7.3. Rehabilitation of Injuries Flashcards
1
Q
Rehabilitation definition
A
A programme devised to enable the athlete to return to the point of almost full, pain free range of motion
2
Q
What does rehabilitation involve?
A
Restoring strength, flexibility, endurance, power
3
Q
Without effective rehab, what happens to the athlete?
A
- Prone to re-injury of affected area
- Incapable of performing at pre injury standard
- Predisposed to injury in another part of the body
4
Q
4 stages of rehabilitation
A
- Initial
- Intermediate
- Advanced
- Return to sport
5
Q
Initial stage description
A
Considered to be from the time of injury to the point of almost full, pain-free range of motion
6
Q
Function level of injured site in initial stage
A
Poor
7
Q
Intermediate stage description
A
Resumption of daily activities and some sporting activity, with activity mainly skill related.
Progressive loading of connective tissue and bones to develop strength.
8
Q
Function level of injured site in intermediate stage
A
Good
9
Q
Sport in intermediate stage
A
Isolated skills
10
Q
Advanced stage description
A
Resumption of functional activities related to the sport
11
Q
Function level of injured site in advanced stage
A
Good
12
Q
Sport in advanced stage
A
Commence sport specific agility work, skills, game drills
13
Q
Return to sport description
A
Return to sport including full participation in training and competition
14
Q
Function level of injured site in return to sport stage
A
Good
15
Q
Sport in return to sport
A
Full
16
Q
What should the therapist continually assess when monitoring their progress?
A
- Pain
- ROM
- Swelling
- Heat
- Redness
- Ability to perform exercises and functional activities
17
Q
Reasons for stretching
A
ROM around a joint is restricted by injury due to:
- Pain
- Swelling
- Shortened muscles
Stretching will restore the normal flexibility of the joint
18
Q
Benefits of stretching
A
- Increases flexibility
- Increases muscle relaxation
- Decreases muscle soreness
- Improves circulation
- Speeds up recovery process
19
Q
Recommendations of stretching
A
- Precede stretching with an adequate warm up
- Heat can be applied to the area before stretching
- No stretching in early stage (first 3 days) - use PRICE
- Gentle static and passive stretching in mid stage
- Late stage add PNF to static/ passive stretching to develop ROM
20
Q
Static stretching
A
Taking a joint just beyond its point of resistance and holding the position for up to 30 seconds
21
Q
Dynamic stretching
A
Using a controlled movement, bounce or swinging motion to take a joint to the limit of its ROM
22
Q
PNF stretching
A
The most effective form of stretching involves taking a joint just beyond its point of resistance and performing an isometric contraction for 10 seconds.
Relax the muscle and repeat 3 times
23
Q
Massage definition
A
A manual therapy used in the assessment, treatment and management of soft tissue injury and pain.
Also known as soft tissue therapy
24
Q
Lymphatic drainage
A
The carrying of waste products away from the tissues towards the heart
25
Reasons for massage
- Help treat soft tissue injuries
- Reduce tension in the musculoskeletal system
- Form part of an injury prevention programme
26
Benefits of a massage
- Realigns deeper levels of connective tissue
- Reduces muscle pain
- Breaks down scar tissue
- Improves circulation and blood supply to an area
- Improves lymphatic drainage to reduce swelling
- Increases the rate of removal of harmful bi-products
- Increases range of motion and flexbility
27
Recommendations of massage
- Not advisable in first 48 hrs due to risk of further damage or restarting bleeding
- Can be used once inflammation has subsided
- Use firm pressure and massage across the line of tissue as well as along it
- Do not use massage on bruising, ligament or tendon ruptures
28
Heat benefits
- Reduces muscle tension
- Provides pain relief
- Vasodilation of blood vessels
- Increases blood flow to injured site
29
Risks of heat
- Increases bleeding and swelling if applied in first 25 hrs of acute injury
- Burns
30
Examples of heat therapy
- Warm shower or bath
- Heat packs
- Apply for 15 mins
31
Cold therapy benefits
- Provides pain relief
- Vasoconstriction of blood vessels
- Decreases swelling
32
Risks of cold therapy
- Ice burns
- Superficial nerve damage
33
Examples of cold therapy
- PRICE
- Ice packs
- Ice wraps
- Ice baths- for muscle soreness
- Cryokinetics - ice plus rehab exercises- good for ligaments strains
- Cryostretching ice plus stretching to decrease pain from muscle soreness
34
Contrast therapies benefits
- Decreases swelling by alternating heat and cold
- Provides pain relief
- Increases blood flow to injured site
35
Risks of contrast therapies
- Increases bleeding and swelling if used in first 24 hrs of acute injury due to heat phase
- Burns
36
Examples of contrast therapies
- Hot bath to cold bath
- 4 mins hot/ 1 min cold
- Repeat 3-7 times
- Always finish with cold to encourage vasoconstriction
37
Benefits of anti inflammatory drugs
- Inflammation occurs at the site of an acute or chronic injury due to release of chemicals and enzymes that initiate an inflammatory response.
