rehabilitation procedures
The general aim of rehabilitation is to return the injured athlete to the field of play and to restore their pre-injury level of physical fitness. Managing the injury correctly using the most suitable techniques may greatly reduce the rehabilitation time for the athletes. Rehabilitation procedures include:
· Progressive mobilisation of the injured part
· Graduated exercise which incorporates stretching, conditioning and maintenance of total body fitness
· Training to re-establish readiness for competition
· Use of hot and cold therapies
· Progressive mobilisation of the injured part
· Graduated exercise which incorporates stretching, conditioning and maintenance of total body fitness
· Training to re-establish readiness for competition
· Use of hot and cold therapies
Progressive mobilisation
Regaining a full range of motion of the knee joint is the first priority in this phase of the rehabilitation process. As you work through the initial stages of recovery, and your knee begins to heal, start to introduce some very gentle movements, using light stretches and rotations to reduce the build up of scar tissue and allow greater flexibility at the injured part. Sports massages (gentle cross frictions) may be possible from day 2 but allow a week for more severe injuries. As pain allows, static quads and hamstring exercises, double leg calf raises, hip abduction and extension should be done. Knee extension mobility should only be to 30 degrees though.
Once you feel comfortable with this range of motion exercises, and can perform them relatively pain free, it is time to move on to the next phase in your rehabilitation process.
Once you feel comfortable with this range of motion exercises, and can perform them relatively pain free, it is time to move on to the next phase in your rehabilitation process.
stretching
Stretching is vital is any rehabilitation process as it restores range of motion and helps to increase muscles and tendon elasticity, with Proprioceptive Neuro-muscular Facilitation (PNF) being one of the most appropriate stretching procedures.
When increasing the flexibility of the injured area it is important to also stretch not only the damaged muscles and tendons, but also the muscle groups around the injured area. This includes the injured knee, foot, achillies tendon, lower calf etc.
Before stretching be sure to warm-up with some light activity, and then place the muscle group into a position where tension is felt. Hold the stretch for an extended period of time, at least 45 seconds.
Isometric exercises (or static stretches) involve pushing against a fixed object with your knee, this is a good way to get started.
Examples include:
Days per week: 5-7 Times per day: 1-2
For more stretches click on the hyperlink below, and watch the video for examples.
When increasing the flexibility of the injured area it is important to also stretch not only the damaged muscles and tendons, but also the muscle groups around the injured area. This includes the injured knee, foot, achillies tendon, lower calf etc.
Before stretching be sure to warm-up with some light activity, and then place the muscle group into a position where tension is felt. Hold the stretch for an extended period of time, at least 45 seconds.
Isometric exercises (or static stretches) involve pushing against a fixed object with your knee, this is a good way to get started.
Examples include:
Days per week: 5-7 Times per day: 1-2
- Hamstring stretch 3-5 reps holding 15 to 30 seconds
- Quadriceps stretch 3-5 reps holding 15 to 30 seconds
- Calf Stretch 3-5 reps holding 15 to 30 seconds
For more stretches click on the hyperlink below, and watch the video for examples.
conditioning
Conditioning is the build-up of fitness as a result of adaptations to gradual increases in physical stress, which allows the muscles to be gradually strengthened to prevent muscle atrophy.
While your injury heals try to maintain overall conditioning if possible. Try alternate forms of training such as walking, water running, swimming, cycling, rowing or weight training of the non-injured parts whilst trying to heal your injury as this will allow for the rest of your body to stay fit making it less difficult to return to play after an injury. This should be done 1-2 days per week of 20-30 minute intervals.
An effective conditioning process uses the overload principle to ensure a greater than normal load is gradually added to allow rehabilitation periods of rest and recover are followed by gradually increasing periods of work. Ensure you DO NOT continue if you feel any pain in the injured area, this conditioning phase should be pain free.
This should also apply principle of specificity and improve the physical and conditioning requirements for the athlete. The conditioning regime needs to target general cardio respiratory fitness together with increasing need for strength, power and local muscular endurance around injured area. Isokinetic exercises are considered beneficial at this stage as they develop strength through full range of movement – important to monitor increasing strength of both agonist and antagonist muscles
Adherence to the principle of progression is important as this recognises an optimal amount of overload for each individual is achieved over the most advantageous time period.
While your injury heals try to maintain overall conditioning if possible. Try alternate forms of training such as walking, water running, swimming, cycling, rowing or weight training of the non-injured parts whilst trying to heal your injury as this will allow for the rest of your body to stay fit making it less difficult to return to play after an injury. This should be done 1-2 days per week of 20-30 minute intervals.
