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Clinicians must understand the sport’s demands when developing rehabilitation programs for athletes. In this series, Helen Bayne will discuss the foundational biomechanical aspects of sports and provide guidance to ensure that rehabilitation meets those demands and reduces the chance of re-injury. In part one, Helen discusses force plates, their use, and applicability within the clinical rehabilitation context.
Salt Lake City, Utah, USA; Utah Jazz guard Jordan Clarkson (00) shoots an open jump shot during the fourth quarter against the Atlanta Hawks at Vivint Arena. Mandatory Credit: Chris Nicoll
Sports and Exercise Medicine (SEM) is undergoing a technological transformation, with affordable and easy-to-use devices widely available to assess multiple performance parameters. The technological advancements in SEM open the possibilities for utilizing objective measures to support clinical decision-making. However, it requires practitioners to understand how to interpret and analyze the data collected.
Practitioners assess jumping performance to guide rehabilitation progression and return to sport (RTS) decisions(1, 2). However, underlying mechanical deficits may persist even after athletes regain overall performance. For example, a single leg hop for distance on the injured limb may match the uninjured limb despite differences in knee joint angles and kinetics during landing(3). In addition, during bilateral tasks, such as the countermovement jump (CMJ), interlimb asymmetries in force production are present after severe lower limb injury (4,5). These deficits are potential contributors to the increased risk of re-injury as the ability to generate force and withstand loads during dynamic sports activities may be compromised.
Newton’s third law states that for every action (force), there is an equal and opposite reaction. When athletes apply pressure to the surface of a force plate, the electrical sensors measure the change in signal. Force plates measure the ground reaction force (GRF) that occurs in the opposite direction to the force applied by the athlete. When an athlete is standing still on a force plate, the GRF equals their body weight, i.e., F=ma: mass multiplied by acceleration caused by gravity (~ 9.8 m/s2).
While the athlete is aerial, gravity acts to accelerate the COM downwards. Therefore, the upwards motion of the COM will start to slow down as soon as they leave the ground until reaching zero velocity at the top of the flight and speed up again on the descent. The factor that determines jump height is take-off velocity. To produce the maximum possible take-off velocity, the athlete relies on the application of the impulse-momentum theorem.
Momentum is the quantity of motion a mass has and is the product of mass and velocity. In the CMJ, the athlete has zero momentum in the starting position (zero velocity) and aims to achieve the maximum possible upwards velocity at take-off. The area under the force-time curve illustrates the change in momentum dependent on the impulse of the force produced.
The period between initiation and take-off can be subdivided into three main phases (see figure 2):
Ballistic and plyometric training is a vital component of RTS rehabilitation as they invoke the stretch-shortening cycle mechanism inherent to most sporting activities. Assessing the CMJ provides clinicians with insight into the tissue capacity during rehabilitation and may guide decision-making. Progressive programming of plyometric exercise is critical to ensuring safe and effective training.
Return to sport testing requires robust, objective measures to support the goal of tissue capacity restoration. Practitioners use metrics such as peak or mean force, peak velocity, and impulse within each phase of the CMJ as considerations in return to sport decision making. If a dual force plate system is available, the athlete performs the CMJ while standing with each foot on separate plates. In that case, practitioners can analyze interlimb differences in force and impulse. Therefore, the CMJ provides clinicians with an easy-to-use, practical, and sport-relevant tool to assess tissue capacity and performance throughout rehabilitation.
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