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Speed training both in general and within rehab settings has gained considerable exposure recently, with many practitioners and athletes across team sports now beginning to recognise the benefits of implementing higher intensity locomotion drills and associated speed training earlier in the process than was previously considered “safe” or “necessary”.
This speed-based approach is something I refer to as my Fast-to-Fit philosophy where my primary focus is on developing biomechanically efficient, effective and educated athletes who can not only tolerate but exhibit high levels of force and velocity outputs earlier in the rehab process before narrowing my attentions to the challenge of developing training or match fitness further down the line of their journey.
This speed-based approach shifts away from the historical methodologies I learnt and used when coming through the ranks of various S&C accreditations and roles which utilised a more volume focused approach. This approach is one that prioritises the exposure to longer, slower distance conditioning modalities earlier in the rehab process. Typically, once an athlete has attained the relevant workloads to be able to integrate back into training, speed would then be considered the final hurdle to overcome, usually coming in the form of limited exposures to prove that the athlete can tolerate the intense demands of sprinting. It is this “traditional” methodology that I found has left players exhibiting high levels of fatigue, chronic undercurrent of soft tissue issues and lacking match speed and agility sharpness. This is synonymous with players describing themselves as “flat”, “slow”, “rusty” or commonly “still not back to where they were pre injury”.
When we consider the type of running a speed-based approach promotes, it’s one that resembles more elastic, upright based running akin to classic track and field drills. Contrary to popular belief, the point is not to try and make team sport athletes move like sprinters. Rather, it is in respect to the joint stresses that occur across the lower limb during different types of running styles. Profoundly, it has been found that in rear foot strike running synonymous with slower & less elastic running results in significantly greater RATE OF LOADING requirements across the lower limb and eccentric work demands of the knee. This increased rate of loading and eccentric contribution around the knee coincides with increased muscle strain, and as a result it is very common to see athletes struggle with slower, plod based running early in the rehab process as their joints and tissues are under-developed or trained by nature of their injury. This to me is a major finding and supporting piece of evidence that promotes the use of drill-based running BEFORE plod based running. I would like to point out here, however, that slower, “plod” based running does make up part of my continuum; however, this comes at the final stages, not the initial stages.
As always however, it’s never quite as simple with drill based running associated with increased work through the ankle and plantar-flexors both eccentrically and concentrically, comparative to its slower, plod based counterpart. So, it is prudent to keep this in mind when thinking about ankle joint or tissue related rehab, with a combined approach of targeted physical development and introductory drills to maximise preparation and minimise stress beyond acceptable limits. It is for this reason that my rehab process pays so much attention to the development of physical qualities of the lower shank, foot and ankle. When I consider rehab, I do not think that it is overly difficult to return a player back to the field (bar any unforeseen circumstances). However, returning a player back to the field BETTER than when they left is a completely different ball game, and a task that I think is made possible only with a speed based approach.
When I consider rehab, I do not think that it is overly difficult to return a player back to the field. However, returning a player back to the field BETTER than when they left is a completely different ball game, and a task that I think is made possible only with a speed-based approach.
Alan murdoch
So how do you implement a speed-based approach within your return to running continuum? For this article, I will use ACL rehab as the example as it is what I spend most of my practice specialising in. It’s important to note here that although this framework is specific to ACL rehab, it can be applied generally across multiple longer-term injuries.
To begin with, there are two separate streams that I consider in my Fast-to-Fit framework. In this diagram, the top half of content (separated by the dashed line) represents my pure speed-based content which is further broken down into horizontal acceleration based work and vertical max velocity based work. The bottom half represents the on feet conditioning component of the framework and is primarily focused on “classic” conditioning modalities although I do use “alternative” methods to supplement this also if I deem it appropriate (see bottom stream).
Importantly, as time progresses, the content of both streams begins to converge towards the end goal: repeatable high intensity game-based actions in the form of agility conditioning, game simulation and conditioned games. These actions are all pitched at an intensity relative to training and match play so that the task of integrating athletes back to training is as seamless and easy as possible. Both streams operate alongside one another to make up my Fast-to-Fit continuum. To fully comprehend the framework, it’s necessary to take a step back and discuss the progression of each stream.
When considering the speed-based stream, specifically the acceleration component, initial exposures take the form of resisted running at higher loads, progressing to unresisted acceleration work. Commonly, I will use steps or distance as my landmark progressions. For example, if an athlete can complete 4 steps or a 5m acceleration at 75% / 50% / 25% bodyweight with no pain or technical malfunction, I will progress to “free runs” at the same distance. I will continue this approach up until 20m. There are two benefits to this:
These two factors are something referred to as training and teaching. Both are necessary for improved health and performance.
