Dr. Martin's notes

Monday May 08, 2017

DEVELOPING A REHABILITATION PROGRAM

Designing an effective rehabilitation program is simple if several basic components are addressed. These basic components may also be considered as the short-term goals of a rehabilitation program and should include: (1) providing correct immediate first aid and management following injury to limit or control swelling; (2) reducing or minimizing pain; (3) restoring full range of motion; {4) restoring or increasing muscular strength, endurance, and power; (5) reestablishing neuromuscular control; (6) improving balance; (7) maintaining cardio-respiratory fitness; and {8 } incorporating appropriate functional progressions. The long-term goal is almost invariably to return the injured athlete to practice or competition as quickly and safety as possible.

Providing Correct First Aid and Controlling Swelling

The process of rehabilitation begins immediately after injury. Initial first-aid and management techniques are perhaps the most critical part of any rehabilitation program. How the injury is managed initially has a significant impact on the course of the rehabilitative process. Everything that is done in first-aid management of any injury should be directed toward controlling the swelling. To control and significantly limit the amount of swelling, the RICE principle: rest, ice, compression, and elevation should be applied. Each factor plays a critical role in limiting swelling, and all these elements should be used simultaneously.

Controlling Pain

When an injury occurs, the athlete experiences some degree of pain. The extent of the pain is determined in part by the severity of the injury, by the athlete's individual response to and perception of pain, and by the circumstances under which the injury occurred. The coach can effectively control acute pain by using the RICE technique immediately after injury. In addition, using appropriate therapeutic modalities such as ice, heat, or electrical stimulating currents can help modulate pain throughout the rehabilitation process.

Restoring Range of Motion

Injury to a joint is always followed by some associated loss of motion. That loss of movement may be caused by resistance of the muscle and its tendon to stretch, by contracture of the ligaments and capsule around a joint or by some combination of the two. The athlete should engage in stretching activities designed to improve flexibility.

Restoring Muscular Strength, Endurance, and Power

Muscular strength, endurance, and power are among the most essential factors in restoring the function of a body part to preinjury status. Isometric, progressive resistance (isotonic), isokinetic, and plyometric exercises can benefit rehabilitation. A major goal in performing strengthening exercises is to work through a full, pain-free range of motion.