Rehabilitation in Sport: Difference between revisions

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''Control pain and swelling''<ref name="1">Chiro-medical Group. Physical Therapy. Phases of rehab. http://www.chiromedicalgroup.com/phases-rehab (accessed 20 May 2016).</ref>  
''Control pain and swelling''<ref name="1">Chiro-medical Group. Physical Therapy. Phases of rehab. http://www.chiromedicalgroup.com/phases-rehab (accessed 20 May 2016).</ref>  


The body's first response to an injury is inflammation.<ref name="2">Human Kinetics. Excerpt: Understand rehabilitation to facilitate a return to competition. http://www.humankinetics.com/excerpts/excerpts/understand-rehabilitation-to-facilitate-a-return-to-competition (accessed 20 May 2016).</ref> It's main function is to defend the body against harmful substances, dispose of dead or dying tissue and to promote the renewal of normal tissue.<ref name="3">Sports Injury Clinic. General Injuries and Conditions. Inflammation. http://www.sportsinjuryclinic.net/sport-injuries/general/inflammation (accessed 25 May 2016).</ref>&nbsp;The goal for treatment during this phase is to provide a&nbsp;healty environment for new tissue regeneration and formation, and to prevent prolonged inflammation and disruption of new blood vessel and collagen production.<ref name="2" />&nbsp;  
The body's first response to an injury is inflammation.<ref name="2">Human Kinetics. Excerpt: Understand rehabilitation to facilitate a return to competition. http://www.humankinetics.com/excerpts/excerpts/understand-rehabilitation-to-facilitate-a-return-to-competition (accessed 20 May 2016).</ref> It's main function is to defend the body against harmful substances, dispose of dead or dying tissue and to promote the renewal of normal tissue.<ref name="3">Sports Injury Clinic. General Injuries and Conditions. Inflammation. http://www.sportsinjuryclinic.net/sport-injuries/general/inflammation (accessed 25 May 2016).</ref>&nbsp;The goal for treatment during this phase is to provide a&nbsp;healty environment for new tissue regeneration and formation, and to prevent prolonged inflammation and disruption of new blood vessel and collagen production.<ref name="2" />&nbsp;
 
The most immediate emotional response at the point of injury is shock. It's degree may range from minor to significant, depending upon the severity of the injury. It is important to note that denial itself is an adaptive response that allows an individual to manage extreme emotional responses to situational stress.<ref name="7">Buschbacher R, Prahlow N, Dave SJ. Sports and Medicine Rehabilitation - A Sport-Specific Approach. 2nd ed. Philadelphia: Lippincott Williams and Wilkins. 2009</ref>


==== RICE: Rest, Ice, Compression, Elevation  ====
==== RICE: Rest, Ice, Compression, Elevation  ====


Primary treatment in initial phase of rehabilitation is RICE.<ref name="2" /><span style="line-height: 1.5em; font-size: 13.28px;">&nbsp;It is the term that stands for Rest, Ice, Compression and Elevation.&nbsp;RICE&nbsp;can be used immediately and 24 to 48 hours after many muscle strains, ligament sprains, or other bruises and injuries.</span><ref name="4">University Health Services. RICE: Rest, Ice, Compression and Elevation for Injuries. http://www.uhs.wisc.edu/health-topics/muscles-and-bone/rice.shtml (accessed 25 May 2016)</ref>
Primary treatment in initial phase of rehabilitation is RICE.<ref name="2" />&nbsp;It is the term that stands for Rest, Ice, Compression and Elevation.&nbsp;RICE&nbsp;can be used immediately and 24 to 48 hours after many muscle strains, ligament sprains, or other bruises and injuries.<ref name="4">University Health Services. RICE: Rest, Ice, Compression and Elevation for Injuries. http://www.uhs.wisc.edu/health-topics/muscles-and-bone/rice.shtml (accessed 25 May 2016)</ref>  


