Rehabilitation

Definition Restoration to a ______________ for daily living Return to an appropriate level of _____________

Individualized and Influenced by: Severity of injury Stage of tissue healing Type of Treatment (surgery, protocol) Strength of the muscles of the limb Pain on motion of the joint Joint swelling Sport specific demands

Rules of Rehabilitation Create an environment for optimal healing Do no harm Be as aggressive as you can without doing harm If it hurts, ____________

Goals of Rehabilitation Vigorous, intense BUT __________ exercise allowing return to competition Ensuring injured part is as optimally conditioned as possible _____________ of function to the greatest possible degree in the shortest possible ______________ Goals must be __________ and ___________

Realistic and Reachable Goals ____________ range of motion ___________ strength _________ joint mobility _________ endurance __________ relaxation Enhance ________ and _______ ________ joint stability Prevent __________ _________ pain I_________ function Minimize _______ and ________________ _____ technique, ______ and mechanics _______ inflammation and swelling _________ motor control

Equipment Specialized equipment is very useful This will not guarantee results if program is inadequate, if athlete is not motivated or there is poor supervision Possible to use little or no equipment As long as the program is carefully and knowledgeably designed for athletes needs and if athlete is adequately motivated and supervised

Psychology of Rehabilitation Rehab is 75% psychological and 25% physical _________ with athlete is critical (motivation and communication) Help athlete deal with fear, anger, depression, self-doubt, and motivation Use a ________ of exercise to achieve the same results and avoid __________ Involve injured athlete with the team as much as possible- meetings, functions and practice

Components of a rehab program Program must be ____________ increase amount of ________ performed at each session Use correct _______ to maximize results and prevent injury _________________ _______________ ___________________ ______________________ _____________________- functional

Common Mistakes in Rehab Look for the “culprit” not the “victim” Focusing on __________ muscle group ______________ until injured limb is equal or superior to the uninjured side ____________ is often forgotten _________ defects, anatomical _________ and biomechanical __________ are neglected _____________ skills are not incorporated

Types of Exercise Isometric Isotonic Isokinetic Plyometrics Manual Resistance Concentric/Eccentric Contraction Open / Closed Chain

ISOMETRIC EXERCISE Does not result in any _________ of the joint Often performed against a ______________ _________ effective form of strength improvement ___________ exercise since there is no movement Examples; Wall press, stationary press

ISOTONIC EXERCISE The joint is moved through a range of motion against the resistance of a ____________ The __________ is fixed and the _____ is variable ________ movement since movement takes place ____________ gain takes place in the _________ movement as the muscle attempts to overcome resistance / _____ strength gain is at the ______ Examples: Bench press, arm curls, squat, heel raises

ISOKINETIC EXERCISE Exercise where there is ________________ and where the ________________ is set _____________ accommodates to match the ________________ Dynamic contraction since there is maintenance of a constant velocity Advantage- visual readouts are possible which helps evaluate progress and acts as a powerful psychological stimulus for the athlete Disadvantage- Cost of isokinetic machines

PLYOMETRICS A variety of exercises that utilize ____________ __________ to increase athletic __________ Maximize the stretch reflex Examples: Power jumps, leaps, bounds, throwing a weighted object- medicine ball Should be performed _________ days a week to allow full recovery from fatigue ____________ should first be attained to provide ___________- current injury is a contraindication

MANUAL RESISTANCE A provider adjusts the ______ of movement and ________ to that best suited to the athlete’s needs Will vary according to the stage of rehabilitation and the state of fatigue

Concentric Exercise Concentric exercises are related to ________ work The muscle ________ as the weight is lifted Example: The up phase of a biceps curl The biceps is the muscle working concentrically

ECCENTRIC EXERCISE Eccentric exercise is related to _________ work Muscle l_________ or is forcibly _____ while the weight is lowered ______ strength gains More stressful work for muscles resulting in muscle soreness Example: Lowering a dumb bell during a biceps curl The biceps is the muscle that is working eccentrically

Open Chain Exercise Exercise when distal segment is ______ and is freely moving in space Functional for ________ Examples: Leg extension Leg flexion Abduction/Adduction exercise machines Functional activities such as throwing, jumping

Closed Chain Exercise Exercise where distal segment is _________ Functional for __________ Examples: Standing leg press with sport cord Lunges Baps board Slide board Therapy Balls

Phases of Rehabilitation There are three phases Phase 1- Acute ______________ Phase 2- Sub-acute ___________________________ Phase 3- Intermediate __________________________

Phase 1- Acute First 48-72 hours Symptoms- redness, heat, swelling, pain, inflammation, loss of function Short Term Goals ______________ pain, swelling and inflammation ___________ Range of Motion and ________ Pain _______________ Cardiovascular conditioning

Phase 1-Acute continued Emphasis of _____________________ _____________ contractions if immobilized Exercise the _____________________ limb, may provide cross over reaction _______________ stimulation ______________ used to control swelling

Phase 2- Sub acute 72 hours to about 2 weeks Inflammation is decreasing and tissue is being repaired Begins as soon as pain and swelling are controlled and complete immobilization is no longer necessary _____________the area prior to attempt exercise and _____ will allow tissue to respond more effectively ________ injured area after working it to prevent secondary swelling and effusion

Phase 2- Sub Acute continued Short Term Goals Reach ________ range of motion ______ muscle strength, power and endurance to all muscle groups ______ cardiovascular endurance to pre-injury strength Begin _________ training Amount of time needed for tissue repair is based on several factors: Degree of injury Location of injury Age Nutritional status Medical problems Medications Use of corticosteroids

Phase 3- Intermediate Lasts up to 6 months Tissue is repairing, changing and remodeling to restore function Prepare for _______________________ Including open and closed chain exercises