1. Phases of Rehabilitation

2. Phase I- Control Inflammation
PRICE- Protect Injury with elastic wrap, tape, sling, cast, etc
Cryotherapy- analgesic effect, stop muscle spasm, swelling
(cryotherapy/thermotherapy notes)
Cardiovascular- swimming, UBE, stationary bike

4. 2 1 3 4 5 6

5. Phase II- Increase ROM and (flexibility)
Scar tissue not as strong
Prolonged immobilization  Contractures
Full pain free motion
Can be passive or active (finger ladder, manipulation)
e.g. CPM

6. Flexibility Increase muscle length Ballistic stretching
Static Stretching
PNF- Proprioceptive neuromuscular fascilitation

7. Phase III- Strength Areas addressed:
Overload Principal: by frequency, intensity, and duration
Endurance- repetitions
Power: amount force in one given time.

8. Types of Strength Training
ISO’s- Isometric, Isotonic, isokinetic
Plyometrics
Concentric vs Eccentric
Agonist vs Antagonist (including reciprocal inhibition)
Open Chain vs Closed Chain
(Leg lifts vs squats)

9. 1) ISO’s Isometric- Contraction without movement
Used when immobile or when pain limits movement.
Isotonic- Contraction with movement- free wgts, tubing, concentric/eccentric, open and closed. Disadvantage- not constant force
Isokinetic- contraction with controlled speed, so resistance throughout full range. Disadvantage- need machine

10. 1 2 3 4 5 6 7

11. 3) Concentric vs. Eccentric
Concentric is when muscle is shortening during lifting phase.
Eccentric is when muscle is lengthening lowering phase.

12. 2) PLYO’s
Rapid eccentric and then explosive concentric – so big stretch of muscle and then quick contraction

13. ** may cause injury!!!

14. 4) Agonist vs Antagonist Muscles
pectorals/latissimus dorsi
anterior deltoids/posterior deltoids
trapezius/deltoids
abdominals/spinal erectors
left and right external obliques
quadriceps/hamstrings
shins/calves
biceps/triceps
forearm flexors/extensors

15. Agonist and Antagonist muscles are
controlled by Reciprocal Inhibition. When
an agonist contracts the stretch
reflex is activated (safety mechanism
that prevents injury) so the antagonist
muscle is told to relax.
A message is sent to the Spinal cord via the
Inhibitory interneron

16. Reciprocal Inhibitions:
This inhibition is accomplished by the action of an inhibitory interneuron in the spinal cord

19. 5) Closed Chain vs Open Chain Open Chain- distal end of the extremity being exercised is open or free to move Closed Chain- distal end of extremity being exercised is on contact with surface

20. Examples
Bicep Curl
Squats

21. Delayed Onset Muscle Soreness DOMS
Eccentric Muscle Contraction causes DOMS
Examples: the lengthening of the thigh muscles while the limb brakes against your body’s momentum as it walks or jogs down a hill.
Jogging or running on a flat surface can
also elicit DOMS symptoms for those who
are unaccustomed to this type of activity.

22. TX of DOMS: How to Avoid DOMS: Causes of DOMS??: *Active cool down
*Foam rubber
*Active cool down
*Stretching after
*RICE/NSAIDS
*Ice bath
*Time
How to Avoid DOMS:
*Warm up
*Cool down
*10% rule
Causes of DOMS??:
*Micro tears
*Repair of tissue causes soreness
*not lactic acid build up

23. Phase IV- Return to Sport
Proprioception/Balance- BAPS Bd, Wobble Bd, etc.
(Balance activity)
Coordination- Fine and Gross motor
Sport Specific (incorporate in all phases)
CV- always with Overload principal

27. Intermittant Compression boot

28. Vapocoolant Spray

29. Ice Immersion therapy

30. Paraffin bath

31. Hydroculator

32. Therapeutic Ultrasound

33. Intermittent Compression Boot