Sports Rehabilitation

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Phases of Rehabilitation - Rehab Roadmap

Sports rehabilitation follows a structured, progressive approach. Key phases ensure safe return to activity.

  • Phase 1: Acute (Protection Phase)
    • Focus: ↓Pain, ↓Inflammation, tissue protection.
    • Key: 📌 POLICE (Protection, Optimal Loading, Ice, Compression, Elevation), gentle pain-free ROM.
  • Phase 2: Subacute (Repair & Controlled Motion Phase)
    • Focus: Restore ROM, initiate controlled loading & basic strength.
    • Key: AROM, light isometrics, early proprioceptive exercises.
  • Phase 3: Remodelling (Strength & Return to Activity Prep Phase)
    • Focus: ↑Strength, ↑Endurance, ↑Power; introduce sport-specific skills.
    • Key: Progressive resistance exercises, plyometrics, agility drills.
  • Phase 4: Return to Sport (Maintenance & Prevention Phase)
    • Focus: Full functional restoration, safe sport re-entry, injury prevention.
    • Key: Sport-specific training, functional testing, maintenance exercises.

⭐ The POLICE principle (Protection, Optimal Loading, Ice, Compression, Elevation) is critical in the acute phase, promoting healing by managing inflammation and encouraging early, safe mechanical stress to tissues rather than complete rest (as in PRICE).

Key Injury Protocols - Tackling Trauma

ACL Tear Rehab:

  • Goals: Stability, strength, function.
  • Phases:
    • Acute (0-2 wks): PRICE, ROM (0-90°), quad activation.
    • Recovery (2-12 wks): Full ROM, closed-chain exercises, proprioception.
    • Functional (3-6 mo): Sport-specific drills, plyometrics.
    • Return to Sport (RTS) (6-9+ mo): Strength (>85-90% contralateral), stability.

      ⭐ RTS criteria: Quadriceps strength >85-90% of unaffected leg.

Rotator Cuff Rehab:

  • Goals: ↓Pain, restore ROM/strength.
  • Phases:
    • Protection (0-6 wks): Pain control, sling, pendulums, AAROM (avoid abduction > 90°).
    • Recovery (6-12 wks): Full ROM, isometrics → isotonics, scapular stabilization.
    • Strengthening (12+ wks): Progressive resistance for RC & scapula.
    • Return to Function: Sport-specific.

Ankle Sprain Rehab (Lateral):

  • Goals: ↓Pain/swelling, restore ROM, strength, proprioception.
  • POLICE Principle: Protection, Optimal Loading, Ice, Compression, Elevation.
  • Phases (Grade I/II):
    • Acute (1-3 days): POLICE, gentle ROM.
    • Subacute (3 days - 2 wks): ROM, strength (Therabands), balance.
    • Functional (2 wks+): Agility, sport-specific, jump/land. 📌 Mnemonic: Anterior TaloFibular Ligament - "Always Tears First".

Therapeutic Modalities - Healing Arsenal

  • Cryotherapy (Cold): Acute injuries (first 24-48h); ↓pain, ↓swelling, ↓inflammation.
    • Contra: Raynaud's, PVD, cold allergy.
  • Thermotherapy (Heat): Subacute/chronic (>48-72h); ↓muscle spasm, ↓stiffness, ↑blood flow.
    • Contra: Acute inflammation, DVT, hemorrhage.
  • Electrotherapy:
    • TENS: Pain relief (gate control).
    • NMES: Muscle strengthening, re-education.
    • Contra: Pacemakers, pregnancy, active cancer.
  • Therapeutic Ultrasound: Deep heat (thermal); tissue healing (non-thermal: cavitation, acoustic streaming).
    • Contra: Malignancy, eyes, gravid uterus, epiphyseal plates (children).

Ultrasound Dose Parameters for Tissue Heating

⭐ Ultrasound is contraindicated over epiphyseal plates in children due to potential growth disturbance.

Return to Play Criteria - Green Light Glory

  • Key Factors: Pain, ROM, strength, functional testing, psychological readiness.
  • Gradual progression is crucial.

Hop tests (e.g., single-leg hop for distance) are vital functional assessments for lower limb injuries before returning to sport, aiming for >90% limb symmetry index (LSI).

High‑Yield Points - ⚡ Biggest Takeaways

  • Sports rehabilitation follows key phases: acute, recovery, functional.
  • PRICE/POLICE protocol is vital for acute injury management.
  • Closed Kinetic Chain (CKC) exercises are often preferred early over Open Kinetic Chain (OKC).
  • Proprioceptive training is crucial for joint stability and re-injury prevention.
  • Return-to-sport decisions require objective functional criteria, not just time.
  • Eccentric exercises are a cornerstone for tendinopathy treatment.
  • ACL rehab prioritizes early motion, strength, and neuromuscular control.

Practice Questions: Sports Rehabilitation

Test your understanding with these related questions

Which of the following phases are directly involved in the recovery phase of the disaster cycle?

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Flashcards: Sports Rehabilitation

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Treatment of myositis ossificans in latent phase involves _____

TAP TO REVEAL ANSWER

Treatment of myositis ossificans in latent phase involves _____

active physiotherapy

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