Injury Rehabilitation Procedure
How Is Injury Rehabilitation Managed?
Rehabilitation Procedures
• Rehabilitation aims to restore the injured site so that the athlete can return to practice and competition without pain, and with the same range of movement they had before the injury.
• Successful rehabilitation procedures reduce the chance of injury
Progressive Mobilisation
• It is important to progressively introduce movement to the injured area once the RICER technique has been complete
• e.g. active and passive movement
• Gradually moving the area using light stretches and rotations will reduce the build-up of scar tissue and allow greater mobility in the injured part
Graduated Exercise
Stretching
• Stretching is a vital part of any rehabilitation program …show more content…
• When an injury occurs muscle fibres seize and scar tissue builds up
• Stretching allows the muscles to regain elasticity so that they can contract and extend without injury, reducing muscle tension, increasing circulation, increasing muscle and tendon length and increasing the range of motion
• Stretches should be held for 30 seconds and be pain free
• Isometric creating tension in the muscles
• Static stretching
• PNF stretches are the best for a rehabilitation program, the muscles surrounding an injury lose strength when they are not used
• Therefore by using isometric exercises to progressively increase the muscle length is important
Conditioning
• The restoration of muscular strength is essential in injury rehabilitation.
• Even if the area is immobilised(for example, in a cast or brace) a program should be designed to prevent muscle atrophy (wasting of muscle tissue)
• As strength is slowly regained, further resistance can be applied.
• It is important to monitor the increase in strength of both the agonist muscles and antagonist muscles; that is, both the muscle being treated, and the muscle that moves in the opposite direction.
• Weights can also assist in building up muscle strength and restoring muscles to their pre-injury strength
• Strengthening muscles acts a source of prevention as stronger muscles can withstand greater forces
• Conditioning the injured area to perform skills and allow a full range of motion is important
• Initially activities should be low intensity high reps – and then gradually move back to one RM
Total Body …show more content…
Fitness
• Injured athletes should maintain their fitness by undertaking certain activities e.g. a person with an injured ankle can undertake deep water running
Training
• Injured athletes will undertake modified training sessions to enable their injury to heal e.g. a modified training program for an athlete who has a dislocated shoulder might include cycling on a stationary bike
• This will improve the athletes fitness whilst allowing the injury to heal
• Athletes can gradually start participating in full training sessions
• Initially the athlete may complete the training session at a lower intensity to ensure the injured area is not aggravated
• A rehabilitation program is deemed successful when an athlete is able to undertake a full training session and participate in all elements – including warm up, skills, drills, match play and a cool down – without any pain in the injured area
• Balance activities USE A WOBBLE BOARD TO DEVELOP KINASTHENIC SENSE
Use of Heat and Cold
• Ice can be used instantly on all injuries as it reduces swelling and pain
• It restricts blood vessels, which reduces the blood flow to the injured area and therefore inflammation
• Cold treatments include ice packs and ice baths
• The use of heat can also assist some injuries to heal
• Heat increases blood flow, which will help to relax them and increase their elasticity
• Heat treatments include hot packs, ultrasound and whirlpools
Return To Play
• If an athlete returns to play to soon after an injury they run the risk of re-injury
• Even when an injury has healed there are specific measures that need to be taken to ensure the injury does not recur
• On some occasions medical clearance is needed
Indicators of Readiness to Play
• An athlete is ready to return to competition when they are able to perform all the skills and fitness components of their sport
• The injured area should have: o Elasticity and flexibility in the injured muscles o Strength in the surrounding muscles to support joints during movement o Full range of movement o No pain
Monitoring Progress (pre and post-test)
• Conducting sport-specific tests will provide both coaches and athletes with information on the athletes fitness and skill ability
• Using a test specific to the sport, such as a beep test for a hockey player, can give indication of how their fitness and skill level is progressing after the injury
• It also places the injured area under competition pressures to see how the body responds
Psychological Readiness
• An injury can impact on an athletes psychological wellbeing
• Athletes may feel that their fitness levels will drop, or they might lose their spot on the team
• This may lead to depressive episodes, which in turn can affect their approach to rehabilitation
• The trauma from sustaining the injury may affect an athletes ability to participate e.g. if an aerial skier crashing doing a somersault in the air and ruptures their ACL, their memories of this accident may prevent them from wanting to return to the sport
• It is important to rehabilitate an athletes mental capability, and make sure they are psychologically ready to restart training and competition
• This ensures that any negative thoughts do not contribute to further injuries
Specific Warm-up Procedures
• When returning to play an athletes needs to include warm-up stretches and drills that are specific to the injured area
• Ensuring muscles are warm, stretched and ready for physical activity is important in preventing further damage
• e.g.