Once an athlete can complete unloaded 10-20m runs (dependent on sport and position), the stream progresses to repeat accelerations whereby rest is progressively shortened. My intended end point here is the completion of 10 runs with as little as a 10% drop off whilst maintaining technical threshold. This can be monitored through coaches’ eye, in real time or commonly through the creation of kinograms to reflect and review technical performance under fatigue.
After this, I will incorporate task specific patterns prior to acceleration (e.g., attacking, defensive or transitional steps) which are intended to look and feel like very isolated game demands. It’s important to me here to base this off historical player footage and positional demands, alongside directed planning with the athlete and coaches to ensure the transfer of closed acceleration mechanics to more relevant and situational scenarios.
Finally, and very importantly, I will look to expose the athlete to game relevant situations and tasks that are acceleration dominant and therefore more “close-quarters” in nature. I find that this structure progressively exposes the athlete to both physical stress whilst providing a progressive learning landscape where new skills can be developed prior to return to training. Without this stage I think we are at risk of just developing fast (or faster) athletes that struggle to exhibit this in game – a quality known as Gamespeed.
The max velocity stream starts at the same time as loaded accelerations and commences with “mini drills” of lower intensity and amplitude. I commonly use 10x10m as my entry point of mini drills and commence these as soon as an athlete has full knee function and ability to complete band assisted pogos – hence why they can be initiated so early in the process. These small amplitude drills act as a great technical and educational stimulus, but also as a low intensity exposure to develop the necessary foot and ankle based qualities previously mentioned to excel within a Fast-to-Fit approach.
Approaching mid stage, I’ll use constrained bleeds which encourage technical focus at the beginning of a given run followed by a “bleed out” zone where the focus is to hold on to the “feeling” prompted in initial stages of the run whilst transitioning to a more “natural” gait. This is my bridge to making lasting technical change over time. I will commonly use sleds, cones and wickets here as constraints based on the athlete’s individual movement needs.
It is here that I think it necessary to also mention that coaching language is by far the most powerful tool I have in my toolbox here to instigating technical change. Constraints are great, and often times make coaching easy, but finding language and imagery that promotes a connection to “feeling”, which is the golden ticket when it comes to helping an athlete make technical changes that actually stick inside the more chaotic environment of training and playing.
Following the transition from mid-to-late rehab, I’ll introduce sprinting which I class as anything over 90% intensity/velocity which I track using GPS, timing gates or app based kinematic feedback. It’s really important to understand here that not all sprinting is equal when it comes to stress, and I will diligently use rolling-to-static-to-transitional starts to progressively increase stress and tax the athlete’s ability to sustain technical threshold during efforts.
Once I have seen tolerance and technical improvement in more closed sprinting, I will introduce sprinting under fatigue with gradually decreasing rest periods. Again, my intended end stage here is to remain above a 10% drop off in time / velocity across specified rep ranges. Finally, I will use isolated expansive situational exposures to help the athlete blend technical and tactical components prior to moving into late stage agility conditioning.
I use my 10x30m protocol as my introduction to “Fit” based running (Figure 5). This protocol is an extremely powerful tool as it allows me to educate the athlete with what I call “review recoveries” where I will review footage of the previous run on the walk back recovery, each time picking one technical focus point to address. This process is intended to allow the athlete to attach value to efficiency and technique which is something I see missing in many rehabs. Another important point of the 10:30 is that the athlete self-selects an intensity that they feel they can tolerate both physically and technically, something I refer to as “technical threshold”.
The final huge benefit of using this protocol is the data collection side of things. I will use live GPS to progressively manage intensity and associated tissue stress as well biomechanical and video feedback to attain baseline kinematics and visuals which provide a platform for review and act as my progression criteria before progressing any further down the stream. I will commonly spend 4-6 weeks on the 10:30 protocol, with the ambition of attaining ~60-70% velocity within technical bandwidths before progressing.
As mentioned, I use kinematic assessment throughout my process and will only progress an athlete past the 10:30 protocol once I see a homeostatic and relative symmetry between limbs. To be able to do this, it is first necessary to grasp the phases of gait that the data relates to (Figure 3).
Simply, there are 4 phases which I refer to as:
With these phases, it is possible with the use of AI to establish the range and velocity that each limb travels through as measures in degrees per second. This then generates my “Stride Cycle” measurement which plots average limb thigh angular velocity (tAV) across both limbs comparatively in a 10m section. In laymen’s, it tells me how balanced limb function is of the injured athlete which is something I use as my objective criteria during return to running in rehab. Additionally, it allows me to hone in on specific cues, exercises and constraints in an attempt to balance out the profile as much as possible.