- NSAIDs block these reactions and help inhibit the inflammatory response to reduce swelling.
38
Risks of anti inflammatory drugs
Can be detrimental to tissue repair as they can inhibit the natural healing process
39
Short term side effects of anti inflammatory drugs
- Rashes
- Headaches
- Nausea
40
Long term side effects of anti inflammatory drugs
- Increased risk of cardiovascular complications
- Gastro-intestinal bleeding
41
Examples of anti-inflammatory drugs
- Aspirin
- Ibuprofen
42
NSAIDs
Medication widely used in the treatment in sports injuries that have analgesic and anti-inflammatory properties
43
What injuries are anti inflammatory drugs good for?
All injuries
44
What injuries are heat, cold and contrast therapies good for?
- Stress fractures
- Dislocation
- Sprain
- Torn cartilage
- Exercise induced muscle damage
45
What injuries are massages good for?
Soft tissue injuries
46
What injuries are stretching good for?
Soft tissue injuries
47
What is physiotherapy?
The treatment of injury using practical methods, rather than drugs or surgery.
48
What may physiotherapy consist of?
- Mobilisation of joints
- Electrotherapy to repair and stimulate tissue
- Exercise to strengthen muscles
- Massage to stretch and relax tissues, relieve pain and increase circulation
49
What is prehabilitation?
Posture and alignment training to release tension, minimise injury and maximise power output
50
Physiotherapy treatments for sporting injuries:
- PRICE
- Manual therapy including massage
- Heat, cold, contrast therapies
- Acupuncture
- Transcutaneous electric never stimulation (TENS)
- Ultra sound
51
Acupuncture
Fine needles are inserted into specific points of the body
52
TENS
A small electrical device is used in the injured site that delivers a low electrical current, reducing pain messages to brain
53
Ultra sound
High frequency sound waves are used to treat deep tissue injuries by stimulating blood flow
54
Arthroscopic surgery
A type of keyhole surgery used both to diagnose and treat joint injuries
55
What is an arthroscope
A thin metal tube that contains a light source and camera that send images to a screen.
Tiny surgical instruments can be used alongside an arthroscope to allow surgeons to treat joint injuries.
56
Open surgery
A traditional type of surgery where a long incision is made in the skin for the surgeon to see the structures underneath and trust the injury by inserting the instruments.
57
What type of treatment is surgery good for?
- Stress fractures
- Dislocation
- Serious sprain
- Serious torn cartilage
58
Why is surgery sometimes necessary?
- To remove damaged tissue e.g. removal of the damaged flap of tissue after a meniscus tear
- To reconstruct damaged tissue e.g. reconstruction of the ACL using patellar tendon or a tendon from the hamstring
- To realign damaged tissue e.g. reduction of the shoulder joint following a dislocation to realign the bones
59
Potential benefits of arthroscopic surgery over open surgery
- Only involves minor cuts to the skin
- Less pain after operation
- Faster healing time
- Lower risk of infection
- Athlete can go home the same day as the surgery
- Athlete may be able to advance through the 4 stages of rehabilitation more quickly
60
What is arthroscopic surgery mainly used for?
To view and treat joint injuries
61
What will the surgeon look at in arthroscopic injuries?
- The articular surface of the bones
- The surrounding ligaments and tendons
- The meniscus
62
What will the surgeon treat in arthroscopic injuries?
- Torn cartilage by removal of the torn part
- Sprained ligaments by repairing the damage in a grade 1 or 2 tear OR by reconstructing the ligaments in a grade 3 tear
63
What is open surgery used for?
To treat bone fractures and joint injuries
The surgeon will aim to recreate the pre-injury anatomy by repairing the damaged tissue.
64
What can the surgeon treat in open surgery?
- An unstable fracture by placing a metal plate, rod or pins in the bone
- Sprained ligaments by repairing the damage in a grade 1 or 2 tear OR by reconstructing the ligaments in a grade 3 tear
65
What is exercise induced muscle damage?
