1. Understanding the Basics of Injury Rehabilitation

2. Athletic Injury Rehab
AT is responsible for design, implementation, and supervision of rehab program
Healthcare providers should be in charge of rehab, not coaches
ANYONE IS ABLE TO HELP CONTROL SWELLING AND DECREASE PAIN BY USING FIRST AID TECHNIQUES.

3. Long Term Goal of Rehab
Return the injured athlete to practice and play as soon as it is safely possible.

4. 8 Short-Term Goals of Rehab (don’t write just read, we will discuss each)
Provide first aid and limit swelling
Reduce pain
Restore full ROM
Restore muscular strength, endurance, power
Re-establish neuromuscular control
Regain balance
Maintain cardiovascular endurance
Include functional progression exercises

5. 1. Control Swelling Less swelling = faster RTP
Main goal of immediate care is to limit swelling
PRICE
Protect, Rest, Ice, Compress, Elevation

6. 2. Controlling Pain All injuries have some degree of pain
Pain is determined by:
Severity
Individual perception and response
Circumstances of the injury
PRICE
Therapeutic modalities

7. 3. Restore Full ROM All joint injuries lose some ROM Stretching
Muscle & tendon resistance, joint capsule and ligament contracture, swelling, or a combination
Stretching
Static, dynamic, PNF, foam rollers

8. 4. Restore Muscular Strength
Muscular strength, endurance, & power
Most essential factor in restoring function to pre-injury status
Exercise through a full, pain free ROM
Isometric
Isotonic – Progressive Resistance Exercises (PREs)
Isokinetic
Plyometrics

9. Strength Techniques Isometric Isotonic No change in muscle length
Early in rehab
Contraction (muscle pump) can reduce swelling
Isotonic
Progressive Resistance Exercises (PREs)
Muscle length changes
Most common training technique
Free weights, tubes, machine, body weight

10. Progressive Resistance Exercises (PREs)

11. Strength Techniques Isokinetic Plyometrics
Muscle length changes at constant speed
Used in rehab to measure strength
Machine set at specific speed
Plyometrics
Jumping and hops
Quick stretch of muscle followed by a contraction
Improves power

12. Plyometric Exercises

13. 5. Reestablish Neuromuscular Control
Produces coordinated movements
Mind teaches the body conscious control of specific movements
Body “forgets” how to move after an injury

14. 6. Regain Balance Improve whole body balance
Balance = postural stability
Balance problems will increase the chance of reinjury

15. 7. Maintain Cardiovascular Endurance
Most often neglected part of rehab
Cardio endurance decreases quickly
Start cardio training ASAP
Bike, swimming, arm bike, eliptical

16. 8. Functional Progression
Incorporate sport specific skills in rehab
Gradual progression to sport skills
Helps with ROM, strength, balance, and neuromuscular control

17. Functional Testing
Uses functional progression drills to assess the athlete’s ability to perform
Timed agility runs, vertical jump,
Compare to baseline or pre-injury test
Compare to uninjured side
Way to determine if the athlete is ready to RTP

18. Therapeutic Modalities
An intervention used to help with healing
Cold (cryotherapy)
Heat (thermotherapy)
Ultrasound (deep heat, not pictures)
Electric stimulation (stim)
Massage
Traction
Anyone can use basic modalities, but not everyone can use advanced modalities like stim, ultrasound, & traction

19. Cold (cryotherapy) Ice bags, ice massage, cold whirlpool
Decrease pain and decrease swelling
Ice 20 min – off 1 hour; repeat
Can place a wet towel between skin & ice
Wrap with elastic wrap and elevate to help decrease swelling
4 phases:
Stinging
Burning
Aching
Numbness

20. Heat (thermotherapy) Not used with an acute injury
Wait until swelling has stopped; do not use for at least 72 hrs after a new injury
Increases blood and lymphatic flow and helps the body reabsorb injury by-products
Increases relaxation
Use hot pack for 7-10 minutes

21. Ice vs. Heat
What do you use immediately after an injury to decrease swelling and pain?
What should be used for at least the first 72 hours after an injury?
What increases blood flow to an area?
What could increase swelling?
Which is safer to use if you are not sure?

22. It is safe to switch from ice to heat when…
There is little to no chance of additional swelling.
The injury is not point tender (sore to touch).
Any discoloration or bruising from the injury is starting to disappear.

23. Massage Is systematic manipulation of the soft tissues of the body.
Movements include:
Gliding, compressing, stretching, percussing, and vibrating to produce a specific response
Has mechanical, physiological, and psychological responses

24. Criteria for Full Recovery
Must determine what full recovery is for each injury
Physical
ROM, strength, NM control, cardio, functional
Must pass functional testing
Psychological (mental)
Confidence
RTP decision made by full sports med team
Doctor, AT, coach, and athlete