Rehabilitation in Sport
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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
This phase lasts approximately 4-6 days.Cite 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 These cells increase in number with movement and decreases with immobilisation. Clinically the role of medical professionals during this phase would be to strike a balance between too little inflammation and too much inflammation. The physiotherapist is usually the professional in charge of this phase although the process may be started by a medical doctor.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
This phase lasts from day 5 to 8-10 weeks.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title After the inflammatory phase, the body begins to repair the damaged tissue with similar tissue, but the resiliency of the new tissue is low. Repair of the weakened injury site can take up to eight weeks if the proper amount of restorative stress is applied, or longer if too much or too little stress is applied.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
Focus of the treatment during this phase is to prevent excessive atrophy and joint deterioration of the injured area.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Rehabilitation in the form of exercise therapy must be initiated during this phase to increase the strength of the muscle tissue adjacent to the scar and to facilitate a healthy, functional scar being laid down.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title In addition, a precarious balance must be maintained in which disruption of the newly formed collagen fibers is avoided but low-load stresses are gradually introduced to allow increased collagen synthesis and prevent loss of joint motion. To protect the new, relatively weak collagen fibers, the athlete should avoid active resistive exercise involving the damaged tissue. Too little activity, though, can also have a deleterious effect, as newly formed fibers will not optimally align and may form adhesions, thereby preventing full motion. Early protected motion hastens the optimal alignment of collagen fibers and promotes improved tissue mobility. As in the inflammatory phase, therapeutic modalities are permissible, but their goal during the second rehabilitation phase is to promote collagen synthesis. Again, the maintenance of muscular and cardiorespiratory function remains essential for the uninjured areas of the body. The strength and conditioning professional has considerable expertise to offer the other members of the sports medicine team regarding selection of the appropriate activities.Cite 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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