Throughout this series we are going to dive into some of the philosophy, physiology, neurology and research behind why we do what we do. During the course of this series we are going to discuss:
- Kinesiophobia - what is it and how does this limit return to sport
- Your impact on psychological movement
- Why Single limb training aids in maximizing return to sport and athletic performance
- What is the roll of fatigued state training and why this is important
- Movement at the hips and how this leads to increased risk and altered performance

So what is the treatment for kinesiophobia? Unfortunately there is not a lot in the literature about how to treat kinesiophobia in the athlete. There is a fair amount out there about how to treat this in the elderly patient and the low back patient but not in the athlete. Looking at what literature there is, there is some common themes.
- Education - educate the athlete about their injury, expected progression of rehabilitation and how importance of restoration of early function
- Graded exposure to therapy techniques to increase confidence
- Graded exposure to activity
- Educate the athlete on their injury, the importance of progression of rehab, importance of incorporating single limb activities early in the rehab process, their role in the rehabilitation process and how this aids in faster/safer return to sport
- Early introduction to single limb activities. Myers et al AJSM 2012 showed that single limb testing is one of the best indicators of risk with return to sport. As such, the earlier single limb training is incorporated into rehabilitation the more confidence the athlete will have in that limbs performance over time
- Incorporating aggressive single limb training in later phases of rehabilitation. Kristineslund et al AJSM 2013 showed that single limb performance is a better indicator of how the limb will function in sport. Considering, this should indicate the importance of pushing more aggressive types of single limb training. Not only does this help from a strength and endurance perspective but will also improve the athlete's confidence in that limb with sport related activity.

Taking this approach is the first step in building the athlete's confidence in their limb, decreases their kinesiophobia and improves their chances with return to sport.
Next week will continue along a similar line of discussion with talking about your impact on psychological movement. If you enjoy this blog, please share with your colleagues and follow us on instagram @ bjjpt_acl_guy and twitter at @acl_prevention. #ViPerformAMI #ACLPlayItSafe
Dr. Nessler is a practicing physical therapist with over 20 years sports medicine clinical experience and a nationally recognized expert in the area of athletic movement assessment and ACL injury prevention. He is the founder | developer of the ViPerform AMI, the ACL Play It Safe Program, Run Safe Program and author of a college textbook on this subject. Trent has performed >5000 athletic movement assessments in the US and abroad. He serves as the National Director of Sports Medicine Innovation for Select Medical, is Vice Chairman of Medical Services for USA Obstacle Racing and movement consultant for numerous colleges and professional teams. Trent has also been training and a competitive athlete in Brazilian Jiu Jitsu for 5 years.
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