How to prepare a player for competition after injury: the Control-Chaos Continuum

by Lander Vandecaveye, 10 June 2020

In our last article we discussed how players often struggle to keep up with the pace of a game after a long period of inactivity. We mainly talked about how players are not used to dealing with all the stimuli of a game anymore, meaning they will have a hard time keeping up with the pace of a game and risk injuries.


As a physio, when helping a player during his RTP (return to play), there’s even more to it. You need to take the above into account, but you also need to make sure that the recovered tissue is ready for the demanding aspects of competition. There is still a big difference between executing movements in a controlled environment and performing uncontrolled movements in the chaos of a game. 


Take for example the RTP after an ACL injury. The player will most likely do jumps and changes of direction at a high intensity during the last phases of rehab. While the player might have no issues with performing these types of movements in the controlled environment, the reality of a game is different. Because of the overload of unpredictable stimuli during a game, the mind doesn’t have the time to focus on a controlled movement of the knee. 


The control-chaos continuum

For this reason, it’s important to gradually increase the stimuli during RTP, to simulate the stimuli a player will have to process during competition. This will be different for every type of injury, but there are some general guidelines that can be followed. One of the frameworks proposed in scientific research is the ‘control-chaos continuum’ by Taberner, Allen and Cohen (2019). 


This framework has 5 phases, with each phase gradually building up from easy and controlled drills (‘high control’) to complex and uncontrolled drills (‘high chaos’). In the case of a lower limb injury, a player will start with simple linear running drills in the high control phase. Change of direction exercises will be implemented in the second phase, as this is asking more from the knee compared to linear running. During phase 3 (control>chaos phase), intensity, explosivity and distance increase.


Things get really interesting in the fourth phase, or the ‘moderate chaos’ phase. As from this phase, more elements of competition are added to the training sessions. The athlete will execute movements based on unexpected cues, just like what would happen during a game. In the fifth phase, the intensity and volume further increase and the ‘worst-case scenarios’ are integrated (think uncontrolled movements with high volume and high intensity). 


It’s not our goal to discuss the CCC in detail, but we do want to want to highlight the importance of transitioning into the chaos phases, because the aspect of unexpected cues is often overlooked. Players may be well recovered and may be able to bear all loads (sprints, change of direction, jumps, etc.), but often only in a controlled environment. The reality of a game is different. There are so many unexpected elements and everything that seemed to go perfectly fine during the last phase of rehab all of a sudden doesn’t seem to be digested that well anymore. 


Whether you’re following the CCS or not, it’s crucial to add these unpredictable stimuli in the last phases of rehab to be fully ready to get back to competition. 


If you are interested in learning more about the different phases of the CCC, you can visit the links below. 


Article about CCC in Aspetar Sports Medicine Journal

Full scientific article in British Journal of Sports Medicine


Join the Ledsreact community and learn more on Instagram, Facebook and YouTube.


How to prepare a player for competition after injury: the Control-Chaos Continuum

by Lander Vandecaveye, 10 June 2020

In our last article we discussed how players often struggle to keep up with the pace of a game after a long period of inactivity. We mainly talked about how players are not used to dealing with all the stimuli of a game anymore, meaning they will have a hard time keeping up with the pace of a game and risk injuries.


As a physio, when helping a player during his RTP (return to play), there’s even more to it. You need to take the above into account, but you also need to make sure that the recovered tissue is ready for the demanding aspects of competition. There is still a big difference between executing movements in a controlled environment and performing uncontrolled movements in the chaos of a game. 


Take for example the RTP after an ACL injury. The player will most likely do jumps and changes of direction at a high intensity during the last phases of rehab. While the player might have no issues with performing these types of movements in the controlled environment, the reality of a game is different. Because of the overload of unpredictable stimuli during a game, the mind doesn’t have the time to focus on a controlled movement of the knee. 


The control-chaos continuum

For this reason, it’s important to gradually increase the stimuli during RTP, to simulate the stimuli a player will have to process during competition. This will be different for every type of injury, but there are some general guidelines that can be followed. One of the frameworks proposed in scientific research is the ‘control-chaos continuum’ by Taberner, Allen and Cohen (2019). 


This framework has 5 phases, with each phase gradually building up from easy and controlled drills (‘high control’) to complex and uncontrolled drills (‘high chaos’). In the case of a lower limb injury, a player will start with simple linear running drills in the high control phase. Change of direction exercises will be implemented in the second phase, as this is asking more from the knee compared to linear running. During phase 3 (control>chaos phase), intensity, explosivity and distance increase.


Things get really interesting in the fourth phase, or the ‘moderate chaos’ phase. As from this phase, more elements of competition are added to the training sessions. The athlete will execute movements based on unexpected cues, just like what would happen during a game. In the fifth phase, the intensity and volume further increase and the ‘worst-case scenarios’ are integrated (think uncontrolled movements with high volume and high intensity). 


It’s not our goal to discuss the CCC in detail, but we do want to want to highlight the importance of transitioning into the chaos phases, because the aspect of unexpected cues is often overlooked. Players may be well recovered and may be able to bear all loads (sprints, change of direction, jumps, etc.), but often only in a controlled environment. The reality of a game is different. There are so many unexpected elements and everything that seemed to go perfectly fine during the last phase of rehab all of a sudden doesn’t seem to be digested that well anymore. 


Whether you’re following the CCS or not, it’s crucial to add these unpredictable stimuli in the last phases of rehab to be fully ready to get back to competition. 


If you are interested in learning more about the different phases of the CCC, you can visit the links below. 


Article about CCC in Aspetar Sports Medicine Journal

Full scientific article in British Journal of Sports Medicine


Join the Ledsreact community and learn more on Instagram, Facebook and YouTube.


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