sports injuries rehabilitation. a progressive model for rehabilitation adapted, by permission, from...
TRANSCRIPT
Sports InjuriesSports Injuries
RehabilitationRehabilitation
A Progressive Model for A Progressive Model for RehabilitationRehabilitation
Adapted, by permission, from J. Hertel and C.R. Denegar, 1998, “A rehabilitation paradigm for Adapted, by permission, from J. Hertel and C.R. Denegar, 1998, “A rehabilitation paradigm for restoring neuromuscular control following athletic injury,” restoring neuromuscular control following athletic injury,” Athletic Therapy Today Athletic Therapy Today 3 (5): 13-14.3 (5): 13-14.
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Immediate TreatmentImmediate Treatment
The more immediate the treatment the The more immediate the treatment the better the outcome and the shorter the better the outcome and the shorter the recovery timerecovery time
Unfortunately many performers delay Unfortunately many performers delay seeking medical advice and continue to seeking medical advice and continue to train with an injurytrain with an injury
This then exacerbates the situation and This then exacerbates the situation and lengthens recovery timelengthens recovery time
RehabilitationRehabilitation
Used to return a performer Used to return a performer to their pre- injury fitnessto their pre- injury fitness
Time varies with injury typeTime varies with injury type
It usually comprises of 5 It usually comprises of 5 phases phases
Focusing on a progressive Focusing on a progressive approachapproach
RehabilitationRehabilitation
Phase 1Phase 1
Phase 2Phase 2
Phase 3 Phase 3
Phase 4Phase 4
Phase 5Phase 5
Medical management with the focus placed on pain relief, swelling reduction and protected mobilisation
Focus on restoring range of motion, non-weight bearing exercises
Flexibility and restoration of strength. Initially starts with isometric exercises, then isotonic with no load then onto proprioceptive exercises
Retain sport specific movement patterns and improve co-ordination and agility
Return to sport specific training
RehabilitationRehabilitation
Phase 1Phase 1
Phase 2Phase 2
Phase 3 Phase 3
Phase 4Phase 4
Phase 5Phase 5
Prevent swelling, Protect, Control bleeding, Relieve pain
Cold compression, elevation and rest
Control bleeding, Relieve pain, protect, Advise
PRICED
Absorbtion of swelling, removal of debris, growth of new vessels, development of scar tissue
Contrast bathing, elevation, massage, passive exercises
No swelling, No inflammation, some ROM, ability to undertake weight bearing
ROM, mobilisation and strength exercises, supports
Improve balance, coordination, skills and movement
TaskTask
Draw a diagram highlighting the 5 different Draw a diagram highlighting the 5 different phases showing the progression between phases showing the progression between each stage.each stage.
Include exercises you think would be Include exercises you think would be beneficial at each stage for a chosen injurybeneficial at each stage for a chosen injury
Hierarchy of Rehabilitation GoalsHierarchy of Rehabilitation Goals
Adapted, by permission, from J. Hertel and C.R. Denegar, 1998, “A rehabilitation paradigm for Adapted, by permission, from J. Hertel and C.R. Denegar, 1998, “A rehabilitation paradigm for restoring neuromuscular control following athletic injury,” restoring neuromuscular control following athletic injury,” Athletic Therapy Today Athletic Therapy Today 3 (5): 13–14.3 (5): 13–14.
RehabilitationRehabilitation
Patterns of motion that use multiple joints Patterns of motion that use multiple joints acting with various axes & in multiple acting with various axes & in multiple planesplanes– Essential part of rehab that places tissues Essential part of rehab that places tissues
under stresses that return tissues to levels of under stresses that return tissues to levels of full activityfull activity
– Places stresses & forces on each body systemPlaces stresses & forces on each body system
Traditional rehab techniques often stress Traditional rehab techniques often stress only single joints in single planes of motiononly single joints in single planes of motion
ProgressionProgressionFunctional progression = succession of Functional progression = succession of activities that simulate actual motor & sport activities that simulate actual motor & sport skillsskills– Enables the patient to acquire or reacquire the Enables the patient to acquire or reacquire the
skills needed to perform activityskills needed to perform activity– Must be able to adapt rehab to the sport-Must be able to adapt rehab to the sport-
specific demands & specific positionspecific demands & specific position
The clinician breaks down the activities into The clinician breaks down the activities into individual components.individual components.– The patient can focus on each specific part of The patient can focus on each specific part of
an activity.an activity.
Benefits for Using Functional Benefits for Using Functional ProgressionProgression
Helps patient reach goals of entire programHelps patient reach goals of entire program
Goals of functional progression:Goals of functional progression:– Restoration of joint ROMRestoration of joint ROM– Restoration of strengthRestoration of strength– Restoration of proprioceptionRestoration of proprioception– Restoration of agilityRestoration of agility– Restoration of confidenceRestoration of confidence
Provides both physiological & psychological Provides both physiological & psychological benefits to the patientbenefits to the patient
Full ReturnFull ReturnDecision requires full evaluation of athlete’s Decision requires full evaluation of athlete’s conditioncondition– Objective observation and subjective evaluationObjective observation and subjective evaluation
Athlete should feel readyAthlete should feel ready physically and physically and mentallymentallyControlled return Controlled return – Added stress to injury can slow healing and result long Added stress to injury can slow healing and result long
and painful recovery or re-injuryand painful recovery or re-injury
CriteriaCriteria– Physician’s releasePhysician’s release– Pain free, no swellingPain free, no swelling– Normal ROM, strengthNormal ROM, strength– Completion of functional testing minus adverse effectsCompletion of functional testing minus adverse effects