Rehabilitation Techniques in Athletic Therapy Tara Sutherland 867-2231 tsutherl@stfx.ca

Rehabilitation Techniques in Athletic Therapy

Tara Sutherland

867-2231

tsutherl@stfx.ca

SOAP REVIEW (HORSP)

S- subjectiveHistory taking , MOI , Pain etc

O- objectiveObserving , special tests , palpations

A- Assessment Impression as to what is wrong

P-PlanRehabilitation plan

Principles

Design of Rehab plans Assess needsDevelop plan Implement planEvaluate plan

Assess needs

Subjective informationObjective dataList problem areas

Develop plan

Establish goalsSelect techniques based on available

resourcesEstablish how changes will be

documented and monitoredImplement return to plan /activity criteria

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

Evaluate Plan

Compare original data with current data at frequent intervals

Modify goals according to changes in patient progress and activity level

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

GOAL SETTING: GOALS BASED ON STAGES OF HEALING

Provide correct immediate first aid and management of the injury

↓ swelling, pain, inflammationRe-establish neuromuscular controlRestore ROMRestore and increase muscular strength,

endurance and power Improve postural stability and balanceMaintain (improve) cardio fitnessProtect/prevent further injury

GOAL SETTING: LONG TERM GOALS

Invariably to return the athlete to practice and or competition as quickly and safely as possible

BALANCE BETWEEN HEALING AND RETURN TO PLAY

“Walking a thin line”Walking the tightrope Pushing the envelope

REMAIN SAFE WITHIN CONFINES OF HEALING

PROCESS

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

What we will cover

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

PATHOMECHANICS

Knowledge of NORMAL and ABNORMAL mechanics of biomechanics and functional anatomy is crucial

Once again you need to know anatomy

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

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

Tools

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

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

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.

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.

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

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

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.

Restoring Muscular strength , Endurance and Power

IsometricProgressive resistive exerciseIsokineticPlyometric Core Open and closed??

Maintain (improve) cardio fitness

This stage can be neglected by many Injured athlete miss training time , the

cardio fitness decreases rapidlyActivities must be found to replace this

training time that they miss.. Alternative can be found..what are some of them ??

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

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