BASICS OF INJURY REHABDavid Smith MS ATC

Sports Medicine 1

Everybody always tries to prevent injuries, but they will happen

Very few tend to be life threatening Most are not serious and have a rapid recovery Since sports are competitive it makes it

necessary to be aggressive in rehab Thin line between holding the athlete back or

returning the athlete too soon A mistake in judgment may hinder the athletes

return in the long run

Goal of Rehab

To return the injured athlete back to activity as soon as safely possible

Goals of Rehab

Provide First Aid and control swellingControl PainRestore ROMRestore Strength, Endurance and PowerReestablish Neuromuscular control and

regain balanceMaintain Fitness levelsFunctional ProgressionFunctional Testing

More Goals

Additional Goals for Long Term Rehab are: Daily Goals Weekly Goals Monthly Goals

First Aid and Control Swelling How the injury is managed initially is

essential to return Must control the swelling at the time of

injury RICE

Controlling Pain

The extent of pain varies Severity of Injury Athlete’s individual pain levels How in-depth the surgery may have been

Control pain using RICE Ice, Heat, Electrical stimulation ?Meds?

Restore ROM

Must get ROM back ASAP after surgery Ways to get ROM back

Active On your own

Passive Someone else doing it for you

Usually it is painful process to get full ROM back

Restore Strength, Endurance and Power

Isometric Exercise Isotonic or Progressive Resistance

Exercise (Concentric and Eccentric) Normal weight lifting

Isokinetic Exercise (later in rehab) Cybex, Biodex

Plyometric Exercise Spinning

Reestablish Neuromuscular Control This is the brains attempt to teach the body

conscious control of a specific movement.

Following injury, rest and immobilization the CNS forgets how to put information together.

Need to reeducate the body since it hasn’t been used

Contraction, Balance, Reaction

Regain Balance

Vital to re-teach the Neuroreceptors in the body part that is injured

If you fail to address balance problems this may predispose the athlete to reinjury

Maintain Cardio Fitness

This can be difficult depending on immobilization

Bike UBE Pool Treadmill Elliptical Stairmaster

Functional Progression

The purpose of any Rehab program is to restore normal function following injury

These involve a series of gradual progressive activities to assist in return to sport

If NO pain then can move on to more advanced skills

Functional Progression

Example: Walk Jog/Walk Jog Run/Jog Run Sprint Acceleration/Deceleration Lunges Shuffles Carioca COD

Functional Testing

Agilities Shuttle run, Figure eights, Carioca,

Fwd/Bkwd, Side to side, any other sport specific movement

Vertical Jump Broad Jump Hopping for Time (Jump Rope) Test for Quads and Hamstring Strength

Are they 70%,80%,90% of unaffected leg?

Return to play

Do they have to see the doctor to get clearance?

When do you let the athlete play again? How do you know? Is there a test?

Criteria for a Full Recovery

The decision to return to play is the final step

Doctor, ATC, Coach and Athlete should all be involved in clearing the athlete to play

Doctor has final decision Doctor will listen to the rest of the Primary

sports Med team to get feedback All should be confident in the return to play Gradual Return To Play Athlete needs to regain confidence playing