This morning I was reading Sahil Bloom’s “Curiosity Chronicle” newsletter (sign up here) where he highlighted a “Framework that Applies to Everything.” Sahil brought up a 1999 book titled “Extraordinary Tennis for the Ordinary Tennis Player”. The author, Simon Ramo, discusses how in amateur tennis, 80% of points are lost due to unforced errors. The exact opposite occurs in professional tennis where you often see incredible winners by highly skilled athletes. There’s nothing better than a “tweener” down the line. Spectators love to see it.
Bloom’s point is that there are situations in life that require us to be conservative and let the game come to us. Likewise, there are situations that arise where we can craft up the perfect shot to win. I thought about his words for a bit and agreed that this framework can be applied to most things, including the rehab world.
Following an injury or surgery the main limiting factor is typically physiological healing early in the rehab process. When we are working to establish rapport with the patient and set the foundation for a successful rehabilitation, we need to do everything we can to avoid a significant setback that will delay healing or cause further injury. Our margin for error is much smaller and it makes sense to address low hanging fruit. This often looks like prioritizing appropriate range of motion, neuro-muscular control, reducing swelling, establishing weight bearing competency, addressing pain, and restoring homeostasis. Don’t make an unforced error.
As rehab progresses you need to continue utilizing checkpoints with criterion-based testing to ensure you are accomplishing what you set out to do and ensure the athlete is prepared for the demands of the next phase of rehab. Ensure the athlete is hitting strength benchmarks and making progress in tests that require power and elasticity, and are similar to the demands of their sport. Ensure they are approaching or surpassing norms. Continue to minimize risk and hit sure-handed, safe shots.
If you’ve ever watched a point play out with Federer, Serena, Rafa, or any of the other tennis greats, you might notice how they exert their will on the opponent. They manipulate them with carefully placed shots. They wear them down. It may even appear that the competitor is in the point until, bam! They hit the winner. We as fans may only remember the “tweeners” and cross court forehand winners. But it was the greats’ willingness to be patient and do the boring shots so excellently well over and over again that put them in the right position to hit the winner.
As rehab progresses, tissues heal, and the athlete grows stronger, the margin of error widens and you have the freedom to take constraints away, gamify drills, and do the “fun” activities with confidence. You get the opportunity to hit a few beautiful shots. But you get to do them with the assurance that you’ve done all the little things well. You’ve got data to back up what you are doing. You’re not carelessly risking the health of the athlete by playing a guessing game. You’ve hit the “boring shots” and put yourself in the right position to win the game.