What we see is a clear lack of symmetry consistently across exposure one at various speeds across a four-week period. This is shown by the lack of overlay between the blue and yellow lines (Figure 4). Specifically, the profile is consistently biased to a lack of “ATTACK” tAV and exaggerated “RIP” tAV on the injured side coupled with “PUNCH” compensations on the uninjured side. This information is very powerful because not only does it influence my coaching and cueing encouraging the athlete to be more aggressive down and through the floor to balance the profile, but encourages engagement through a simple visual that the athlete can strive to improve over time.
Positively, after multiple exposures and specific coaching and interventions, we see a harmonious symmetry develop as seen by the overlapping radar plots (Figure 4). This progression is an overcoming of inhibition through focused and specific coaching and gym-based exercise selection, general familiarity with the task and confidence. Interestingly, what we see with each velocity increase across weeks 1-4 is a regression to initial strategy, despite having found relative symmetry after coaching and exposure at the previous speed. Additionally, as speeds increase across the weeks, it takes more exposures to find equilibrium in the gate cycle meaning that as velocity increases, it takes more repetitions and exposures to learn and adapt both cognitively and physically to the increases in neuromuscular demands that accompany faster running. My point here is not to show off fancy graphs and data points, rather it is to showcase that truly understanding and measuring the demands of speed can greatly influence our objective measures and thus create more robust progression criteria for our athletes moving forwards during rehab. On reflection, this information also promotes a speed-based approach further given that speed is clearly a skill that demands focus, frequency and appropriate underpinning physical and neural development to develop to a point where relative symmetry is established, especially at higher velocities. This is something that is not possible in a “plod approach” where limited time and focus is often placed on developing the skill of speed.
Moving on to the rest of the continuum, contrast dribble runs not only demand tolerance and force adaptation to greater volume but also act as a bridge between dribble running and “normal running” to allow the athlete to feel the difference between the two styles. This I have found enhances learning and transfer, but also importantly trades between two styles that demand stress in different areas, thus minimizing overload of a particular area (usually calves).
Through mid and mid-late stages I heavily rely on extensive and intensive tempos, commonly alternating between the two modalities within a week. I view extensive tempos as engine grease and intensive tempos as superchargers. What I mean by this is that my extensive tempos bias the development of more aerobic capabilities and the faster, shorter intensive tempos build a resistance to technical breakdown alongside a tolerance to higher outputs and specific tissue conditioning of speed specific physical qualities.
My final phase of mid stage rehab for ACL rehab will involve exposure to both death shuttles which I consider to be influential in the physical tolerance of sub optimal mechanics under fatigue (an under-appreciated consideration in rehab in my opinion) whilst challenging and enhancing tolerance to the psychological inhibition that exists within these challenging sessions. Additionally, I will heavily rely on mixed modal work, where I utilise many different variations of “the square” which aims to collect high volumes of varied stressors, similar to volumes that reflect periods of gameplay (see Figure 5).
During late-stage rehab I utilize 3 modalities of training that overlap, all with the purpose of developing athletes who can tolerate and express high intensity actions under fatigue, whilst tolerating loads relative to training and in some cases, the game. This quality is what is commonly referred to as Gamespeed.
The first is what I call agility conditioning. This conditioning modality is critical in the development of skill execution and decision making progressively under fatigue in scenarios that mimic the demands of the athlete’s position and playing style. Although this modality undoubtedly develops “fitness” both from an energy system and tissue tolerance perspective, it is more about the development of technical and tactical decision making under progressive fatigue and cognitive challenge. I will break this content down in to restricted or expansive spacing dependent on the stimulus and skill set we are trying to develop and will commonly design these scenarios in collaboration with the athlete. Importantly I will ask the athlete to identify a number of “dynamite actions” and “kryptonite actions”. These super strengths and perceived weaknesses will heavily influence task design in an attempt to challenge athlete work-ons while promoting what is their super strengths and ultimately build confidence prior to a return to training. I will limit volume progressions to 20% per session here to provide a fairly large bandwidth if additional reps and exposures are needed to refine and learn.
The final training modality I will use prior to return to training is GameSim. GameSim sessions are designed to replicate specific volumes, intensities and densities of Game Play. They include bouts of worst-case intensities and regular case intensities at progressive time or volume exposures. My end goal here is for an athlete to be able to thrive both physically, technically, and in some cases tactically, inside the time demands of a worst-case half of their sport (which commonly will be the entry point for their introduction back to match play). For this to be effective, an understanding of the game and its demands for each player is necessary.
By building both “fast” streams and “fit” streams in harmony alongside each other we can create technically efficient, fast and repeatable athletes capable of exiting rehab better than when they left. And like I said, that’s not an easy task to achieve.
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