Al-Reem Al-Rashidi to Al-Rai: Treating athletes' injuries is a matter of science and planning
- The player’s treatment journey begins by determining the type of injury, the rehabilitation stage, the nature of his sport, and the demands that will be placed on him upon return.
- My focus is on restoring the player’s range of motion, strength, and function, then building his capacity to withstand the demands of his sport, progressing from rehabilitation to training, and finally to competition.
- Not all injuries can be prevented, but proper assessment and preparation reduce risk factors and enable early detection of problems.
- The cornerstone of treatment is exercise, restoring strength and mobility, gradual reloading, followed by functional and sport-specific training.
- One can purchase the best therapeutic equipment in the world, but what matters most is having someone who knows how to use it effectively.
- Training stimulates the body to adapt and improve, but adaptation requires adequate sleep, proper nutrition, and sufficient time for recovery.
Dr. Al-Reem Al-Rashidi, a physical therapist, emphasized that athlete rehabilitation after injury has evolved into a science with structured plans that go far beyond merely alleviating pain. Readiness is not measured solely by the absence of pain or injury, especially since a player may be able to train without necessarily being prepared to handle the full demands of competition.
In an interview with Al-Rai, Al-Rashidi noted that in modern sports, returning to the field no longer signifies the end of an injury or the disappearance of pain. Athletes may require additional phases to regain strength, speed, endurance, and the ability to replicate sport-specific demands under pressure and fatigue. She stressed that athletic readiness is a comprehensive concept that begins with prevention and assessment, proceeds through rehabilitation and reloading the body, and culminates in return to sport and performance.
She pointed out a lack of data and information regarding players’ injury histories. Documenting an athlete’s medical and injury records helps specialists design more accurate and effective treatment and rehabilitation programs, thereby reducing the likelihood of recurrent injuries. The following is the full interview:
- Injuries vary by sport, as each sport features specific movement patterns, loads, and common injury types. We frequently deal with muscle, tendon, joint, and ligament injuries, as well as overuse injuries. Additionally, old injury symptoms often resurface when training loads increase.
Prevention should not begin only after an injury occurs. We must understand the player’s history, previous injuries, strength, mobility, weaknesses, training regimen, and how his body responds to loads. While not all injuries can be prevented, thorough assessment, monitoring, and proper preparation help minimize risk factors and detect issues early.
- Readiness is not measured solely by the absence of pain or injury. A player may be able to train but not necessarily withstand the full demands of competition.
Therefore, I review the player’s injury history, range of motion, muscular strength, neuromuscular control, balance, and functional tests, in addition to his ability to execute sport-specific demands at the required intensity and speed. Often, the problem lies in the lack of information about the player’s injury history.
Thus, I ensure that the player is compared to his previous performance levels and baseline data, rather than just general averages. True readiness does not mean a player can simply step onto the field; it means he can perform at the level required by competition.
- I treat these modalities as part of the overall treatment plan, not as standalone therapies. Dry needling and therapeutic taping can be helpful in certain cases, but they alone do not return a player to the field.
The foundation is therapeutic exercise, restoring strength and mobility, gradual reloading, followed by functional and sport-specific training. Technology should serve the treatment program, not the other way around.
- The final days are not a time to build new fitness, but to maintain the balance between readiness and fatigue. We focus on sleep, nutrition, hydration, and recovery, while monitoring for any unusual pain or stress and avoiding sudden loads. During the tournament, it is time to showcase what has been built through training, not to construct something new.
At the same time, recovery should not turn into an attempt to shield the player from load. Athletes need load to become stronger and more capable of handling competition. The requirement is the appropriate dose for the right person at the right time, as athletes’ responses to loads vary from individual to individual.
• Can a player be medically recovered but not ready for competition?
Absolutely; a medical clearance to return does not always equate to performance readiness. The tissue may have healed, pain may have subsided, and mobility may have improved, yet the player may not yet have regained the required strength, speed, or endurance.
A player might be able to run, but unable to change direction with the same intensity, or may execute movements well initially, only for quality to decline with repetition and fatigue. Therefore, I do not view return to sport as having a fixed date, but rather as a gradual process based on clear criteria: tissue healing, absence of pain, restoration of mobility, strength, speed, and endurance, and finally, the ability to maintain performance quality under repetition and fatigue.
- I start with the athlete themselves, as there is no one-size-fits-all program. I consider the type of injury, rehabilitation stage, previous level, nature of the sport, position, and what will be required upon return. Then, I determine what needs to be restored in terms of strength, capacity, balance, neuromuscular control, speed, endurance, and change of direction, according to the sport’s demands.
After that, we begin sport-specific loading progressively, because a football player’s return differs from that of a weightlifter or a volleyball player. The goal is not merely to return the player to the field, but to return them prepared to stay and perform there.
