Phases of Rehabilitation

Rehabilitation Rehabilitation~ process of recovering from an injury Treatment and education to regain maximum function and high level of independence

Rehabilitation Team Physician Physical Therapist Athletic Trainer Fitness Instructor Physical Therapist Assistant Family THE PATIENT

The Patient Motivated Desires to return to pre-injury level Belief in Recovery Compliance

Rehab Environment Patient Safety Patient Needs Patient Comfort This includes: ~Sight, Smell, Sound, Touch

First Session Patient History is EXTREMELY important Knowing entire situation = ease into physical rehabilitation

Motivation Motivation~ reason for performing an action; stimulus for behavior ~ Intrinsic Motivation ~ Extrinsic Motivation What is the difference? How do you motivate?

Motivating the Athlete Greet and know athletes Use name frequently Education of athlete about injury Convey confidence and knowledge Explain Objectives Provide clear and simple directions Positive Attitude (it ’ s contagious!)

Goals Education Assist athlete in reaching goals Return athlete to pre-injury level

Education Giving knowledge to athlete gives sense of control Education will help the athlete understand what his/her body is doing

Goals Take time out initially to set goals Short term goals are rehabilitative in nature Long term goal is Sport Specific (return to play)

Return to Play Physically Ready ~ Functionally able to do skills ~ In good Cardiovascular shape Mentally Ready Physician Clearance

Rehabilitation Process Each program needs to be unique Healing process is universal Three phases of Rehabilitation Phase 1 ~ Control pain and damage Phase 2 ~ Repair damage Phase 3 ~ Rebuild healthy tissue Objectives of phases interlinked

Safety Guidelines Monitor any type of pain or edema increase Advise pt on need to regain strength in a controlled manner Review limitations of ADL with each pt Ensure pt can do exercises properly on own

Phase 1 Immediately after the injury (2-3 days) Primary Goal: decrease inflammation Secondary Goal: prevent additional loss of function by protecting injury Establish a baseline for future evaluations Maintain currently levels of fitness

Phase 1 Plan Decrease blood flow to tissues Protect the injured area to prevent further damage Bracing, splinting, or taping area Suggest use of supportive devices (slings or crutches Evaluate strength, ROM, and amount of edema

Phase 1 Plan Cont ’ d Maintain strength and flexibility in injured area as well as rest of the body Educate athlete on safe and effective methods that can be done at home Instruct athlete on how to safely modify ADL ’ s to help avoid further injury Use motivation techniques

Phase 2 Occurs after inflammation and pain controlled Repair of damaged tissue through strength and ROM exercises Promotion of self-sufficiency to return to ADL ’ s

Phase 2 Plan Evaluate strength, girth, and ROM Compare results with results from phase 1 Increase functional use of injured area Increase blood flow prior to strengthening Continue to decrease pain and edema Begin gait training and improve weight bearing activities for lower extremity injuries

Phase 2 Plan Cont ’ d Increase patients ADL ’ s as appropriate Continue to increase confidence and self- esteem Be as creative as possible No cook book way to do rehabilitation

Phase 3 Remodeling: retraining muscles to function in normal capacity as close to “ normal ” as possible Prepare the athlete to return to daily life Exercise Modalities ~ rehabilitative treatment involving use of physical activity to increase strength and flexibility

Phase 3 Plan Increase endurance, strength, and flexibility in the injured area Teach athlete how to use treatments at home safely Prepare athlete to return to play Evaluate strength, girth, and ROM Compare to previous evaluations

Phase 3 Plan Cont ’ d Enhance coordination and balancing skills Make them sport specific Assist patient in organizing and developing a plan to meet his/her fitness goals Released by physician to return to play