Commentary - Journal of Physical Therapy and Sports Medicine (2021) Volume 5, Issue 6
Neuroscience approach to sports injuries.
Department of Sports Medicine
E-mail: [email protected]
Accepted on November 10, 2021
In the last few years, there has been a revolution in sports injury rehabilitation research and tactics. This has generated a substantial theoretical framework, yet there has been a rise in the incidence and reoccurrence of injuries, particularly those involving the ACL and soft tissue diseases. Injury occurs most frequently in a multi-stimulus setting, in which players must process information from multiple sensory organs at the same time. Although there is evidence that neuromuscular training can help with injury prevention and rehabilitation, many of these programmes focus on biomechanical aspects like muscle strength, balance, and plyometric function and ignore cognitive or neurological factor.
While muscles are necessary for skill performance, they do not think. The visual, vestibular, and somatosensory systems are all part of an integrated unit that starts with sensory and perceptual activities. Unresolved neuroplastic abnormalities after injury, reconstruction, and rehabilitation have been reported in recent studies, which may impair function and return to sports participation. Athletes suffer from sensory loss in the balance system as a result of serious injuries. Reduced drive for alpha motor neuron recruitment, disrupted reflex joint stabilisation, increased postural sway in balancing activities, and decreased visual movement acuity tasks are all consequences of proprioceptive impairment. Acute neural reactions to joint and muscle pain safeguard the body by reducing strength, agonist activation, muscular endurance, and modifying co-ordination patterns.
This helps to alleviate the strain on tissues in the immediate aftermath of an injury, but it also leads to chronic CNS changes. From the beginning, rehabilitation must be focused on maintaining cognitive skills, including exercises with proprioception, visual, and time and space decision-making actions. The difficulty of tracking numerous players and the ball while simultaneously identifying their position in the space associated to the individual is the most significant nonphysical stimulus during team sports. Attention switching, spatial and pattern recognition, memory recall, reflexes, vision, sensorimotor processing, and impulse control are all required of players. These abilities can usually be maintained through regular technical and tactical training.
Some soft tissue and skeletal injuries cause the affected area to be immobilised (and subsequently limits full movement). Immobilization causes a decrease in cerebral activity and lowers the player's cognitive functioning. Evidence also suggests that neuromuscular injuries can have a deleterious impact on cognitive abilities. Furthermore, when a visual task was added to a cutting task, those with a history of ACL damage performed worse than non-affected participants.
When a player is unable to train, this might be seen as evidence of cognitive detraining, emphasising the significance of stimulating neural pathways and maintaining cognitive skills. Sensory, motor, and autonomic function can all be regained during rehabilitation, as well as axonal/dendrite strength, which can lead to physical improvements and reflex normalization. In the rehabilitation process and return-to-play progressions, interventions to minimise these negative neuroplastic consequences, as well as the established biomechanical modifications, must be recognised. During recovery, motor skills training can be a useful tool. This aids in the reorganisation of the CNS's motor cortex, as well as increased protein synthesis, synaptogenesis, and map reorganisation.
New neural interconnections can be formed in the brain and spinal cord, allowing new functions to be established and old functions to be restored. New neural connections compensate for there-learning' processes after an injury. Adjusting synaptic connections is possible. Sensory motor training leads to improvements in functional performance. In feed forward motor planning during activity, the capacity to keep the continually changing surroundings (player or ball positions) in short-term visual memory is also critical. If visual-motor processing is impaired, the ability to adapt for external cues is harmed, and rapid manoeuvres that rely on quick visual-motor interaction are harmed, resulting in re-injury motor errors.
Athletes' sensory input from the wounded location and representation in the brain are altered when they return after rehab. For motor planning, the organism continues to rely on visual input rather than accumulating information from the previously wounded part all the way to the brain. This, in turn, could make it more difficult to respond appropriately to external inputs in game circumstances, thereby increasing the likelihood of re-injury. Mental imagery can be employed as a type of neurological and sport-specific therapy when athletes are still limited in their mobility. Despite the absence of any gross muscular movement, muscles reveal small quantities of electrical energy associated with specific performances when visualised.
Eccentric exercise is another technique that is frequently included in rehabilitation regimens. Eccentric training not only has a physical effect, but it also causes brain adaptation, such as improved motor unit recruitment. In addition to the biomechanical strategies that are already widely used, the requirement to bridge the intensive neurocognitive and motor control demands of sport during rehabilitation may benefit from particular interventions that target these neurocognitive factors.