- Pain experienced after intense exercise due to microscopic tears in the muscle fibres that cause swelling and pain.
- It peaks between 24-72 hrs post event
66
Eccentric exercise
Exercise that involves eccentric contraction of the muscle where it lengthens under tension
E.g. running downhill, plyometric work
67
Characteristics of exercise induced muscle damage
- The mildest type of muscle damage
- Causes muscle soreness 1-3 days after exercise
- More severe after eccentric exercise
- Usually disappears without treatment by 5-7 days
68
Symptoms of exercise induced muscle damage
Stiffness
Soreness
69
Treatment of exercise induced muscle damage
- Usually disappears without treatment by 5-7 days
- Relatively mild inflammation so does not need anti-inflammatory drugs
70
Factors that reduce exercise induced muscle damage
- Cool down
- Massage
- Active non-weight bearing exercise
- Hydrotherapy
- Heat, cold, contrast therapies
71
Examples of acute injuries
- Simple fracture
- Dislocation
- Sprain
- Torn cartilage
- Exercise induced muscle damage
72
Example of chronic injury
Stress fracture
73
3 phases of soft tissue sports injury management
1. Acute inflammatory phase
2. Repair phase
3. Remodelling phase
74
Acute inflammatory phase
- 0-72 hrs
- Characterised by pain, swelling, bruising
- Treatment is PRICE, gentle massage, anti inflammatory drugs
75
Repair phase
- 3 days - 6 weeks
- Characterised by reduced pain and swelling
- Area may still be bruised or discoloured
- Treatment is stretching, massage, heat, cold and contrast therapies, pain relief, physiotherapy
76
Remodelling phase
- 6 weeks - 12 months
- Characterised by formation of scar tissue and the return to previous level of function of limb or joint
- Treatment is stretching, massage, cold, heat and contrast therapies, anti inflammatory drugs, physiotherapy
77
Simple fracture signs and symptoms
- Pain
- Reduced movement
- Swelling
- Change in colour
78
Potential causes of a simple fracture
- Impact
- Falling/ twisting
- Poor technique
79
Treatment of a simple fracture
- Medical attention
- Immobilise
- Anti-inflammatory/ pain medication
- Potentially surgery
- Physiotherapy to strengthen connective tissue
- Stretching + mobility
80
Signs and symptoms of a stress fracture
- Specific spot of pain, especially during exercise
- Gets worse with further use
81
Potential causes of stress fracture
- Overtraining
- Too much overload
- Unfamiliar playing surface
82
Treatment of a stress fracture
- Medical attention to diagnose
- PRICE
- Full rest for 2 weeks + up to 8 weeks activity avoidance
- Strengthen connective tissue
- Gentle return to activity
- If rehab is rushed, further injury can occur
83
Signs and symptoms of dislocation
- Severe pain
- Loss of movement
- Deformity
- Swelling
A 'pop' feeling
84
Potential causes of dislocation
Excessive impact force from collision or fall
85
Treatment of dislocation
- Medical attention
- PRICE
- Immobilisation
- Anti-inflammatory/ pain medication
- Potential surgery for severe dislocation
- Physiotherapy to strengthen connective tissues
- Stretching and mobility
86
Signs and symptoms of a sprain
- Pain
- Reduced movement/ inability to bear weight
- Swelling
- Change in colour
87
Potential causes of sprain
- Impact
- Falling/ twisting
88
Treatment of sprain
- Medical attention may be required
- Immobilise
- PRICE
- Anti-inflammatory/ pain medication
- Strengthening mobility + balance exercises
- Surgery may be required
89
Signs and symptoms of torn cartilage
- Pain
- Swelling
- Clunking or popping sensation + locking of joint
90
Potential causes of torn cartilage
- Impact
- Twisting
- May occur during dislocation
91
Treatment of torn cartilage
- Medical attention may be required
- Immobilise
- PRICE
- Anti inflammatory/ pain medication
- Physiotherapy to strengthen + mobilise
- Hydrotherapy to maintain fitness without bearing weight
- Arthroscopy surgery may be required to remove damaged cartilage
92
Signs and symptoms of exercise induced muscle damage
- Pain
- Swelling
- Reduced RoM and strength peaking between 24-72 hrs after exercise
93
Potential causes of exercise induced muscle damage
- High intensity exercise
- Excessive eccentric exercise
94
Treatment of exercise induced muscle damage
- Symptoms stop within 5 days
- Cold therapy
- Anti inflammatory/ pain medication
- Massage
- Stretching
- Light exercise
- Very heavy swelling may require medical attention
