Rehabilitation

Rehabilitation Restore to an appropriate level of competitive fitness Each program must be individualized Programs influenced by Severity of injury Stage of tissue healing Type of treatment Sport demands

Guidelines Restore of function in the shortest time possible Be aggressive, without causing harm Involve athlete with team Program needs to be progressive Use variety of equipment

Equipment

Common Mistakes Treat the cause not only the symptoms Fail to focus on all muscles involved, and only a single muscle Fail to improve and correct technique, anatomical misalignment and biomechanics

Goals Must be realistic Must be reachable If you don’t know where you are going you’ll end up someplace else - Yogi Berra

Program Components Surgery Immobilization, bracing RICE Modalities Joint stability / structural integrity Surgery Immobilization, bracing Decrease pain, inflammation and swelling RICE Modalities

Program Components ROM and flexibility Stretching exercises Muscular strength Resistance training

Program components Muscular endurance Bike, jog, run Speed

Program components Muscular Power Plyometrics Power lifts Agility, coordination and sport specific skills Balance Sport drills

Program Components Maintain cardiovascular Endurance Should begin immediately X-training- bike, swimming, UE ergo

3 Phase Approach to Rehab Phase 1 Symptoms Inflammation, swelling and loss of function Goals Decrease pain, swelling and inflammation Increase ROM Maintain strength of unaffected limb X-over effect Maintain cardiovascular conditioning Examples Immobilization Braces Crutches Isometric exercises Cross Train Bike or pool Modalities Muscle Stimulation RICE

Phase 2 Symptoms Examples Goals Pain and swelling are controlled Immobilization is not necessary Goals Restore ROM Increase muscle strength Begin to work on muscle endurance and power Maintain CV fitness Examples Passive, active and resistive exercises Cross training Bike Pool Modalities Muscle stimulation Thermotherapy before therapy session Cryotherapy after therapy session

Phase 3 Symptoms Goals Sport Specific skills Tissue repair and remodeling is occurring Goals Functional exercise Sport Specific skills Correct technique and biomechanical problems Restore balance and proprioception Evaluate the need for protective taping, bracing or padding Return to Play Examples Strength training continues to progress Heel raises, single leg stands Balance boards Plyometrics Sport drills Return to practice Return to competitive event Modalities Ultrasound Massage

Principles of Rehabilitation Overload To facilitate improvement the system involved MUST be progressively CHALLANGED Implement by increasing: Resistance Repetitions Sets Rate / intensity Duration SAID Specific Adaptations to Imposed Demands Principle of Specificity Conditioning program are specific to the type of stress applied during competition Practice how you want to perform