Toe, ankle, knee, hamstring -- every week it seemed like there was another NFL player on the injured list. In October 2015, it was the Arizona Cardinals' Alex Okafor with a strained calf, and a season-ending blow to Baltimore Ravens wide receiver Steven Smith's knee. More recently, it was a combination of thumb and wrist injuries for Andy Dalton and A.J. McCarron, leaving the Cincinnati Bengals hurting for a quarterback.

Workouts and training continue year-round for serious athletes who want to maintain muscle, improve their performance, or make a full recovery after an injury. Physical therapists help get them there.

And it's not just the pros. An estimated 4.2 million men, women and youth played football in either a professional or amateur capacity as of 2012, according to the National Center for Catastrophic Sport Injury Research. Nearly one-tenth of them are treated in emergency departments every year nationwide, according to the U.S. Department of Health and Human Services.

Movement screenings help get these players and other athletes back on the field in time for the next fantasy football draft, or even the annual company flag football game. Typical football injuries include lower back and knee pain typically caused by overtraining, but often more serious are traumatic knee injuries, especially ones to the anterior or posterior cruciate ligament and to the menisci. 

These athletes are also more prone to ankle sprains as a result of field surfaces and the cutting motions used in defensive and offensive play.

In order to best treat a patient's persistent pain, a thorough movement analysis is required to determine the etiology of the symptoms. Included in the movement examination is the passive and active mobility of spinal segments, body mechanics, neural structures, and non-contractile tissues.

Teenage athletes are injured at about the same rate as professional athletes, but injuries that affect high school athletes are often different from those that affect adult athletes, according to the American Academy of Orthopedic Surgeons.

Certain strength-building exercises aren't appropriate for young athletes because we need to take care not to stress their growth plate. As a result, teens can be more susceptible to muscle and tendon injuries.

A minor league baseball player with zero experience in weightlifting may be placed on the same movement and base-building program as a middle-school baseball player. Movement analysis is individual specific and understanding the integration of the whole musculoskeletal system, neural system and mechanical system is imperative to preventing injury and optimizing performance.

Physical therapists screen athletes by observing them while they perform a set of functional movements such as squats and leg raises, as well as walking and running.

Rating can be based on a zero-to-3 score. Each movement screen has scoring criteria and in general, zero = pain, unable to perform; 1 = unable to perform correctly with compensation; 2 = able to perform correctly with compensation; and 3 = able to perform correctly without compensation."

These scores help create a personalized fitness plan and can identify dangerous weaknesses a patient may have before injury occurs. Movement screenings can also establish a starting point for people who are not traditional athletes.

We had an adult who never mastered the motion of kicking a ball. In fact, he was always picked last in gym class early in life, and always wanted to excel at soccer, albeit never played once. In our movement analysis session, he was able to learn the coordination and the ability to step up, time it, balance, and kick a ball athletically. He then became the striker, or forward, on his volunteer league and scored the most goals all season.

This individual's progress was made possible by detecting underlying balance issues that would have gone unnoticed if it weren't for continual assessments.

Re-testing is done every 6-12 weeks. Through the proper, constant feedback and a home exercise program (HEP), the athlete hears the repetition required for learning and is able to integrate the new skill into the fabric of their own technique with constant coaching.

While the athlete is undergoing rehab, it's extremely important for them, their family, the team, and coaches to realize that they may not be able to return to the game at the same level, despite time and hard work put into recovery.

As physical therapists, we must continue to engage the patient in order for greatest efficacy, determining best practices and those that have not worked for the patient in the past. Educating the patient is also of the utmost importance, because that empowers the patient to become more independent and more importantly, prevent future re-injury.

As a result, the work of a physical therapist is a heavy weight to bear year-round. When it comes to working with athletes, we work very hard to manage their expectations. But they are, of course, incredibly eager to get back to their sport.

Most high-school players aspire to play on the collegiate level, and strive to earn scholarships in the process. Collegiate players are also trying to get back into the game so NFL scouts can see them and make steps to advance their career. Once the athletes go pro, physical therapists face pressures working with patients who rely on their physical ability to make money in a competitive industry.

Physical therapists must remain objective despite these stressors, and ultimately leave it to the screenings to determine whether an injured athlete should get back into the game.

So whether you are a professional athlete or a weekend warrior, we all strive to perform well and stay on the road of healthy living. If you have questions about movement screenings or experience impairments that hav affected your function, don't delay on getting a physical therapy assessment completed today.