Wk 1 Pt 1 - Rehabilitation of sport injuries

Question 1

Effects of sports injury [9]

- physio

Answer 1

1. pain
2. instability
3. reduced ROM
4. muscle weakness
5. loss of function
6. biomechanical deficits
7. scarring
8. adhesions
9. strength and function imbalance

Question 2

Why is rehab critical?

Answer 2

restore function + RTS

Question 3

Key objectives of rehab [9]
[Can Respect People For Real So People Make Rice]

*think in the sequence of attaining recovery from the point of injury

Answer 3

1. Control Inflammation
2. Reduce swelling
3. Promote healing
4. Faster and complete recovery
5. Restore function
6. Safe and quick RTS
7. Prevent reinjury/recurrence
8. Minimise detraining
9. Reduce economic implications

Question 4

What is PRICEMMM?

Answer 4

1. Protect
2. Rest
3. Ice
4. Compression
5. Elevation
6. Medication
7. Mobilisation
8. Modalities

Question 5

Steps of rehab of process

Answer 5

1. First Aid
2. Treatment modalities
3. Physical Therapy
4. Exercises

Question 6

What do you do in the First Aid phase?

Answer 6

Take care of the initial damage - Ice, compression and elevation

Question 7

What do you do in the Treatment modalities phase?

Answer 7

Try to speed up the biological healing with the different modalities

Question 8

What do you do in the Physical Therapy phase?

Answer 8

Bring about the restoration of lost function such as flexibility and strength

Question 9

What do you do in the Exercises phase?

Answer 9

Lay the foundation for athletes to RTS.

Question 10

What is the wound healing process? (3 overlapping phases)

Answer 10

1. Inflammation
2. Proliferation
3. Remodeling

Question 11

What is the inflammation (wound healing) process?

Answer 11

• Last 4-6 days
• Acute phases of the injury
• starts from the point of injury
• Represented by the pain, discomfort - where the body part is unable to perform as it should be

Question 12

What are the 5 cardinal signs of inflammation?

[D.C.R.T.F - Dom Called Ron To Fly]

Answer 12

1. Dolor (Pain)
2. Calor (Heat)
3. Rubor (Redness - bleeding)
4. Tumor (Swelling - plasma exudation aka pus)
5. Functio Laesa (Loss of function)

Question 13

What is the proliferation (wound healing) process?

Answer 13

• Last 4-24 days (3-7 days, up to 6wks or more)
• subacute stage
• inflammation settles down
• aka healing phase begins to take place – macrophages and fibroblast comes into the picture
• less painful
• laying down collagen + extracellular matrix (scar)
• mature and strengthen (6-8wks)
• more strengthening and remodelling after 8 wks
• In the proliferative phase, the wound contracts as new tissues are built

***High risk of re-injury as the pain is less. One feels better and tries to return to sports/activities (too soon) but the collagen fibres are still weak and not able to withstand the stresses.

Question 14

What is the remodelling (wound healing) process?

Answer 14

• Last 21 days to 2 years (2-3 wks or months/years if more severe)
• phase where wounds become stronger, robust to deal with the stresses of sport participation
• scar collagen strengthens, improves in quality and organisation

Question 15

What is the aim of rehab during the inflammatory phase?

Answer 15

• PRICEMMM Protocol
• protect and prevent worsening of the injury
• control bleeding, pain and swelling
• medicine
• modified activity (mobilization)
• modalities

Question 16

What is the aim of rehab during the proliferative phase?

Answer 16

• restore function and promote movement
• ROM
• joint mobilisation
• scar mobilisation
• exercises to promote re-alignment of collagen fibres along lines of stress (tissue healing)
• prevent secondary complications
• prepare athletes for sport-specific movement/loading

Question 17

What is the aim of rehab during the remodelling phase?

Answer 17

• promote tissue healing - more re-alignment and strengthening of scar collagen
• full ROM of joint (restored)
• increase muscle strength
• improve aerobic fitness
• neuromuscular fitness
• sport-specific skill training to restore performance-related function and help athletes RTS, cope with training load and competition

Question 18

What are the things that you need to take note of when helping an athlete through rehab?

Answer 18

• every rehab program is tailored to the athlete individually
• it needs to meet sport-specific needs
• able to restore performance-related function
• cope with training load and competition

Question 19

How should the rehab program be like?

Answer 19

• should be gradual and progressive

- controlled rehab of impairment

Question 20

Why does it need to be controlled?

Answer 20

controlled aggression is important because you want to be fast but at the same time, not too aggressive to help the athlete RTS

Question 21

What are the things to consider when planning the rehab program for every separate individual?

Answer 21

• type of injury
• tissue that is injured
• what’s the nature of injury (is it the first injury; is it an aggravation of existing injury; recurrence of an existing injury that happened previously)
• to what extent that damage has happened needs to be understood