==== Physical Therapy&nbsp;  ====
==== Physical Therapy&nbsp;  ====
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Therapeutic modalities and medications are used to create an optimal environment for injury repair by limiting the inflammatory process and breaking the pain-spasm cycle. Use of any modality depends on the supervising physician's exercise prescription, as well as the injury site, and type and severity of injury.&nbsp;In some cases, a modality may be indicated and contraindicated for the same condition. For example, thermotherapy (heat therapy) may be contraindicated for tendinitis during the initial phase of the exercise program. However, once acute inflammation is controlled, heat therapy may be indicated. Frequent evaluation of the individual’s progress is necessary to ensure that the appropriate modality is being used.<ref name="5">Anderson MK, Foundations of Athletic Training: Prevention, Assessment, and Management. 4th ed. In: Therapeutic Modalities. Lippincott Williams and Wilkins. 2008</ref>  
Therapeutic modalities and medications are used to create an optimal environment for injury repair by limiting the inflammatory process and breaking the pain-spasm cycle. Use of any modality depends on the supervising physician's exercise prescription, as well as the injury site, and type and severity of injury.&nbsp;In some cases, a modality may be indicated and contraindicated for the same condition. For example, thermotherapy (heat therapy) may be contraindicated for tendinitis during the initial phase of the exercise program. However, once acute inflammation is controlled, heat therapy may be indicated. Frequent evaluation of the individual’s progress is necessary to ensure that the appropriate modality is being used.<ref name="5">Anderson MK, Foundations of Athletic Training: Prevention, Assessment, and Management. 4th ed. In: Therapeutic Modalities. Lippincott Williams and Wilkins. 2008</ref>  


Despite the fact that rapid return to competition is crucial, rest is necessary to protect the damaged tissue from additional injury.<span style="font-size: 13.28px; line-height: 19.92px;">&nbsp;</span><span style="line-height: 1.5em; font-size: 13.28px;">Therefore, exercise involving the injured area is not recomended during this phase, although t</span><span style="font-size: 13.28px; line-height: 19.92px;">here are a few exceptions such as the tendinopathy protocols used to rehabilitate Achilles and patella tendon injuries.<ref name="2" /><ref name="6" />&nbsp;</span><span style="line-height: 1.5em; font-size: 13.28px;">However, it is important to realize that a quick return to function relies on the health of other body tissues.&nbsp;The power, strength, and endurance of the musculoskeletal tissues and the function of the cardiorespiratory system must be maintained.</span><ref name="2" /><span style="line-height: 1.5em; font-size: 13.28px;">&nbsp;</span><span style="line-height: 1.5em; font-size: 13.28px;">A medical professional’s advice should be sought before embarking on such a regime as more harm can be done than good if carried out incorrectly.</span><ref name="6">Sports Injury Clinic. Rehabilitation and Exercises. http://www.sportsinjuryclinic.net/rehabilitation-exercises (accessed 26 May 2016)</ref><span style="line-height: 1.5em; font-size: 13.28px;">&nbsp;</span><span style="line-height: 1.5em; font-size: 13.28px;">Assuming that this requirement is fulfilled, exercises may include general aerobic and anaerobic training and resistance training of the uninjured extremities. If movement of the injured limb is not contraindicated, isolated exercises that target areas proximal and distal to the injured area may also be permissible provided that they do not stress the injured area. Examples include hip abduction and rotation exercises following knee injury or scapula stabilizing exercises following glenohumeral joint injury.<ref name="2" /></span>
Despite the fact that rapid return to competition is crucial, rest is necessary to protect the damaged tissue from additional injury.<span style="font-size: 13.28px; line-height: 19.92px;">&nbsp;Therefore, exercise involving the injured area is not recomended during this phase, although there are a few exceptions such as the tendinopathy protocols used to rehabilitate Achilles and patella tendon injuries.<ref name="2" /><ref name="6" />&nbsp;However, it is important to realize that a quick return to function relies on the health of other body tissues.&nbsp;The power, strength, and endurance of the musculoskeletal tissues and the function of the cardiorespiratory system must be maintained.<ref name="2" /><span style="line-height: 1.5em; font-size: 13.28px;">&nbsp;Athlete needs to understands the reasons for following a particular treatment regime or exercise program and&nbsp;medical professional’s advice should be sought before embarking on any regime as more harm can be done than good if carried out incorrectly.<ref name="6">Sports Injury Clinic. Rehabilitation and Exercises. http://www.sportsinjuryclinic.net/rehabilitation-exercises (accessed 26 May 2016)</ref>&nbsp;Assuming that this requirement is fulfilled, exercises may include general aerobic and anaerobic training and resistance training of the uninjured extremities. If movement of the injured limb is not contraindicated, isolated exercises that target areas proximal and distal to the injured area may also be permissible provided that they do not stress the injured area. Examples include hip abduction and rotation exercises following knee injury or scapula stabilizing exercises following glenohumeral joint injury.<ref name="2" />&nbsp;Active range of motion is performed under one's own control, while passive range of motion occurs when another person or device produces the movement. Isometric exercises are used for strengthening when range of motion is restricted or needs to be avoided due to the fracture or acute inflammation of a joint. Otherwise, isotonic strengthening can begin within the painless arc of joint motion.<ref name="7" />&nbsp;<br>
 
