Practical Sports Exercise Physio
From pitch-side assessment to return-to-performance: evidence-based rehab skills you can apply in clinic the next day.
Intermediate · 12 chapters · 144 MCQs · 144 flashcards · Illustrated
Practical Sports Exercise Physio takes you through a complete clinical pathway, from tissue biology and load management to assessment, targeted exercise prescription, and return-to-sport decision-making. Every chapter pairs current evidence with hands-on frameworks, testing batteries, and progression templates for real athletes. You will finish able to build, adapt, and justify rehabilitation programs across the most common sports injuries and populations.
What you'll learn
Chapter 1: Foundations of Sports Physiotherapy: Roles, Evidence-Based Practice, and the Athlete-Centered Model
Chapter 2: Tissue Biology, Healing Timelines, and Mechanotherapy Principles
By the end of this chapter you should be able to: - Describe the phases of soft-tissue healing and the time course for muscle, tendon, ligament and bone. - Explain mechanotransduction and how load is dosed to drive repair.
Chapter 3: Load Management, Training Principles, and Injury Risk Monitoring
By the end of this chapter you should be able to: - Explain the load–capacity model and tissue-specific adaptation timelines. - Calculate and critically interpret sRPE, monotony, strain, and ACWR.
Chapter 4: Clinical Assessment I: Athlete History, Red Flags, Screening, and Clinical Reasoning
Chapter 5: Clinical Assessment II: Movement Analysis, Strength, Power, and Range Testing
By the end of this chapter you should be able to: - Explain how neuromuscular and tissue-level deficits produce measurable impairments. - Select, administer, and interpret valid movement, range, strength, and power tests.
Chapter 6: Exercise Prescription Fundamentals: Dosage, Progression, and Pain-Guided Loading
By the end of this chapter you should be able to: - Explain the load-capacity model and how tissues adapt to mechanical stress. - Recognise load-related pain presentations and screen for red flags.
Chapter 7: Lower Limb Interventions: Hamstring, Groin, Knee, Ankle, and Tendinopathy Rehabilitation
Hamstring strain. Injury usually occurs in late swing phase of sprinting, when the biceps femoris long head reaches peak eccentric length. The result is a musculotendinous junction tear.
Chapter 8: Upper Limb, Trunk, and Spine Interventions: Shoulder, Elbow, Core, and Low Back Rehabilitation
By the end of this chapter you should be able to: - Explain the pathomechanics of common shoulder, elbow, and lumbar presentations in athletes. - Select and interpret key tests and normative values.
Chapter 9: Neuromuscular Control, Plyometrics, Speed, and Change-of-Direction Retraining
The SSC has three phases: eccentric (pre-stretch), amortisation, and concentric. A fast SSC has ground contact under 250 ms (sprinting, hopping, cutting). A slow SSC is over 250 ms (countermovement jump).
Chapter 10: Special Situations: Concussion, Acute Pitch-Side Care, Youth, Female, and Masters Athletes
Chapter 11: Return-to-Sport Decision-Making: Criteria-Based Testing, Psychological Readiness, and Shared Decisions
Chapter 12: Functional Outcomes and Performance: Prevention Programs, Outcome Measures, and Long-Term Athlete Development
Practice questions
5 sample MCQs from this course. Tap a question to see the answer.
A 24-year-old male footballer rolled his right ankle inversion-first during training 48 hours ago. He now has localised swelling, warmth over the lateral ligaments, and pain that limits him to walking with a limp. He cannot yet bear full weight comfortably.
1. Which healing process is most active in this tissue during the current stage?
- A. Inflammatory phase: haemostasis with neutrophil and macrophage infiltration
- B. Remodelling phase: collagen maturation and cross-linking over months
- C. Proliferative phase: fibroblast-driven collagen deposition at peak
- D. Regeneration phase: full restoration of native collagen type I alignment
Show answer
Answer: A. At 48 hours post-injury, the tissue is in the inflammatory phase, characterised by haemostasis, neutrophil clearance, and macrophage activity that produces the swelling and warmth seen here. Proliferation and remodelling occur later, and native tissue architecture is not restored in the early days after injury.
A 19-year-old male university footballer is 8 weeks into pre-season conditioning after an uneventful off-season. His coach plans to raise weekly running volume and intensity in small, planned steps so that his aerobic capacity keeps improving. He currently has no injuries and is symptom-free.
2. Which training principle is the coach applying by systematically raising the stimulus above what the athlete's body is currently accustomed to?
