sports medicine cq4; rehabilitation procedures

Question 1

What are the rehabilitation procedures?

Answer 1

1. Progressive mobilisation
2. Graduated exercise (stretching, conditioning, total body fitness)
3. Training
   - Use of heat and cold

Question 2

What is rehabilitation?

Answer 2

The process of restoring the athlete to pre-injury level of physical fitness by aiming to restore optimal function of the injured area and return the athlete to competition and safely prevent re-injury.

Question 3

What is progressive mobilisation?

Answer 3

The period of the rehabilitation stage in which aims to restore the range of movement within the injured site

Question 4

What should an athlete do within progressive mobilisation?

Answer 4

• Both passive and active movements specific to the injured site with limited pain
• In the early stage ice and compression from RICER can help remove waste products and reduce swelling
• After waste products and swelling is gone, gentle static stretching will help to increase muscle fibre length, joint mobility and breakdown accumulated scar tissue.

Question 5

What is graduated exercise?

Answer 5

The step in the rehabilitation process in which increases the strength and flexibility of the injured site.

Question 6

What are the factors of graduated exercise?

Answer 6

Placing increased physical demands on the body through; stretching, conditioning and total body fitness.

Question 7

Why is stretching essential for graduated exercise?

Answer 7

Due to the accumulation of scar tissue apart of the natural process for recovery, it can make the injured site inflexible and increase the risk of secondary injury.
- This is why stretching is required in order to reduce scar tissue and return flexibility and range of motion to the injured area.

Question 8

What is an example of graduated exercise stretching for a basketball player suffering a hamstring injury?

Answer 8

They should implement static and PNF stretches of the hamstring to help restore the flexibility and muscle length that is lost through inactivity.

Question 9

What is conditioning in graduated exercise?

Answer 9

Conditioning refers to strengthening the injured site through the introduction of more demanding exercises (this should be done pain free) which is aimed at restoring the full range of motion and flexibility.

Question 10

Is specificity essential at the stage of conditioning within graduated exercise?

Answer 10

Specificity is essential at this stage so that the regime targets the appropriate areas.
For example;
- For a shoulder dislocation, exercises should target external rotation and abduction such as shoulder press, rear deltoid raises and lightly weighted arm raises.

Question 11

What is total body fitness in graduated exercise?

Answer 11

The maintenance of overall physical fitness during the rehabilitation stage in order to prevent reversibility.

Question 12

How would an athlete conduct total body fitness?

Answer 12

The program must progressively overload the muscle groups and energy systems specific to the sport without detrimenting recovery.

Question 13

What are adaptations that must be regained during total body fitness?

Answer 13

• Hypertrophy of muscles
• Strengthening of tendons and ligaments
• Increased joint mobility
• Increased elasticity of fibres
• Absence of pain
• Fully restored coordination

Question 14

What are examples of total body fitness for a basketball player?

Answer 14

If a basketball player has injured their ankle and are on crutches, they can work on their upper body strength by doing exercises such as shoulder press, bicep curls or seated ropes as upper body weight training.

Question 15

What should an athlete in rehab start to incorprorate in the rehabilitation process after graduated exercises?

Answer 15

Training, the athlete should undertake modified training activities and progressively increase the level of competition on the physical demands.

Question 16

What do teams do to prevent re-injury during the reintroduction of training in rehabilitation?

Answer 16

Elite teams require athletes to wear different coloured shirts
e.g. In basketball and rugby league , previously injured athletes wear a pink coloured bib to indicate to the coach and players the level of training and contact that the player can safely do.

• It is essential that there is communication between player, coach, trainer and physiotherapist at this stage in order to make clear what activities are safe or unsafe to do.

Question 17

What are the benefits of heat for rehabilitation?

Answer 17

Heat can;
- Increase elasticity and blood flow
- Reduce pain, stiffness and inflammation

Question 18

What are the benefits of ice for rehabilitation?

Answer 18

Icing the injured site will;
- Remove waste products and swelling
- Increase joint mobility

Question 19

When should ice be used during rehabilitation?

Answer 19

• Immediately after an injury occurs (the RICER procedure should be followed for soft tissue injuries)
• Ice can also be used throughout the process of rehab if inflammation and swelling returns namely during graduated exercise.

Question 20

When should heat be used?

Answer 20

As swelling decreases, heat may be used prior to the exercise to ensure adequate blood flow to the injured site
- Heat should NOT be used 2-3 days after the injury occurs and only for certain injuries (e.g. back tightness)