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Examples of functional exercise progressions

By Todd S. Ellenbecker, DPT, Mark DeCarlo, MS, MHA, and Carl DeRosa, PhD


Once the athlete has been clinically assessed for functional deficits, it is time to progress to the functional movements necessary to return the athlete to his or her sport. At this point, full range of motion, a normal gait pattern, symmetrical flexibility, strength, proprioception, and balance should be close to their preoperative levels. As previously discussed, the clinician should be cognizant of the basic injury mechanisms and biomechanics while moving the athlete through the functional progression. Athletes should not experience pain or altered gait mechanics as they attempt each movement. Supervision by the clinician or coach is imperative to ensure that each movement is mechanically correct. Braces or tape can be worn if needed during the functional progression.

Wrestling

1. Jumping on both legs: 5 times

2. Jumping on injured leg: 5 times

3. Jogging laps: both directions

4. Jogging figure eights (half, three quarter, full speed): 10 yards (10 m)

5. Cariocas (crossovers): both directions

6. Circling: both directions

7. Stand-up sequence from down position: 5 times

8. Spin drills, partner in down position (wrestler uses hands for balance, chest on opponent’s back), both directions: 5 times

9. Shooting from standing position, with opponent progressively increasing speeds

10. Circling, with tying-up opponent

11. Shoot and sprawl: wrestler balances on injured leg while working against unanticipated maneuvers of opponent

12. Down position sequence: opponent applies resistance as injured wrestler attempts to get up

13. Live wrestling


Court Sports

1. Heel raises, injured leg: 10 times

2. Walking at fast pace: 50 yards (50 m)

3. Jumping on both legs: 10 times

4. Jumping on injured leg: 10 times

5. Jogging straight: full court

6. Jogging straight and curves: 2 laps

7. Sprinting (half, three quarter, full speed): full court

8. Running figure eights (half, three quarter, full speed): baseline to quarter court

9. Triangle drills: sprint baseline to half court, backward run back to baseline, defensive slides along baseline; repeat in opposite direction

10. Cariocas (crossovers): half, three quarter, full speed

11. Cutting: half, three quarter, full speed

12. Position drills


Baseball and Softball

1. Heel raises, injured leg: 10 times

2. Walking at fast pace: first base

3. Jumping on both legs: 10 times

4. Jumping on injured leg: 10 times

5. Jogging straight: first base

6. Jogging straight and curves: 2 laps around bases

7. Sprinting (half, three quarter, full speed): first base

8. Sprinting (half, three quarter, full speed): rounding first base

9. Running figure eights: home plate to pitcher’s mound

10. Backward running: simulate fielding fly ball

11. Throwing: short toss to long toss

12. Hitting: tee to batting cage to live

13. Position drills


Field Sports

1. Heel raises, injured leg: 10 times

2. Walking at fast pace: 50 yards (50 m)

3. Jumping on both legs: 10 times

4. Jumping on injured leg: 10 times

5. Jogging straight: 50 yards (50 m)

6. Jogging straight and curves: 2 laps

7. Sprinting (half, three quarter, full speed): 40 yards (40 m)

8. Running figure eights (half, three quarter, full speed): 15 yards (15 m)

9. Cariocas (crossovers), both directions: 40 yards (40 m)

10. Backward running: 40 yards (40 m)

11. Cutting (half, three quarter, full speed)

12. Position drills


Distance Running: Distance

When an athlete is able to begin running again, it is necessary to return to previous mileage gradually. Provide the following guidelines to help ensure a safe return to the road.

  • Make sure you stretch before and after running.
  • Keep the running surface as soft, smooth, and level as possible.
  • Emphasize form.
  • Ice the involved area until numb after running.
  • Follow these mileage guidelines. Do not progress to the next step if the previous one caused pain.

Previously Running 20-30 Miles per Week
  Day  
Week 1 2 3 4 5 6 7 Total Miles
1 1 0 1 0 1 0 2 5
2 0 2 0 2 0 3 0 7
3 3 2 0 3 2 0 3 13
4 3 0 4 3 0 4 4 18
5 0 5 4 0 5 5 5 24

Previously Running 30-40 Miles per Week

  Day  
Week 1 2 3 4 5 6 7 Total Miles
1 2 0 2 0 2 0 3 9
2 0 3 0 3 0 4 3 13
3 0 4 4 0 5 4 0 17
4 5 4 0 5 5 0 6 25
5 5 0 6 5 5 0 6 27

 


Distance Running: Time

When an athlete is able to begin running again, it is necessary to return to previous mileage gradually. Provide the following guidelines to help ensure a safe return to the road.

  • Make sure you stretch before and after running.
  • Keep the running surface as soft, smooth, and level as possible.
  • Emphasize form.
  • Ice the involved area until numb after running.
  • Follow these mileage guidelines. Do not progress to the next step if the previous one caused pain

Previously Running 30 to 45 Minutes per Day
Day  
Week 1 2 3 4 5 6 7 Total Minutes
1 10 0 10 0 12 0 14 46
2 0 16 0 18 0 20 0 54
3 25 20 0 25 25 0 30 125
4 30 0 30 35 0 35 40 170
5 0 40 35 0 45 40 45 205

Previously Running 45 Minutes per Day

  Day        
Week 1 2 3 4 5 6 7 Total Minutes
1 10 0 12 0 15 0 17 54
2 0 20 0 20 0 22 0 62
3 25 20 0 30 25 0 35 135
4 30 0 35 35 0 40 35 175
5 0 40 40 35 0 45 40 200
6 40 0 45 45 40 0 50 220
7 45 45 50 0 55 50 50 295



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