by Vincent M. Burke, MPT,BS,CSCS,*DPT
Is my athlete ready to return to sport? Should I continue to train my client with this Theracise RX?
Can my son/daughter play?
These are common questions that I entertain on a daily basis from parents, coaches, scouts, agents and players. When asked these “golden standard” questions about an injured athlete and/ or a “well” client, the trainer needs to ask a few of his/her own prior to giving an answer. Over the last twenty years I have used this scale, called the “Tissue Reaction- Athletes Action Scale” (TRAAS, pronounced trace). This scale is very simple and it is a nice guide for all pediatricians, trainers, coaches, parents and clinicians to use. It also puts the “tissue” into a category which can be easily explained.
“TRAASing” the injury…
0: No injury
I: Irritation
II: Inflammation
III: Partial/Full Tear
The trainer should ask, “How reactive is the tissue?”
Tissue Reaction Athletes Action Scale: “TRAAS” 0-3
0: If the athlete has no symptoms pre-game, game /practice, post-game.
I: The athlete has symptoms after playing, but not before or during.
II: The athlete has symptoms during play, but not before.
III: The athlete has symptoms before play
What to do when the questions are answered?
If the athlete reports a 0, then he can play, however he needs to be part of an injury reduction theracise program to include proper rest, hydration, sufficient performance/ recovery nutrition, in season strengthening/conditioning and flexibility training program.
If the athlete reports a 1, then he can play, but with caution. The athlete may also be able to tolerate playing in a less stressful (on the tissue) position, giving the tissue time to rest and heal; such as playing first base if he is a pitcher. Having a 1 requires the athlete to have some type of therapeutic intervention after playing. This may include ice and/or other modalities, coupled with the aforementioned theracise program with a focus on the “reactive tissue”.
If the athlete reports a 2, he must stop immediately when it hurts and/or looses muscle performance function, especially if it is the same symptoms that originally sidelined them. This also means that some type of therapeutic intervention is needed immediately in order to “douse the fire.” The RICE principle is always effective. One can never put out a fire with gasoline and so if one continues to play when a fire is going on in the tissue it is equivalent to putting gas on a brush fire, it only gets worse, never to get better.
If the athlete reports a 3, he should be sidelined while participating in rehabilitation and/or a pre-habilitation program and also be under the care of a medical person.
I hope this will assist you in sorting out how to push your client or athlete when dealing with pain, inflammation or loss
of function. It should also assist you on how to quantify and qualify the tissue state of healing and if the athlete can play
or not.
Best of Health and Fitness,
Vincent M. Burke MPT,BS,CSCS,*DPT
President/Founder: Infinity Fitness & Sports Institute and Infinity Rehabilitation and Sports Medicine,LLC
201-913-4472