Drill design using the 'control-chaos continuum': Blending science and art during return to sport following knee injury in elite football. (July 2021)

• Record Type: Journal Article
• Authors: Allen, T.; Wilson, S.; Cohen, D.D.; Taberner, M.
• Is Part Of: Physical therapy in sport. Volume 50(2021)
• Page Start: 22
• Page End: 35
• Publication Date: 2021-07
• Subjects: Football -- Rehabilitation -- Return to Sport -- Knee injuries -- 'Control-Chaos Continuum' -- Global Positioning Systems; Sports physical therapy -- Periodicals; Sports injuries -- Patients -- Rehabilitation -- Periodicals; Athletic Injuries -- diagnosis -- Periodicals; Athletic Injuries -- therapy -- Periodicals; Physical Therapy -- Periodicals; Sports Medicine -- Periodicals; 615.82088796
• DOI: 10.1016/j.ptsp.2021.02.011
• Languages: English
• ISSNs: 1466-853X

Abstract

Abstract: Establishing the level of risk, planning and adapting the return to sport (RTS) process following a complex knee injury involves drawing on a combination of relevant high-quality evidence and practitioner experience. On-pitch rehabilitation is a critical element of this process, providing an effective transition from rehabilitation to team training. The 'control-chaos continuum' (CCC) is an adaptable framework for on-pitch rehabilitation moving from high control to high chaos, progressively increasing running load demands and incorporating greater perceptual and neurocognitive challenges within sport-specific drills. Drills are a key element of the CCC, and are designed to ensure specificity, ecological validity and maintaining player interest. We showcase drill progression through the phases of the CCC, highlighting the use of constraints to create drills that incorporate the physical, technical, tactical and injury-specific needs of the player. We also provide recommendations to help practitioners create training session content using the CCC to help replicate the demands of team training within their own environment. Highlights: The 'control-chaos continuum', provides a framework to create drill content relevant to the phase aims and objectives, aligned with the physical, technical, tactical and injury-specific requirements of the player. Strength and power diagnostic testing throughout the RTS process provides objective feedback on components of physical performance and associated loading strategies, helping to inform progression of rehabilitation and decision-making. The use of constraints-led approach to shape the on-pitch environment allows the practitioner to manipulate movement variability, running load demand and decision-making while incorporating greater perceptual and neurocognitive challenges, respecting the principles of specificity and ecological validity.