As physios and therapists we have a natural desire to be the best which is why we read journals, go on courses and listen to podcasts. So why do we find it so hard to programme and precribe agility training for lower limb rehabiltation ? Well, unfortunately agility training in our Undergraduate training is never taught, so many of us have had no exposure to this important set of skills. The skills required to precribe effective agility and change of direction for lower limb rehab are the same qualities required for athletic performance.
So, what is agility training?
Before I tell you what it is, I have to tell what it is not!
It is not as may physios have been taught simply the asking your patient hop in and out of a set of agility ladders!
So, let’s now define what agility is ....... because everyone likes a definition:
Agility is a rapid whole-body movement that either involves a change of direction or a deceleration in response to a stimulus (Nimphius et al., 2017)
Agility can therefore be broken into 2 discreate areas
1. Perceptual and cognitive factors (i.e. things like reaction time)
2. Technique and leg muscle qualities (i.e. how strong are you and what your technique looks like)
So, I will define it again ….
Agility is a rapid whole-body movement that either involves a change of direction or a deceleration in response to a stimulus
The bit to take a way... here is the response to a stimulus! This is the perceptual and cognitive aspect of agility. So, for example if you are using agility ladders with your patients, which I don’t really advise, and you blow a whistle to indicate they should change direction … that would be the cognitive and perceptual aspect in response to a stimulus.
Change of direction (COD) speed
This is the other half of the equation and in my opinion by far the most valuable part of the agility equation where physiotherapists can add significant value . This is the very trainable component; including technique and skill development and leg muscle strength qualities (Paul et al., 2016).
To define COD speed:
It is a rapid whole-body movement that either involves a change of direction or deceleration using a pre-determined route or course.
So, what are the clinical take home messages that you can use in your clinical practice to get better outomes.
1. The perceptual cognitive part of agility is often best left to a sports coach once you have discharged the patient as fit to return to training. For example this is best achieved with team sports using small sided games in a sporting environment unless you feel confident to deliver this type of training.
Technique and leg muscle qualities are the change of direction speed part of agility training
2. Improving Technique for change of direction speed is well within your capabilities as a physiotherapist if you understand the physics that underpin it. But even if you don’t, please don’t worry because my next point is more important than reading a physics text book! (Nimphius et al., 2017)
3. Get your patient stronger than THEY or YOU think they need to be! Consistently, leg muscle strength and power development have been shown to differentiate elite from novice athletes when it comes to change of direction speed (Fiorilli et al., 2020). This is where you really “CAN’T GO WRONG WITH GETTING STRONG”
Further reading
Fiorilli, G., Mariano, I., Iuliano, E., Giombini, A., Ciccarelli, A., Buonsenso, A., Calcagno, G., & di Cagno, A. (2020). Isoinertial Eccentric-Overload Training in Young Soccer Players: Effects on Strength, Sprint, Change of Direction, Agility and Soccer Shooting Precision. Journal of Sports Science & Medicine, 19(1), 213–223.
Hammami, A., Gabbett, T. J., Slimani, M., & Bouhlel, E. (2018). Does small-sided games training improve physical fitness and team-sport-specific skills? A systematic review and meta-analysis. The Journal of Sports Medicine and Physical Fitness, 58(10), 1446–1455. https://doi.org/10.23736/S0022-4707.17.07420-5
Nimphius, S., Callaghan, S., Bezodis, N., & Lockie, R. (2017). Change of Direction and Agility Tests: Challenging Our Current Measures of Performance. Strength and Conditioning Journal, 40, 1. https://doi.org/10.1519/SSC.0000000000000309
Paul, D. J., Gabbett, T. J., & Nassis, G. P. (2016). Agility in Team Sports: Testing, Training and Factors Affecting Performance. Sports Medicine (Auckland, N.Z.), 46(3), 421–442. https://doi.org/10.1007/s40279-015-0428-2
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