Plyometrics in Rehabilitation
Plyometric training, also termed 'jump training', is a mode of exercise that enables a muscle to reach maximal force in the shortest possible time. This form of activity was first implemented in strength and conditioning programmes by coaches from the Soviet Union in the 1960's, and aroused international curiosity following the 1972 Olympics when Eastern European countries dominated the gold medals in track and field, gymnastics, and weight-lifting.
More recently, rigorous scientific research has demonstrated that plyometric training is currently the most effective of all interventions for injury prevention and late-stage rehabilitation in sport and high-level occupational activities.
"Plyometric" is a combination of Greek words that literally means to increase measurement (plio=more, metric=measure). Practically defined, Plyometric movements involves first a rapid muscle lengthening movement (eccentric phase), followed by a short resting phase (amortization phase), then an explosive muscle shortening movement (concentric phase). This movement pattern uses the strength, elasticity and innervation of muscle and surrounding tissues to jump higher, run faster, throw farther, or hit harder.
Plyometric exercises are thought to resolve post-injury neuromuscular impairments and to prepare the musculoskeletal system for rapid movements and high forces that may be similar to the demands imposed during sport participation, thus assisting the athlete with a return to full function.
Since the aim of rehabilitation is to regain the pre-injury level of function of the injured site and also to return the athlete to their pre-injury state of fitness, plyometrics are an excellent rehab tool. If an athlete has to run, jump, change direction and so on in their sport, then their rehabilitation should prepare them specifically for those actions.
Low intensity plyometrics is a very useful tool to retrain dynamic balance and proprioception after injury, and once functional stability is regained, such exercises can be gradually introduced. In late stage rehabilitation, when the injury site is strong and close to fully repaired, higher level plyometric drills that mimic the sporting environment may be included. It is essential that recovering athletes perform explosive type movements in a closed environment before returning to any field or court sport.
Clinically, plyometrics can be categorized according to the loads applied to the healing tissue to provide optimal strengthening of the injured tissue:
- Medial/lateral loading
- Rotational loading
- Shock absorption/deceleration loading
Types of lower body plyometric drills include:
- Jumps in place
- Standing jumps
- Multiple hops and jumps
- Box drills
- Depth jumps
Types of upper body plyometric drills include:
- Ball throws
Plyometric exercises place a great demand on the tissues targeted, and therefore are implemented at the end-stages of a rehabilitation program. To reduce the risk of re-injury and to facilitate the performance of exercises, it is important to have your physiotherapist properly assess strength, speed and balance.
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