1. Hamstring muscles
2. Rectus femoris and quadriceps group
3. Gastronemius and soleus of calf
4. Adductor group of hip (groin)
5. Short extensor muscles of back

Most of the above are two joint muscles i.e. that pass and work over two joints. The exceptions are the hip (groin) adductors. Any warm-up should therefore focus on dynamic stretching of these muscle groups for example controlled leg swings to dynamically stretch the hamstring muscles. Whilst a developmental flexibility session should include the static stretching of these muscle groups.

Phase 4 - Active Rehabilitation Stage
For the player to be allowed to exercise in the active rehabilitation stage he/she should be able to:

• Begin non weight bearing exercises
• Progress to partial weight bearing exercises
• Progress to full weight bearing exercises
• Progress to active functional activities related to the game

Intermediate Grade Exercises

The player in this phase will progress from:

1. single muscle group movement
2. single joint movement
3. non complex movements
4. dynamic non weight bearing exercises

Next progression to partial weight bearing exercises

• multi-muscle movements (patterns of functional movement)
• multi-joint movements (patterns of functional movement)
• dynamic partial weight bearing (pwb) exercises
• exercises that involve more complex balance and co-ordination

The player will carry out exercises where the hip, knee and ankle joints all work together with the muscles that move these joints. The injured limb bears some body weight with the arms and good limb.

The aim is in turn to take progressively more weight which will in turn develop

• Muscle strength
• Balance
• Coordination

The key to progress is to alter the exercise starting position so that the body weight is moved progressively more and more against the effects of gravity.

Exercises in a horizontal plane, Progress to exercises in a diagonal / oblique plane, progress to exercise in a vertical plane.

All of these movements involve: -

• Concentric muscle work when extending the joints and raising the body.
• Eccentric muscle work when flexing the joints or lowering the body.

Both of these actions being multi-joint/multi muscle in type are the movement we use to move and play football/rugby when we walk, run, jump or land from jumping.

Other full weight-bearing exercises of this type can be mixed with strengthening techniques using weights, endurance activities be the use of static bicycles, rowing machines and swimming pool.

• Full joint range
• Full muscle strength and power
• Good balance
• Good co-ordination

He/she can move into functional rehabilitation phase of using the ball and practising to regain the activities and skills to return to full match play.

Movement

Motor control and learning

As the individual reaches higher levels of motor control the limits of performance are extended which allows for finer coordinated movement.

Correct practice makes perfect.

A specific motor learning objective becomes maximally efficient when it can be performed automatically. It becomes automatic through successful repetition. The player passes through phases of reduced concentration and difficulty to perform the task.

When the movement pattern can be performed easily you can say that motor learning has occurred.
Often repeated movements lead to preferred pathways in the central nervous system which enhances control and delivery of the movement.
Re-education of specific/balance movement/skills should follow a progression from single to more complex movements. The early movements should be designed with the end complex in mind.

Phase 5 - Functional Rehabilitation Phase

Aims of treatment

1. To improve balance/proprioception and movement co-ordination.
2. To provide psychological reassurance of function.
3. Restore specific skills and movement patterns to pre-injury levels
4. Weight bearing control of movement
5. Balance of body
6. Transference of body weight
7. Co-ordination of skilled body movement
8. Reaction time of movement

The late rehabilitation stage concentrates on formal full–weight bearing exercises such as squats, lunges or step ups. These exercises are pre-requisites to achieve the desired muscle strength, power, endurance, joint range of movement, balance and co-ordination attributes required to work at this functional level.

Activities/functions performed during a game

1. walking
2. jogging
3. low speed running
4. moderate speed running (cruising)
5. high speed running
6. sprinting
7. straight line running
8. backward running
9. sideways running
10. diagonal running
11. hopping (left leg/right leg)
12. bounding (starting/stopping)
13. jumping (right foot/left foot/both feet)
14. landing (left foot/right foot/both feet)
15. squatting
16. lunging/stretching
17. directional changes at speed
18. rotational work (weight bearing)
19. turning
20. side stepping or cutting
21. dribbling
22. passing the ball
23. receiving/controlling the ball
24. throwing the ball heading the ball
25. kicking (stationary ball/moving ball/half volley/volley)
26. shooting
27. tackling
28. being tackled

Rugby/Football consists of many complex movements requiring high skill levels both with and without a ball. These cannot be performed without high degrees of balance and co-ordination ability.

North West Pilates & Yoga Centre provides a bespoke programme, football and rugby specific based on the original works of Joseph Pilates and has applications of Hatha yoga implemented were appropriate.