- A. Progressive overload
- B. Specificity
- C. Reversibility
- D. Individuality
Show answer
Answer: A. Gradually increasing the training stimulus beyond current capacity to drive adaptation is progressive overload. Specificity concerns task-matching, reversibility concerns loss of adaptations, and individuality concerns differences between athletes.
A 24-year-old male soccer player is 4 months after left anterior cruciate ligament reconstruction. He reports fear of cutting and pivoting and feels his left leg is weaker than his right. He is preparing for a return-to-sport assessment.
3. Which test best quantifies single-leg performance asymmetry for return-to-sport decisions?
- A. Single-leg hop for distance with limb symmetry index
- B. Two-leg standing broad jump distance
- C. Sit-and-reach flexibility test
- D. Handheld dynamometry of knee extension at 90 degrees
Show answer
Answer: A. Single-leg hop tests with a limb symmetry index compare the injured limb to the uninjured side under functional, sport-relevant loading. Two-leg, static, or single-plane strength measures do not reflect the single-leg demands of cutting and landing.
A 45-year-old man with mid-portion Achilles tendinopathy reports morning stiffness. He rates his pain at 4/10 during single-leg heel raises, and it settles to baseline by the next morning. He is three weeks into a loading programme and wants to know how quickly to progress.
4. Which pain-monitoring rule is most appropriate for guiding his next load increase?
- A. Pain up to about 5/10 during loading that returns to baseline by the next morning is acceptable for progression
- B. Any pain during exercise indicates tissue damage, so loading should stop until he is completely pain-free
- C. Pain should be ignored entirely once the exercise has started
- D. Progression should occur only when pain reaches 0/10 during every repetition
Show answer
Answer: A. Pain-guided loading accepts a tolerable level of exercise-related pain (commonly up to about 5/10) that settles by the next morning, indicating the tendon tolerated the load. Requiring zero pain or stopping for any pain removes the stimulus needed for tendon adaptation.
A 24-year-old male sprinter felt a sudden sharp pain in the back of his right thigh at top speed and heard a pop. Examination reveals bruising below the buttock, tenderness over the ischial tuberosity, and pain on active knee flexion in a lengthened position. He cannot sprint or walk up stairs without pain.
5. Which of the following is the most likely diagnosis?
- A. Proximal hamstring muscle strain
- B. Patellar tendinopathy
- C. Lateral ankle sprain
- D. Osteitis pubis
Show answer
Answer: A. Sudden posterior thigh pain during sprinting, a palpable pop, bruising and tenderness at the ischial tuberosity point to a proximal hamstring muscle-tendon injury. The other options involve different tissues and regions not supported by the presentation.
Flashcards
What are the three overlapping phases of soft tissue healing, and approximately when does each occur after injury?
The inflammatory phase lasts from injury to about day 3-5, the proliferative (repair) phase runs from about day 3 to week 3-6, and the remodeling (maturation) phase begins around week 3 and can continue for 12 months or more. The phases overlap and are not discrete, so timelines are guides rather than fixed rules. Rehab load should be matched to the dominant phase.
What is the acute:chronic workload ratio (ACWR), and how is it typically calculated?
ACWR compares recent training load (acute, usually the past 7 days) with the average load over a longer period (chronic, usually the past 21-28 days). It is calculated by dividing acute load by chronic load. It is used to flag sudden spikes in load that may raise injury risk, although its predictive validity and statistical limitations are debated.
What are the common compensations observed during an overhead squat screen, and what might they indicate?
Common compensations include excessive forward trunk lean, lumbar flexion, knee valgus, heels rising, and arms falling forward. These faults can point to restricted ankle dorsiflexion, limited thoracic extension or shoulder flexion, tight hip flexors, or weak trunk and hip stabilisers.
What are the core variables that make up exercise dosage (the FITT-VP framework) in rehabilitation prescription?
FITT-VP stands for Frequency, Intensity, Time (duration), Type, Volume, and Progression. Together they define how much stimulus a tissue or system receives. Manipulating one variable at a time lets the clinician see what drives a response or a flare-up.
Which exercise has the strongest evidence for reducing hamstring strain injury risk in sprinters, and what type of contraction does it use?
The Nordic hamstring exercise, an eccentric exercise in which the athlete lowers the trunk from a kneeling position with the ankles anchored. Trials show it substantially reduces hamstring injury incidence, particularly recurrence, when performed consistently. It targets the hamstrings' eccentric strength and fascicle capacity during lengthening.
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