BASICS OF INJURY REHABILITATION Chapter 12

Introduction Rehabilitation of athletic injuries through programs utilizing progressive therapeutic exercises, is a major responsibility of the athletic trainer. Today athletic trainers must perform rehabilitation programs on athletes in the traditional setting, as well as in the clinical setting on the non-traditional athlete.

Therapeutic Exercise Versus Conditioning Exercise Programs Effects of General Inactivity & Immobilization on the Body Effects on Muscle Effects on Joints Effects on Cardiorespiratory System

Major Components of a Rehabilitation Program Minimizing Swelling Controlling Pain Restoring Range of Motion Physiological versus Accessory Movements Restoring Muscular Strength, Endurance and Power

Types of Exercises Isometric Exercises Isotonic Exercises Progressive Resistive Exercises Concentric and Eccentric Exercises Isokinetic Exercises Testing Strength, Endurance & Power Reestablishing Proprioception

Rehab of a ligament assess degree of injury immobilize joint (all ankles, shoulders, wrists, etc.) For first 48 hours place injured ligament in shortened position in order to heal as close to pre-stretched length as possible (mid-range of joint) controlled range of motion for healing to occur along the lines of stress (pain free range of motion exercises) controlled strengthening exercises (need to move out of mid range to stress inert and contractile t tissue)  

Rehab of Strains (must be pain free) PIER assess degree of injury gradual increase in stretching of injured muscle (must be pain free) gradual increase in strengthening of injured muscle (isometric, isokinetic, isotonic) gradual return to activity - sport specific exercises proprioceptive exercise maintain CV fitness maintain joint above and below, opposite limb and rest of body

Treatment for Tendonitis Rest, PIER find cause and make appropriate adjustments recognise signs and symptoms early to prevent condition from worsening gradual stretch and strength must do eccentric loading for complete recovery sport specific activity and gradual return to sport

Treatment for Contusions PIER restricted movement treat as strain after acute phase

Developing a Rehab Plan Exercise Phases Controlling Mobility during Rehabilitation Adhering to a Rehabilitation Program Criteria for Full Return to Activity

Additional Approaches Open versus Closed Kinetic Chain Exercise Aquatic Exercise PNF Techniques and Patterns Joint Mobilization and Traction Mobilization Techniques

Summary Athletic Trainers use of Rehabilitation Effects of Inactivity & Immobilization Major Components of a Rehab Program Developing a Rehabilitation Plan Additional/Unusual Approaches to Rehabilitation and Uses of Therapeutic Exercises