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Rehabilitation Techniques

Rehabilitation Techniques. Jenna Page, M.Ed., ATC November 2008. Objectives of Rehab. Prevent De-conditioning Rehabilitate the Injury Work to prevent repetitive injury. Principles of Rehab. ATC IS IT A: Avoid Aggravation T: Timing C: Compliance I: Individualization

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Rehabilitation Techniques

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  1. Rehabilitation Techniques Jenna Page, M.Ed., ATC November 2008

  2. Objectives of Rehab • Prevent De-conditioning • Rehabilitate the Injury • Work to prevent repetitive injury

  3. Principles of Rehab • ATC IS IT • A: Avoid Aggravation • T: Timing • C: Compliance • I: Individualization • S: Specific Sequencing • I: Intensity • T: Total Patient

  4. Goals of Rehab • These are the results one strives to achieve • Goals need to objective and measurable • Short-term and Long-term goals should be set • Goals need to be realistic

  5. Goals • What is the ultimate goal of rehab? • What are objective/measurable goals? • What do short-term goals allow the patient to do?

  6. Components of Rehab • Flexibility • ROM • Proprioception • Coordination • Core Stability • Muscular Strength • Muscular Endurance • Cardiovascular fitness • Functional Exercises

  7. Phases of Rehab • The phases of rehabilitation coincide with the phases of healing • Prehab • Phase I: Inflammation (Days 1 to 4) • Phase II: Proliferation (Day 4 to Week 6) • Phase III: Remodeling (Week 4 to 2-3 Years)

  8. Factors Affecting Healing • Modalities • Proper Medication • Surgical or Non-surgical • Age • Disease • Size and Location of Injury • Possible Infection • Nutrition • Swelling • Type of Tissue

  9. Prehab • Only when surgery is required • The setup for SUCCESS! • The stronger you are going into surgery the easier the recovery.

  10. Phase I GOALS of PHASE I • Control Swelling and Pain • Limit Undue Stress • Range of Motion • Progress out of assistive device (crutches, boot, sling, etc)

  11. Control Swelling • RICE • By controlling swelling, pain is controlled as well.

  12. Limit Undue Stress • Undue Stress – increases pain and impedes the healing process causing more harm

  13. Range of Motion • Early mobility is essential for returning the injured part to full ROM • Follow the instructions given in rehab protocol or specific surgeon instructions

  14. What is going on now • This is were scar tissue is laid down • Scar is not as strong as the original tissue • Tensile Strength = strength of the tissue • Tensile strength is related to the amount, type, and arrangement of collagen

  15. What does this mean to the clinician? • Collagen fibers are laid down originally in an unorganized manner • The fibers can be organized with exercise and stretching • If not straightened out this means a mass of scar tissue • More Tensile Strength = less scar tissue • Elasticity of scar tissue is much less than normal muscle and ligamentous tissue

  16. Goals of Phase II • Strengthen the injured tissue • Strengthen the surrounding tissues • Continue ROM • Remember the tissue is weak but improving • Important to work on stretching muscle and tendon tissue to help align collagen fibers.

  17. Strengthening • Progression: • Isotonic • Isometric • Isokinetic • Plyometric • Weight should be challenging but not irritating • How many repetitions and sets for rehab exercises?

  18. Range of Motion • Progression: • AAROM • AROM • PROM

  19. What’s going on in the healing process? • Phase III is called Remodeling • Tensile strength is continuing to increase • As tensile strength continues to increase in the tissue the patient is able to increase the stress they can apply to the tissue (usually with exercise)

  20. Goals of Phase III • Building confidence in athlete’s ability • Start with multi-functional rehab • Move onto Sport Specific Rehab • Complete Functional Rehab • End of this Phase = Return to Play • How do you know when athlete is ready to return to play and when to stop coming in for rehab?

  21. How aggressive can you be? • If your rehab program is too aggressive then athlete may experience: • ↑ pain • ↑ swelling • ↓ performance • Inability to progress • If there is Sx of further injury, then play it safe and be cautious

  22. Tools to Use in Rehab • Foam Roller • Theraband • Swiss Ball • Cuff Weights • Airex Pad • AND MANY MANY more. . .

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