CHAPTER 12
Understanding the Basics of Injury Rehabilitation
OVERVIEW
Rehabilitation is the restoration of an athlete to his or her pre-injury fitness level through a carefully planned and executed program. A coach should rely on an athletic trainer or physical therapist to plan, implement, and supervise an athlete’s rehabilitation program. The goal of every rehabilitation program is to return the athlete to his/her pre-injury participation status as quickly and as safely as possible.
The rehab process begins as soon as the athlete is injured with controlling swelling and pain. Once those are controlled, the athlete can work on restoring range of motion, muscular strength and endurance, neuromuscular function, and balance. Through the entire rehabilitation process it is important to try to maintain cardiovascular fitness so that when athletes are ready to return they are at close to the same fitness level as when they became injured. In order to return to participation there are criteria that must be met, and the athlete should go through a series of functional testing and progressions.
LEARNING OBJECTIVES
After studying Chapter 12, the student will be able to:
Explain the PRICE principle.
Describe the stretching techniques used to restore ROM and flexibility.
Describe the basic components of a rehabilitation program.
Identify the individual short-term and long-term goals of a rehabilitation program.
Describe the criteria and the decision-making process for determining when the injured athlete may return to full activity.
Discuss which modalities a coach is allowed to use to assist an athlete with rehabilitation.
Describe the different types of exercises used to build strength including isometrics, (PRE’s), isokinetics, and plyometrics.
Explain the concept of neuromuscular control.
Explain functional progressions and give an example of functional tests.
KEY TERMINOLOGY
Functional progression - A series of gradual progressive activities designed to prepare the individual to return to his/her specific sport
Isometric exercise – An exercise that increases static strength where no motion occurs at the joint
Isokinetic exercise - Uses a fixed speed and a variable resistance to provide the maximum amount of resistance through a range of motion
Massage – A systematic manipulation of the soft tissues of the body
Neuromuscular control – The mind's attempt to teach the body conscious control of a specific movement
Plyometric exercise - Uses a quick stretch of a muscle to facilitate a contraction
Progressive resistive exercises (PRE’s) - Use isotonic contractions of the muscle in which there is a constant resistance against the muscle as it changes in length
DISCUSSION QUESTIONS
1. What is the difference between short- and long-term goals? Why are each important in the rehabilitation process?
2. What are the major components that should be included in a rehabilitation program?
3. At what point in the rehabilitation process is it appropriate to incorporate functional progression?
4. What are the criteria for returning to participation? Why is it important to set such criteria?
5. What are the different modalities that can be used? What are their effects?
CLASS ACTIVITIES
1. Take the class to the training room or local sports medicine clinic to see the equipment used to rehabilitate an injured athlete. Such devices as an isokinetic machine, BAPS board, multiaxial machine, weight cuffs, Theraband, and the use of manual therapy can be demonstrated to show how they contribute to the total improvement of flexibility and strength of athletes to aid in their rapid and full recovery.
2. Have the class get into groups, give each group an injury, and have them design a rehabilitation program for that injury. Discuss the programs with the rest of the class.
3. Have each member of the class put the types of modalities on themselves to experience what the athlete feels.
WORKSHEET ANSWERS
Matching
1. h / 5. e2. g / 6. b
3. d / 7. f
4. a / 8. c
Short Answer
9.Control pain and swelling
10.To return the athlete to his/her activity as soon and as safely as possible
11.In order to regain the ability to follow some previously established sensory or movement pattern
12.An athlete with a lower extremity injury can utilize pool activities, bike riding, and upper and lower body ergometer exercises.
13.Hot packs are used most often post-acutely (after swelling has stopped).
14.Used to increase blood and lymphatic flow and facilitate reabsorption of the by-products of the injury process into the lymphatic system. Heat may also be used for its analgesic and relaxation effects.
Listing
15. Isometric exercise
16. PREs
17. Isokinetic exercise
18. Plyometric exercise
19. Agility runs (figure eights, shuttle runs, cariocas)
20. Side Stepping
21. Vertical Jumps
22. Hopping for time or distance
Essay
23-27.An athlete can return to activity once they have achieved full range of movement, strength, neuromuscular control, cardiovascular fitness, and sport-specific functional skills. They must also have regained full confidence to return to his/her sport.
NAME______
SECTION______
CHAPTER 12 WORKSHEET
Understanding the Basics of Injury Rehabilitation
MATCHING: Match the following terms with the appropriate response.
______1.PREs______2. Isometric Exercise
______3. Muscular strength
______4. Muscular endurance
______5. Isokinetic Exercise
______6. Massage
______7. Plyometric Exercise
______8. Neuromuscular Control / a.The ability to sustain a muscle contraction over a period of time
b.Systematic manipulation of the soft tissues of the body
c.The mind’s attempt to teach the body conscious control of a specific movement
d.The ability of a muscle to generate force
e.Uses a fixed speed and a variable resistance to provide maximal resistance through a ROM
f.Uses a quick stretch of a muscle to facilitate a contraction
g.Uses a static contraction to increase strength without motion occurring at the joint
h.Uses concentric and eccentric exercises in which there is a constant resistance against a muscle as it changes length
SHORT ANSWER: Answer the following questions with a brief response.
9.What are the two things that can be done initially when an injury occurs?
10.What is the long term goal of any rehabilitation program?
11.Why is it important to restore neuromuscular function?
12.How can cardiovascular fitness be maintained in an athlete with a lower extremity injury?
13.When is a hot pack used?
14.Why are hot packs used in the rehabilitation process?
LISTING: List the ways in which muscular strength, endurance, and power can be restored.
15.
16.
17.
18.
List four functional tests used to evaluate an athlete's ability to return to participation.
19.
20.
21.
22.
ESSAY:
23-27.What are the criteria to return an athlete to activity?
IM-12 | 1