Transcript Chapter 12 - Basics of Injury Rehabilitation

Chapter 12 - Basics of Injury
Rehabilitation
Philosophy of Athletic Injury
Rehabilitation
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Injury is the nature of sport
Most injuries do not require a long term rehab
Long term rehabs must be safe and effective
Athletics are competitive and thus necessitate an
aggressive rehab
• Goal is to return as soon as possible
• Thin line between not pushing hard enough and
being to aggressive
Goals of a Rehabilitation
Program
• Short term goals are:
• 1 - Provide correct immediate first aid and management
following injury to limit or control swelling
• 2 - Reducing or minimizing pain
• 3 - Restore full ROM
• 4 - Restoring or increasing muscular strength, endurance,
and power
• 5 - Reestablishing neuromuscular control
• 6 - Improve balance
• 7 - Maintaining cardiorespiratory fitness
• 8 - Incorporating appropriate functional progressions
Providing Correct First Aid and
Controlling Swelling
• Most critical
• Should be directed towards controlling
swelling
• RICE principle
Controlling Pain
• Amount of pain is determined by extent of
injury, individual’s response or perception
of pain, and circumstances of the injury
• RICE for acute pain
• Appropriate modalities can be used during
rehab to help with pain
Restoring Range of Motion
• Injury always results in some loss of ROM
• Stretching
Restoring Muscular Strength,
Endurance, and Power
• Most important factors in returning to
normal activities
• Always work in a full, pain-free ROM
Isometric Exercise
• Commonly performed in early phases of
rehab when a joint is immobilized
• Useful when exercises in the full ROM will
make the injury worse
• Increase static strength and decrease
atrophy
• May lessen swelling by pumping action
Progressive Resistance Exercise
• PRE can be done with
free weights, exercise
machines, or rubber
tubing
• Isotonic contractions
with muscle changing
in length
Isokinetic Exercise
• Common in later
phases of rehab
• Uses a fixed speed
and accommodating
resistance
• Speed can be changed
• Used for testing, more
functional
Plyometric Exercise
• Often in later stages
• Uses a quick eccentric stretch of a muscle
and a subsequent concentric contraction of
that same muscle
• Helps the athlete develop dynamic strength
(in motion)
• Ability to generate force rapidly is a critical
element in athletics
Reestablishing Neuromuscular
Control
• The mind’s attempt to teach the body how
to control movement
• Mind must read the body and respond
efficiently
• The CNS forgets how to do things
• Strengthening exercises help to retrain
pathways
Regaining Balance
• Rehab must incorporate balance drills to
prepare the athlete for return to competition
Maintaining Cardiorespiratory
Fitness
• Usually the most
neglected component
of rehab
• Level decrease rapidly
• Must substitute
alternate activities
(pool, bike, etc)
Functional Progressions
• Purpose of rehab is to restore normal
function
• Those skills necessary for a sport are broken
down into component parts
• If each new activity does not produce pain
or swelling, it should be advanced,
introducing new activities
Functional Testing
• Uses functional progression drills to test
• Figure 8s, shuttle runs, cariocas, side
stepping, vertical jumps, hopping, back
pedaling
Criteria for Full Recovery
• Besides physical well being, the athlete
must be confident in returning to
participation
• The decision should consult opinions of the
entire sports medicine team
• Team physician is ultimately responsible