a bowler in cricket who has injured their rotary cuff needs to ensure they include circular movement to the shoulder joint to prepare for the bowling action
Return to Play Policies and Procedures
• Clubs have a duty of care to ensure athletes are fit to return to training and competition when they are injury-free – not before their injury has healed
• For example the Australia Rugby League recommends that if a player has suffered memory loss or loss of conciseness as a result of a head injury, they may not return to play for 1-2 weeks
• If the concussion was severe they may not return for a month, and if it was not the players first concussion, return to play may take even longer
• Can be subject to fitness tests or have to complete a full week of training
Ethical Considerations
• Elite athletes in particular feel pressure from their coaches, teammates, sponsors and society to be back on the field as soon as possible.
• These added pressures can force athletes to return to competition before the injury has completely healed, running the risk of further damage to the
area
• Some players play through the pain so they feel as if they haven’t let others down
• Others whose sport is their job may feel they have no choice but to return early so their financial security is not jeopardised
• Athletes may choose to use pain killers that numb the pain, such as cortisone injections, but this numbness sets the athlete up for further damage as they will not feel the pain when further damage occurs
• This can ultimately occur in a career ending injury
• Coaches and sports practitioners have full responsibility to support athletes in undertaking the full rehabilitation procedure
• They need to support athletes to take time to let their injury heal naturally, and not use pain killers to enable them to return sooner
Rehabilitation Procedures
• Rehabilitation aims to restore the injured site so that the athlete can return to practice and competition without pain, and with the same range of movement they had before the injury.
• Successful rehabilitation procedures reduce the chance of injury
Progressive Mobilisation
• It is important to progressively introduce movement to the injured area once the RICER technique has been complete
• e.g. active and passive movement
• Gradually moving the area using light stretches and rotations will reduce the build-up of scar tissue and allow greater mobility in the injured part
Graduated Exercise
Stretching
• Stretching is a vital part of any rehabilitation program …show more content…
• When an injury occurs muscle fibres seize and scar tissue builds up
• Stretching allows the muscles to regain elasticity so that they can contract and extend without injury, reducing muscle tension, increasing circulation, increasing muscle and tendon length and increasing the range of motion
• Stretches should be held for 30 seconds and be pain free
• Isometric creating tension in the muscles
• Static stretching
• PNF stretches are the best for a rehabilitation program, the muscles surrounding an injury lose strength when they are not used
• Therefore by using isometric exercises to progressively increase the muscle length is important
Conditioning
• The restoration of muscular strength is essential in injury rehabilitation.
• Even if the area is immobilised(for example, in a cast or brace) a program should be designed to prevent muscle atrophy (wasting of muscle tissue)
• As strength is slowly regained, further resistance can be applied.
• It is important to monitor the increase in strength of both the agonist muscles and antagonist muscles; that is, both the muscle being treated, and the muscle that moves in the opposite direction.