An effective conditioning process uses the overload principle to ensure a greater than normal load is gradually added to allow rehabilitation periods of rest and recover are followed by gradually increasing periods of work. Ensure you DO NOT continue if you feel any pain in the injured area, this conditioning phase should be pain free.
This should also apply principle of specificity and improve the physical and conditioning requirements for the athlete. The conditioning regime needs to target general cardio respiratory fitness together with increasing need for strength, power and local muscular endurance around injured area. Isokinetic exercises are considered beneficial at this stage as they develop strength through full range of movement – important to monitor increasing strength of both agonist and antagonist muscles
Adherence to the principle of progression is important as this recognises an optimal amount of overload for each individual is achieved over the most advantageous time period.
total body fitness
As well as managing the injured site, the health of the overall body, including the mind should also be maintained. The use of activities that improve strength, flexibility and endurance should be used so that the athlete doesn’t just recover from the injury but regains the level of fitness needed for the competition before the injury occurred. The program must progressively and gradually overload the muscle groups and energy systems so that the required adaptions occur. This must happen before athlete returns to competition.
Physical adaptations necessary may include:
Physical adaptations necessary may include:
- Hypertrophy of the muscles
- Strengthening of tendons and ligaments
- Increased capillarisation and subsequent blood flow to injured site
- Increased elasticity
- Increased mobility
- Absence of pain
- Full confidence that injured area can handle the stress
- Fully restored balance and co-ordination
training
Full body training can begin when total body fitness is achieved. The athlete should be able to fully participate in the training and be pain free. This involves participating in the warm-up, conditioning, drills, skill development, tactics and cool down. The athlete should be prepared to train until he/she is at least at a stage where pre-injury fitness has been attained.
- Before returning to competition, the athlete needs to re-train to prevent re-injury
- Risk from undeveloped movement skills, game-specific skills and confidence
- Timing, speed and co-ordination also affected
- Active training must take place in preparation for the physical and psychological demands of competition
- The athlete should be prepared to train until he/she is at least at a stage where pre-injury fitness has been attained
USe of heat and cold
The application of heat and cold to an injured site is important in the healing process. Appropriate ice and heat treatment can help to reduce bleeding, inflammation, swelling, muscle spasm and pain following injury. Ice and heat treatment can also accelerate healing and hasten injury recovery.
The application of ice to your injured knee helps to reduce blood flow to the affected region, which is beneficial in the inflammatory phase of an injury (the first 72hours following the injury) as it helps to reduce the amount of inflammation and swelling that accumulates in the injured region. Ice treatment may also help to reduce pain and muscle spasm.
Cold should be applied for 15 minutes every 2 hours during the first 72 hours following the injury or after any activity that aggravates your symptoms. This can be done by using anything cold, from crushed ice, to ice packs, topical cold sprays, or even frozen peas. (For more info refer to RICER)
Heat has the opposite effect to ice on the blood flow. That is, it encourages blood flow to the affected region. Therefore heat should be avoided when inflammation is developing. However, after about 72 hours, no further inflammation is likely to develop. Since more blood flow means more nutrients and oxygen are transported to damaged tissue, therefore speeding healing. Heat can also help to reduce pain and muscle spasm as well as reduce muscle tightness and joint stiffness. To apply heat, simply use heat packs, hydrotherapy, infra-red lamps or contrast baths.
The application of ice to your injured knee helps to reduce blood flow to the affected region, which is beneficial in the inflammatory phase of an injury (the first 72hours following the injury) as it helps to reduce the amount of inflammation and swelling that accumulates in the injured region. Ice treatment may also help to reduce pain and muscle spasm.
Cold should be applied for 15 minutes every 2 hours during the first 72 hours following the injury or after any activity that aggravates your symptoms. This can be done by using anything cold, from crushed ice, to ice packs, topical cold sprays, or even frozen peas. (For more info refer to RICER)
Heat has the opposite effect to ice on the blood flow. That is, it encourages blood flow to the affected region. Therefore heat should be avoided when inflammation is developing. However, after about 72 hours, no further inflammation is likely to develop. Since more blood flow means more nutrients and oxygen are transported to damaged tissue, therefore speeding healing. Heat can also help to reduce pain and muscle spasm as well as reduce muscle tightness and joint stiffness. To apply heat, simply use heat packs, hydrotherapy, infra-red lamps or contrast baths.