, replaying the week, running tomorrow’s list, and staying half on alert even while lying still.

The only explanation that makes sense is that you’re bad at resting, or too wound up to relax, or just built wrong.

But here’s the truth: physical stillness only covers one kind of exhaustion. If your eyes, ears, and screen never got a break, that’s sensory depletion still running underneath you. If you spent the day holding everything together for everyone else, that’s emotional depletion still running. If your brain never stopped making decisions, that’s mental depletion still running.

You didn’t fail at resting. You used the right tool on the wrong job…the screwdriver when you needed scissors.

So if you want to try this differently tonight, here’s where to start:

First, name which kind you’re actually short on (sensory, emotional, or mental) instead of defaulting to more sleep.

Second, match the rest to the deficit. Sensory rest means screens off and quiet, no noise. Emotional rest means nothing that requires you to hold anyone else up. Mental rest means no decisions, not even small ones, for one hour.

Third, expect it to feel smaller than you think rest should look like. It still counts and it adds up over time. Small consistencies matter here.

You’re not lazy. You’ve just been resting the wrong thing.

Save this so you know which kind of rest to reach for tonight.
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