Injury Rehabilitation Chapter 12 301-314

Components of a Rehabilitation Program Provide immediate first aid Controlling swelling Reducing pain Restoring full range of motion Restoring muscle strength, power and endurance Reestablishing neuromuscular control Regaining balance Maintain cardio-respiratory fitness Functional progression

Initial First Aid HOPS History Observation Palpation Stress

Controlling Swelling PRICE Protection Rest Ice Compression Elevation NSAIDS/SAIDS

Types of Muscle Contractions Isometric - static Concentric- shortening of a muscle Eccentric – controlled lengthening

Controlling Pain This is determined by the extent of the injury The athletes response and perception of the injury Circumstances of the injury Ice, heat, electrical stimulation, movement patterns, meds

Restoring Range of Motion Injuries to tissues or joints usually results in a loss of ROM Due to resistance of the muscle or tendons to stretch, contracture of ligaments or capsule, development of scar tissue Dynamic, static, or PNF stretching Mobilizations

Restoring Muscle Strength, Endurance, and Power Muscle strength – the maximum force that can be applied by a muscle during a single maximum contraction Muscular endurance – the ability to perform repetitive muscular contractions against some resistance Muscle power – the ability to generate force rapidly

Reestablishing Neuromuscular Control Neuromuscular control is the mind’s attempt to teach the body conscious control of a specific movement Following injury the body “forgets” how to put this information together. Strengthening and functional movements help to reestablish neuromuscular control

Regaining Balance The ability to balance and maintain postural stability is essential in athletics Proprioception – your bodies awareness to position a joint in space. Swelling inhibits mechanoreceptors which aid in balance

Maintain Cardio-respiratory fitness Athlete spends a considerable amount of time to condition themselves for activity to handle demands Injuries result in lost training time Must be able to offer alternative measures for cardio fitness UBE Pool Eliptical Treadmill Underwater Unweighted

Functional Progression Gradually progressing activities to prepare the athlete for a specific sport Advance as tolerated with activity Progressing to position specific drills Assist in regaining neuromuscular control, skills specific for sport, and confidence in abilities

Modalities to Help with Healing Ice – first 24-72 hrs, 20 minutes at a time Vasoconstriction of vessels “Hunting Effect” Hot packs – after 72 hrs Vasodilation of vessels Ultrasound ↑ extensibility of tissues ↓ joint stiffness ↓ muscle spasm Modulation in pain ↑ in blood flow Mild inflammatory response to help with chronic swelling

Modalities (cont.) Massage Electrical Stimulation Mechanical Physiological Psychological Electrical Stimulation Interferential Hi-volt Transcutaneous Electrical Nerve Stimulation (TENS)