<span style="font-size: 13.28px; line-height: 1.5em;" /><span style="font-size: 13.28px; line-height: 1.5em;"> It is also important that the athlete understands the reasons for following a particular treatment regime or exercise program.<ref name="6" /></span>


<br>  
Loss of proprioception occurs with injury to ligaments, tendons, or joints, and also with immobilization. Restoration of proprioception is an important part of rehabilitation in order to prevent further injuries.<ref name="7" />  


=== Intermediate Stage  ===
=== Intermediate Stage  ===

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Introduction[edit | edit source]

Rehabilitation is the act of restoring something to its original state. The noun rehabilitation comes from the Latin prefix re-, meaning “again” and habitare, meaning “make fit.”

Principles[edit | edit source]

Components[edit | edit source]

Stages[edit | edit source]

Initial Stage [edit | edit source]

Control pain and swellingCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title

The body's first response to an injury is inflammation.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title It's main function is to defend the body against harmful substances, dispose of dead or dying tissue and to promote the renewal of normal tissue.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title The goal for treatment during this phase is to provide a healty environment for new tissue regeneration and formation, and to prevent prolonged inflammation and disruption of new blood vessel and collagen production.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title 

The most immediate emotional response at the point of injury is shock. It's degree may range from minor to significant, depending upon the severity of the injury. It is important to note that denial itself is an adaptive response that allows an individual to manage extreme emotional responses to situational stress.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title

RICE: Rest, Ice, Compression, Elevation[edit | edit source]

Primary treatment in initial phase of rehabilitation is RICE.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title It is the term that stands for Rest, Ice, Compression and Elevation. RICE can be used immediately and 24 to 48 hours after many muscle strains, ligament sprains, or other bruises and injuries.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title

Physical Therapy [edit | edit source]

Therapeutic modalities and medications are used to create an optimal environment for injury repair by limiting the inflammatory process and breaking the pain-spasm cycle. Use of any modality depends on the supervising physician's exercise prescription, as well as the injury site, and type and severity of injury. In some cases, a modality may be indicated and contraindicated for the same condition. For example, thermotherapy (heat therapy) may be contraindicated for tendinitis during the initial phase of the exercise program. However, once acute inflammation is controlled, heat therapy may be indicated. Frequent evaluation of the individual’s progress is necessary to ensure that the appropriate modality is being used.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title

Despite the fact that rapid return to competition is crucial, rest is necessary to protect the damaged tissue from additional injury. Therefore, exercise involving the injured area is not recomended during this phase, although there are a few exceptions such as the tendinopathy protocols used to rehabilitate Achilles and patella tendon injuries.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title However, it is important to realize that a quick return to function relies on the health of other body tissues. The power, strength, and endurance of the musculoskeletal tissues and the function of the cardiorespiratory system must be maintained.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Athlete needs to understands the reasons for following a particular treatment regime or exercise program and medical professional’s advice should be sought before embarking on any regime as more harm can be done than good if carried out incorrectly.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Assuming that this requirement is fulfilled, exercises may include general aerobic and anaerobic training and resistance training of the uninjured extremities. If movement of the injured limb is not contraindicated, isolated exercises that target areas proximal and distal to the injured area may also be permissible provided that they do not stress the injured area. Examples include hip abduction and rotation exercises following knee injury or scapula stabilizing exercises following glenohumeral joint injury.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Active range of motion is performed under one's own control, while passive range of motion occurs when another person or device produces the movement. Isometric exercises are used for strengthening when range of motion is restricted or needs to be avoided due to the fracture or acute inflammation of a joint. Otherwise, isotonic strengthening can begin within the painless arc of joint motion.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title 

Loss of proprioception occurs with injury to ligaments, tendons, or joints, and also with immobilization. Restoration of proprioception is an important part of rehabilitation in order to prevent further injuries.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title

Intermediate Stage[edit | edit source]

Begin with ROM and resume cardiovascular trainingCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title


Advanced Stage[edit | edit source]

Restore ROM, improve strength and endurance, proprioception, continue cardiovascular trainingCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title


Return to Sport[edit | edit source]

Restore strength, add sport specific movements with progression of velocity of these movement patterns to game speedCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title


Monitoring[edit | edit source]

Recent Related Research (from Pubmed)[edit | edit source]

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References[edit | edit source]

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