• Weights can also assist in building up muscle strength and restoring muscles to their pre-injury strength
• Strengthening muscles acts a source of prevention as stronger muscles can withstand greater forces
• Conditioning the injured area to perform skills and allow a full range of motion is important
• Initially activities should be low intensity high reps – and then gradually move back to one RM
Total Body …show more content…
Fitness
• Injured athletes should maintain their fitness by undertaking certain activities e.g. a person with an injured ankle can undertake deep water running
Training
• Injured athletes will undertake modified training sessions to enable their injury to heal e.g. a modified training program for an athlete who has a dislocated shoulder might include cycling on a stationary bike
• This will improve the athletes fitness whilst allowing the injury to heal
• Athletes can gradually start participating in full training sessions
• Initially the athlete may complete the training session at a lower intensity to ensure the injured area is not aggravated
• A rehabilitation program is deemed successful when an athlete is able to undertake a full training session and participate in all elements – including warm up, skills, drills, match play and a cool down – without any pain in the injured area
• Balance activities USE A WOBBLE BOARD TO DEVELOP KINASTHENIC SENSE
Use of Heat and Cold
• Ice can be used instantly on all injuries as it reduces swelling and pain
• It restricts blood vessels, which reduces the blood flow to the injured area and therefore inflammation
• Cold treatments include ice packs and ice baths
• The use of heat can also assist some injuries to heal
• Heat increases blood flow, which will help to relax them and increase their elasticity
• Heat treatments include hot packs, ultrasound and whirlpools
Return To Play
• If an athlete returns to play to soon after an injury they run the risk of re-injury
• Even when an injury has healed there are specific measures that need to be taken to ensure the injury does not recur
• On some occasions medical clearance is needed
Indicators of Readiness to Play
• An athlete is ready to return to competition when they are able to perform all the skills and fitness components of their sport
• The injured area should have: o Elasticity and flexibility in the injured muscles o Strength in the surrounding muscles to support joints during movement o Full range of movement o No pain
Monitoring Progress (pre and post-test)
• Conducting sport-specific tests will provide both coaches and athletes with information on the athletes fitness and skill ability
• Using a test specific to the sport, such as a beep test for a hockey player, can give indication of how their fitness and skill level is progressing after the injury
• It also places the injured area under competition pressures to see how the body responds
Psychological Readiness
• An injury can impact on an athletes psychological wellbeing
• Athletes may feel that their fitness levels will drop, or they might lose their spot on the team
• This may lead to depressive episodes, which in turn can affect their approach to rehabilitation
• The trauma from sustaining the injury may affect an athletes ability to participate e.g. if an aerial skier crashing doing a somersault in the air and ruptures their ACL, their memories of this accident may prevent them from wanting to return to the sport
• It is important to rehabilitate an athletes mental capability, and make sure they are psychologically ready to restart training and competition
• This ensures that any negative thoughts do not contribute to further injuries
Specific Warm-up Procedures
• When returning to play an athletes needs to include warm-up stretches and drills that are specific to the injured area
• Ensuring muscles are warm, stretched and ready for physical activity is important in preventing further damage
• e.g.
a bowler in cricket who has injured their rotary cuff needs to ensure they include circular movement to the shoulder joint to prepare for the bowling action
Return to Play Policies and Procedures
• Clubs have a duty of care to ensure athletes are fit to return to training and competition when they are injury-free – not before their injury has healed
• For example the Australia Rugby League recommends that if a player has suffered memory loss or loss of conciseness as a result of a head injury, they may not return to play for 1-2 weeks
• If the concussion was severe they may not return for a month, and if it was not the players first concussion, return to play may take even longer
• Can be subject to fitness tests or have to complete a full week of training
Ethical Considerations
• Elite athletes in particular feel pressure from their coaches, teammates, sponsors and society to be back on the field as soon as possible.
• These added pressures can force athletes to return to competition before the injury has completely healed, running the risk of further damage to the
area
• Some players play through the pain so they feel as if they haven’t let others down
• Others whose sport is their job may feel they have no choice but to return early so their financial security is not jeopardised
• Athletes may choose to use pain killers that numb the pain, such as cortisone injections, but this numbness sets the athlete up for further damage as they will not feel the pain when further damage occurs
• This can ultimately occur in a career ending injury
• Coaches and sports practitioners have full responsibility to support athletes in undertaking the full rehabilitation procedure
• They need to support athletes to take time to let their injury heal naturally, and not use pain killers to enable them to return sooner