- Load is part of treatment and development. However, after an injury, a player may have lost some of their capacity to tolerate the volume, intensity, or repetition they previously handled. Therefore, tissue healing alone is insufficient; the body’s capacity to tolerate load must be gradually rebuilt.
I monitor the amount of work the player has completed, their body’s response, the emergence of any symptoms during or after training, and their performance the following day. Load is part of treatment, but it is the dose, timing, and progression that make the difference.
- It has made me view the athlete as an integrated performance system, not just an injured muscle or joint. As a physiotherapist, I start with the injury and work on restoring mobility, strength, and function. However, exercise physiology prompts me to ask the more critical question: What happens after treatment ends? Has the player regained their physical capacity? Can they tolerate training? Have they restored the strength, capacity, and endurance required for competition?
For this reason, I approach the athlete’s journey holistically: injury, then rehabilitation, then return to sport, and finally, return to performance.
- I do not want to know the player only when they enter the clinic injured. I want to know their baseline when they are healthy: their strength, mobility, fitness, previous injuries, results, and how these indicators change throughout the season.
If I do not know the player’s level before the injury, to what level do I want to return them? Therefore, I believe in maintaining a file that tracks the athlete over time. Often, the best reference for an athlete is the athlete themselves before the injury.
- A high-performance athlete cannot be the project of a single individual. Every professional—the physician, the physical therapist, the exercise physiologist, the conditioning coach, the nutritionist, the psychologist, and the technical staff—sees only part of the picture. However, their mere presence in the same place does not necessarily constitute a team. A true team begins when we exchange information and make decisions about the athlete together. The athlete must be at the center of the system, with the various disciplines working around them in the same direction.
- I am very optimistic. We have skilled professionals, talented athletes, and great potential, but the next phase requires an integrated system. We need regular testing, monitoring of injuries and training loads, clear return-to-sport protocols, long-term health and performance records, and stronger integration between medical and performance teams. I hope we invest in specialists as much as we invest in equipment. One can purchase the best equipment in the world, but what matters most is who knows what to measure, why to measure it, and how to translate the results into decisions.
We also need to generate more data and research from Kuwait and the Arab region, because our athletes and society have their own unique characteristics.
I start with injury management, then work on restoring movement, strength, and function. Afterward, I rebuild the player’s capacity to withstand the demands of their sport, helping them transition from rehabilitation to training, and from training to competition.
Dr. Al-Reem Al-Rashidi spoke about the role of technology and modern measurements, stating that “technology has given us the opportunity to understand athletes more accurately. However, there is an important principle for me: science must guide the use of technology, not the other way around.”
She added, “Today, we can measure strength, movement, balance, loads, and more. But owning advanced equipment does not automatically mean having an advanced system. What matters is knowing why we measure, what the results mean, and what actions we will take based on them. The value lies not in the volume of data, but in translating numbers into decisions that benefit the athlete.”
When asked about the impact of her PhD at Loughborough University on her work, Al-Rashidi said, “The PhD changed the way I frame questions and build solutions. My research focused on assessing communities as a foundation for designing interventions and national physical activity policies to achieve more active societies. This made me always ask: What is the problem? How do I measure it? What do the data say? What is the most appropriate plan? And how do I know if the intervention succeeded?” She added, “This mindset has become part of my work with athletes as well: assessment, then planning, then intervention, followed by reassessment. Furthermore, the research highlighted the importance of generating data and research rooted in the realities of Arab societies, rather than always relying on data from different environments.”
Al-Rashidi emphasized that “women’s sports have witnessed significant development and growing interest in recent years,” noting that physical activity has become inclusive of various demographics, including pregnant women, amid rising sports awareness among women.
Al-Rashidi pointed out that “recreational sports are highly important, especially given lifestyles that involve prolonged sitting, which can lead to injuries and chronic pain over time.” She highlighted that shoulder and knee injuries are among the most common in Kuwait, urging regular physical activity and adherence to proper techniques to prevent injuries.
Al-Rashidi sent a message to players before any tournament, saying, “Trust the work you have done, and do not try to make up for everything at once in the final days. Pay attention to sleep, nutrition, hydration, and recovery, and do not ignore any unusual pain or fatigue. Do not hesitate to inform the medical team early about any issue. Sometimes, addressing a problem while it is still small allows the player to continue, whereas ignoring it may turn it into a bigger problem.”
Dr. Al-Reem Al-Rashidi holds a Bachelor’s degree in Physical Therapy from the University of Kuwait, a Master’s degree in Exercise Physiology, and a PhD in Exercise, Sport, and Health Sciences from Loughborough University in the United Kingdom. She has both field and academic experience in sports medicine, having participated in numerous sports tournaments and events.
She works on developing the sports readiness pathway—from assessment and prevention, through rehabilitation and load monitoring, to safe return to performance—and emphasizes the role of technology and integrated efforts in advancing Kuwait’s sports system.
