1. The 10 Phase Approach To Rehabilitation

2. 1. Structural Integrity 2. Pain - Free Joints and Muscles 3. Joint Flexibility 4. Muscular Strength 5. Muscular Endurance 6. Muscular Speed 7. Muscular Power 8. Skill Patterns 9. Agility 10. Cardiovascular Endurance

3. The 10 Phase Approach To Rehabilitation Structural Integrity Pain-Free Joint Flexibility Strength Endurance Speed Power Skill Patterns Agility Cardiovascular Endurance

4. The 10 Phase Approach To Rehabilitation Structural Integrity anatomical structures are intact surgery immobilization rest Pain - Free Joints and Muscles ways to diminish pain immobilization therapeutic modalities cryotherapy graded exercise (quad sets, isometric contractions..)

5. Joint Flexibility Decreased joint flexibility results from: muscle spasm, pain (Therapeutic exercise with cold) connective tissue adhesions (Therapeutic exercise with heat) When 80% of flexibility is restored rehabilitation emphasis moves to the development of muscular strength.

6. Muscular Strength Must perform a progressive resistive exercise on a regular basis. (DAPRE) Each side of the body should be worked independently. Once strength in the injured side is 90% of the non-injured side, emphasis moves to the development of muscular endurance.

7. Muscular Endurance Stationary bike Running when tolerated (jog 400 meters first day and increase by 400 meters each 1 or 2 days) When athlete can run 1 mile emphasis should move to next phase

8. Muscular Speed high intense stationary bike Cybex Muscular Power Isokinetic devices high- speed resistive work

9. Skill Patterns Participation in team drills at 2 speed Sport-specific skill patterns Agility Participation in team drills at 3/4 speed to full speed skill patterns are performed quickly and speedily Cardiovascular Endurance develop creative ways to maintain cardiovascular endurance throughout rehab.

10. Modalities and the 10 Phase Approach To Rehabilitation If you use a systems approach to rehabilitation, you must have some basis for choosing which therapeutic modality to use in each phase. The therapeutic modality must be matched with the therapeutic goal. In the following chart, the numbers 1,2, and 3 represent: 1. The modality has direct effect and is a good choice during the phase of rehabilitation 2. The modality can be effective if used in a specific way. 3. The modality is somewhat effective but is not the best choice to use for developing this phase.

11. Intact Pain-Free Intact Pain-Free Joints/muscles Joints/muscles Flexibility Strength Endurance Speed Skills Cardio Cold Pack Ice Massage Cold Whirlpool Hot Whirlpool Hot Packs Paraffin baths Contrast baths UltrasoundDiathermy Low volt MS High volt MS Exercise Passive Passive Assistive Assistive Active Active ROM ROM Jogging Jogging Sprinting Sprinting Agility drills Agility drills Team drills Team drills Practice Practice Resistive Ex. Manual Manual Isometric Isometric Isotonic Isotonic Free weight Free weight Universal Universal Nautilus Nautilus Isokinetic Isokinetic 1 2 1 2 1 3 2 1 3 2 1 3 3 1 3 3 1 3 1 3 1 2/3 2/3 1 2/3 2/3 2 1 2 1 2 3 2 3 2 2 3 2 2 3 2 3 1 1 1 2 3 1 1 1 2 3 2 1 1 2 3 2 1 1 2 3 2 1 1 2 2 3 2 1 1 2 2 3 2 2 1 2 2 3 2 2 1 2 2 2 1 2 2 3 3 1 2 2 3 3 1 2 2 3 1 2 2 3 2 1 2 2 3 2 1 2 2 3 1 2 1 3 1 2 1 3 Efficacy of Therapeutic Modalities in Rehabilitation of Sports Injuries