1. Chapter 12 - Basics of Injury Rehabilitation

2. Philosophy of Athletic Injury Rehabilitation
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

3. 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

4. Providing Correct First Aid and Controlling Swelling
Most critical
Should be directed towards controlling swelling
RICE principle

5. 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

6. Restoring Range of Motion
Injury always results in some loss of ROM
Stretching

7. Restoring Muscular Strength, Endurance, and Power
Most important factors in returning to normal activities
Always work in a full, pain-free ROM

8. 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

9. Progressive Resistance Exercise
PRE can be done with free weights, exercise machines, or rubber tubing
Isotonic contractions with muscle changing in length

10. Isokinetic Exercise Common in later phases of rehab
Uses a fixed speed and accommodating resistance
Speed can be changed
Used for testing, more functional

11. 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

12. 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

13. Regaining Balance
Rehab must incorporate balance drills to prepare the athlete for return to competition

14. Maintaining Cardiorespiratory Fitness
Usually the most neglected component of rehab
Level decrease rapidly
Must substitute alternate activities (pool, bike, etc)

15. 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

16. Functional Testing Uses functional progression drills to test
Figure 8s, shuttle runs, cariocas, side stepping, vertical jumps, hopping, back pedaling

17. 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