1. Rehabilitation Techniques in Athletic Therapy
Tara Sutherland

2. SOAP REVIEW (HORSP) S- subjective O- objective A- Assessment P-Plan
History taking , MOI , Pain etc
O- objective
Observing , special tests , palpations
A- Assessment
Impression as to what is wrong
P-Plan
Rehabilitation plan

3. Principles Design of Rehab plans Assess needs Develop plan
Implement plan
Evaluate plan

4. Assess needs
Subjective information
Objective data
List problem areas

5. Develop plan Establish goals
Select techniques based on available resources
Establish how changes will be documented and monitored
Implement return to plan /activity criteria

6. Implement Plan
Use procedures and techniques that will fulfill the plan and meet the goals
Incorporate the following into plan
Verbal motivation, visualization, imagery etc

7. Evaluate Plan
Compare original data with current data at frequent intervals
Modify goals according to changes in patient progress and activity level

8. Principles
Knowledge of the inflammatory process is crucial in understanding injury rehabilitation
Goals of Rehabilitation will be achieved through the use of therapeutic exercise to develop , improve , restore/maintain
Neuromuscular control
ROM and flexibility
Muscular strength
Postural stability and balance
Cardiorespiratory fitness

9. GOAL SETTING: GOALS BASED ON STAGES OF HEALING
Provide correct immediate first aid and management of the injury
↓ swelling, pain, inflammation
Re-establish neuromuscular control
Restore ROM
Restore and increase muscular strength, endurance and power
Improve postural stability and balance
Maintain (improve) cardio fitness
Protect/prevent further injury

10. GOAL SETTING: LONG TERM GOALS
Invariably to return the athlete to practice and or competition as quickly and safely as possible

11. BALANCE BETWEEN HEALING AND RETURN TO PLAY
“Walking a thin line”
Walking the tightrope
Pushing the envelope
REMAIN SAFE WITHIN CONFINES OF HEALING PROCESS

12. Rehab , what we know RECOLLECT PAST LEARNING:
Physiology and Exercise Physiology
Histology
Human growth and development
Motor Learning
Biomechanics and Kinetics
Strength and Conditioning
Personal Training
Sport Psychology

13. What we will cover

14. Inflammatory / Healing Process
PHASES OF HEALING:
Inflammatory Phase
2-4 days
Fibroblastic-Repair Phase
First few hours post-injury to 4-6 weeks
Maturation-Remodeling
3 weeks to several years

15. PATHOMECHANICS
Knowledge of NORMAL and ABNORMAL mechanics of biomechanics and functional anatomy is crucial
Once again you need to know anatomy

16. Kinetic Chain The therapist must understand the kinetic chain
If a system within kinetic chain is not working efficiently, the other systems are forced to adapt and compensate, this can lead to tissue overload, decreased performance and predictable injury patterns

17. Psychological Aspects
Individuals deal with injuries differently
Injuries and illnesses produce a wide range of emotions
Athletes vary in terms of pain threshold, cooperation , compliance, competitiveness, denial, depression, anger, fear , guilt and the ability to adjust to the injury
Belief that therapists are 95% psychologist and 5 % clinician

18. Tools
Electrical modalities, medications, massage, flexibility, strengthening, joint play, proprioception, alternative therapies, plyometrics, cardiovascular conditioning….

19. PAIN All injuries will experience some kind of pain
Severity may help to determine extent of pain, however athletes individual pain threshold will determine a major component of the pain.
PAIN IS REAL

20. PAIN
The therapist should address pain levels at each therapy session, modalities and medicines will be used to help reduce the pain.
Pain levels will dictate the rate of progression, as pain decreases.. Healing will progress.

21. Re-establish neuromuscular control
Re-establish neuromuscular control is a prime concern
Traditionally, certified athletic therapists have used the terms proprioception, strength, and functional exercise. Neuromuscular control relates to all of these concepts.

22. Restoring ROM
Loss of movement can be attributed to a number of pathological factors
Resistance of Musculotendinous units to stretch
Contracture of connective tissue
Or combination of two
Crucial to restore normal ROM , with out it difficult to achieve many other goals of the rehab program

23. Restoring ROM
Stretching is utilized to increase flexibility when Musculotendinous units are involved
OR Joint mobilizations are used to increase accessory movement with in a joint

24. Restoring Muscular strength , Endurance and Power
A major goal in performing strengthening exercises is to work through a full pain free range of Motion
A functional rehab strength program should involve exercises in all three planes of motion, with concentric and eccentric exercise.

25. Restoring Muscular strength , Endurance and Power
Isometric
Progressive resistive exercise
Isokinetic
Plyometric
Core
Open and closed??

26. Maintain (improve) cardio fitness
This stage can be neglected by many
Injured athlete miss training time , the cardio fitness decreases rapidly
Activities must be found to replace this training time that they miss.. Alternative can be found..what are some of them ??

27. Criteria for Full Recovery
Physiological healing constraints
Pain Status
Swelling
ROM
Strength
Neuromuscular control
Cardio fitness
Sport specific demands
Functional testing
Prophylactic strapping and or bracing
Responsibility of athlete
Predisposition to injury
Psychological factors
Athlete education

28. FUNCTIONAL TESTS Valid and reliable
Easy to apply, cost efficient, minimal time and space demands, applicable
Unilateral and bilateral function to ensure no compensation
Normative/pre-injury values exceptionally helpful
Limb symmetry
Ipsilateral limb/contralateral limb