Sport Injury Rehabilitation
Sport Injury Rehabilitation: So what exactly is the therapist meant to do during the rehabilitation period?
Exercise is a vital part of the rehabilitation process for most sporting injuries. When athletes visit therapists, in conjunction with receiving a course of treatment, they will be set specific strengthening and flexibility exercises. Exercises are included in rehabilitation programs to ensure the injury site returns to a fully functional state and/or to ensure that the original cause of the injury is eliminated.
For example, an athlete recovering from a hamstring strain would need to stretch and strengthen the injured hamstring to ensure that flexibility and strength are equal for both injured and non- injured sides. Or, an athlete recovering from tennis elbow will need to strengthen the wrist extensor muscles to prevent the injury recurring. The extensor muscles are often weak compared to the wrist flexor muscles and so are susceptible to overload. Because exercise is intrinsic to the rehabilitation process, therapists and staff need to be aware that they have a significant part to play in helping their athletes back to full fitness.
Diagnosis and treatment
The first step in injury management is getting an accurate diagnosis. Often the best people to see are chiropractors specializing in sports injuries since they deal with such injuries on a regular basis. Even orthopedic surgeons are not always sports-injury specialists, often spending most of their time with more general patients.
The sports-injury specialist will then plan and implement the treatment required. Once pain and any swelling are reduced, the treatment will begin to involve more exercises. At this point, the chiropractor will set exercises to target specific goals that will help solve the athlete’s problems. Initially, this is likely to be mobility and flexibility training and then, later, strengthening work. This is where the athlete and therapist can work together.
Athletes can continue to train even when they are injured. It means adopting different types of training or training methods that do not stress the injury. One of the major goals of the rehabilitation process is to maintain aerobic fitness levels by using alternative training methods. For instance, instead of running, athletes can try water running with a flotation belt, or cycling. We implement this alternative aerobic training program as soon as possible. It is vital that athletes believe that even though they are injured, they can stay in shape.
In addition to maintaining aerobic fitness, the athlete can use the injury period as an opportunity to strengthen other areas of the body. Remember, it is only the injured part that needs to be
rested, not the whole body. For example, a football player with a groin strain can use the injury period to improve leg, trunk and upper-body strength. It’s up to the coach to set an appropriate, and safe, strength program.
Progressive return to full training
Once the pain has subsided and the athlete has started to meet the flexibility and strengthening goals, the therapist will be able to advise on when normal training can start again. This is the point when clear communication between therapist, coach and athlete is vital. One of the major reasons why athletes suffer a recurrence of an injury is that they have started training too hard, too soon. What they fail to understand is that, just because the injured part is pain-free, it doesn’t mean they are fully fit.
Once the athlete is able to use the injured part, he or she must gradually retrain the endurance, strength and coordination of that part so that it can withstand full competition conditions again. Thus, the goal at this stage in the rehabilitation process has moved on from healing the injury to regaining full function. To achieve this, the rehabilitation program must be specific to the athlete’s sport. For example, for the injured football player, strength exercises should be functionally related movements, such as single-legged squats, jumps and plyometric drills.
The program must also include proprioceptive training. This is very important because, in basic terms, proprioception is the coordination of balance and joint positioning sense. The brain must know accurately which position the joints are in so that movements can occur smoothly and effectively. Often, after a period of injury, especially joint injuries, the athlete can lose this ability. Any deficiency in this area, unless retrained, is likely to cause a recurrence of the injury. Therefore, exercises such as unilateral balance drills, wobble-board exercises and hopping and jumping drills are important to retrain any lost proprioception. As well as being sports-specific, the rehabilitation program must be progressive – for example, starting at 10 minutes running three times a week and then building slowly to 30 minutes running five times a week.
The final stage
A good example of the necessity for this final stage of the rehabilitation process is a football player recovering from a hamstring injury. The player has completed a successful treatment period and the hamstrings’ flexibility is equal both sides, as is their strength on the hamstrings curl station. The player can now jog pain-free. However, when he tried to join in a game, his hamstring felt weak. It is at this point that the player needs to slowly build up the training and include more specific exercises to bridge the gap between healing the injured part and making the injured part fully functional.
To do this, the player must gradually increase the amount of running he can do, as well as slowly increasing the speed he can run at. First, he must start with half-pace sprints, then three-quarter pace, until gradually increasing to full efforts. The player also needs to include more closed- chain multi-joint strength exercises, such as squats or dead lifts, where the hamstrings work in conjunction with other muscles. He will also need to include dynamic and eccentric hamstring exercises, because this is how the hamstrings must work hard during sprinting. Both these types of exercises will strengthen the hamstrings in a sports-specific fashion. The player will also need
to introduce kicking, ball-skills work and agility drills into his training, first at three-quarter speed and then full-out. This will ensure that all the skilled movements involved in the sport will have been slowly retrained.
After a period of this specific training and progression, the athlete will be ready to try playing a game. Once again, even this should be built up gradually, and the rehabilitation program will need to be continued to ensure the problems do not recur. During this final stage, it is the coach’s job to make sure the therapist is giving the athlete the right kind of rehabilitation program, and also to make sure that the athlete continues to follow the program set. The athlete cannot do too much but, at the same time, if he/she does too little then there will be no improvement in the areas that need to be worked on. This is where the coach must be fully involved, communicating with the therapist, and supervising the athlete. During this period the coach needs to invest as much time in the athlete, if not more, than in normal training.
Athletes know there are many benefits of cross-training. The most important and most widely recognized benefit is injury prevention. Cross-training is used to rehabilitate injuries, improve conditioning and speed, and enhance recovery. It is also a way for an athlete to rejuvenate mentally and physically between events. For beginning runners who haven’t developed their strength and flexibility, cross-training will improve strength and endurance without the wear and tear on the joints and low back that comes with over training or running too much too soon.
Our state-of-the-art facility at Elevation-Fitness has the latest in Functional Training Equipment.
Functional Training is defined as “activity that trains movement” and includes: balance training, stabilization training, core training and dynamic movement training. The result of functional training is agility – improved reactionary forces that give your body the ability to compensate for changes in your center of gravity and move quickly and efficiently. Your body is trained to react quickly, making you less prone to injury. Exercises promoting core strength and stability improve or maintain posture and alignment as well as challenging balance and equilibrium.
Your body core is the midsection of your body, from your groin to your shoulders. The core includes the pelvis, abs, back and chest muscles. It is this core that offers stability, balance and flexibility. Every movement you make originates in the core – whether you are reaching for your toothbrush or running a marathon. If the core is not properly conditioned it will limit your physical abilities.
Core conditioning combines strength, balance, agility and flexibility of the muscles that control the entire trunk and spine. Regular conditioning of the core muscles is essential to prevent injuries, correct posture and help make you more efficient in all that you do.