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Sports Med Critical Question 4.notebook
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Critical Question 4How is injury rehabilitation managed?
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Syllabus
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Big Heading: Critical Questions 4: How is injury rehabilitation managed
Heading: Rehabilitation Procedures
Rehabilitation after injury can take some time depending on the type and severity of the injury. A qualified doctor or physiotherapist should supervise the process.
The aims of any rehabilitation program are to:
• restore optimal function of the injured area
• return the athlete to competition quickly and safely
• prevent reinjury.
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Sub: Progressive Mobilisation
• It is important to progressively introduce movement to the injured area once the RICER technique has been applied.
• Gradually moving the injured area using light stretches and rotations will reduce the buildup of scar tissue and allow greater mobility in the injured part.
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Sub: Graduated ExercisesStretching• During healing, the muscle length decreases• Stretching should be performed regularly after a warmup, and should always remain within the painfree range• PNF stretching is the best (partner assisted)
Conditioning• Graduated exposure of the injured area to resistance/weight
training, to make sure that strength is back to preinjury levels before returning to sport.
Total Body Fitness• Gradually exposing the entire body (including the lungs and
heart for aerobic fitness) to increasingly high levels of exercise as the rehabilitation process progresses.
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Sub: Training• Training should be modified throughout the rehabilitation process to match the athlete’s current level of function.
• Normal training should be avoided through the initial stages to allow the injury to settle.
• Following this stage, basic skills strength and flexibility should be introduced.
• It is only after the athlete is able to train back at their preinjury level that they should be considered fit to return to full sporting participation.
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Sub: Use of heat and coldInjuries can be treated using heat packs or cold packs. This will depend on the type of injury and the length of time since the injury occurred. Cold is usually used during the first 24 48 hours.
Cold (Cryotherapy)• Ice can be used instantly on all injuries, as it reduces swelling and pain, restricts the blood vessels, which reduces the blood flow to the injured area and inflammation.
• Cold treatments can include ice in bags, ice packs, ice gels and ice baths.
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Cont...Heat
• As heat increases blood flow, the use of heat on sore muscles and tendons will help to relax them and increase their elasticity.
• Heat treatments include hot packs, ultrasound treatments and whirlpools.
• While heat can make body tissue more mobile, if inflammation is visible, ice should be used.
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Questions Research Task
Outline the rehabilitation process for thefollowing:• a hamstring tear• a shoulder dislocation• a ruptured anterior cruciate ligament.
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Heading: Return to PlayIf an athlete returns to training and competition too soon after an injury, they run the risk of reinjury. Even when an injury has healed, there are specific measures that need to be taken to ensure the injury does not recur. In some instances, medical clearance must be given before an athlete can return to play Sub: Indicators or readiness for return to play• The athlete should have regained full painfree range of motion of the injured joint/area prior to returning to sport.
• They should also have full strength and the ability to perform the basic movements and skills required in their sport
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Sub: Monitoring Progress (pre and post test)
• An athlete must meet specific criteria for function and fitness to be considered ready for return to play.
• Having pre injury results to compare against helps coaches and Physio's make a more informed decision about return to play
• Example: A Baseball pitcher recovering from a shoulder injury may use a measurement of shoulder external and internal rotation compared with that at the start of the season
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Sub: Psychological Readiness
As an athlete recovers from injury, they may become anxious about the prospect of returning to play. Techniques to encourage an athlete to be psychologically prepared include:• The gradual introduction of sportspecific skills to training sessions – for example, practising layups in basketball• Playing lowintensity/impact games at training – for example, touch football for Rugby League• Playing the athlete at a lower level of competition – for example, reserve grade if a firstgrade player.
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Sub: Specific WarmUp Procedures
• An athlete who has been injured might need to go through a longer, harder or more specific warmup and stretch routine than other athletes.• Extra time and care might be needed at the injury site and surrounding tissues to ensure adequate flexibility, blood flow and readiness to perform.
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Sub: Return to play policies and procedures
Each sport will have its own set of policies andprocedures that govern whether an athlete is readyto return to sport postinjury. E.g. The rule in contact sport regarding ‘knockouts’/concussions, with a set period of time and psychological screening tests deciding the player’s readiness for resumption of contact sport.
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Sub: Ethical Considerations• When athletes are injured, they are faced with many dilemmas about returning to their sport.
• Elite athletes in particular feel pressure from their coaches, teammates, sponsors and society to be back on the field as soon as possible.
• These added pressures can force an athlete to return to competition before the injury is completely healed.
• Athletes may choose to use pain killers that numb the pain, such as cortisone injections, but this numbness sets an athlete up for further damage as they cannot feel the injury and hence will not feel the pain when they incur more damage.
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Questions1. Identify the internal and external pressures that may
be experienced by an injured athlete when deciding whether to return to play.
2. Outline measures an athlete should utilise to know when he or she is ready to return to play after an injury.
3. Discuss who should be responsible for deciding whether an athlete continues to play with an injury.
4. Outline the problems that can be associated with leaving this decision to the athlete..
5. Explain how graduated exercise can assist an athlete to return to play
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