Phases of Rehabilitation

Rehabilitation

Rehabilitation~ process of recovering from an injury

Treatment and education to regain maximum function and high level of independence

Rehabilitation Team

Physician Physical Therapist Athletic Trainer Fitness Instructor Physical Therapist Assistant Family THE PATIENT

The Patient

Motivated Desires to return to pre-injury level Belief in Recovery Compliance

Rehab Environment

Patient Safety Patient Needs Patient Comfort This includes:

~Sight, Smell, Sound, Touch

First Session

Patient History is EXTREMELY important Knowing entire situation = ease into

physical rehabilitation

Motivation

Motivation~ reason for performing an action; stimulus for behavior

~ Intrinsic Motivation

~ Extrinsic Motivation What is the difference? How do you motivate?

Motivating the Athlete

Greet and know athletes Use name frequently Education of athlete about injury Convey confidence and knowledge Explain Objectives Provide clear and simple directions Positive Attitude (it’s contagious!)

Goals

Education Assist athlete in reaching goals Return athlete to pre-injury level

Education

Giving knowledge to athlete gives sense of control

Education will help the athlete understand what his/her body is doing

Goals

Take time out initially to set goals Short term goals are rehabilitative in

nature Long term goal is Sport Specific (return to

play)

Return to Play

Physically Ready

~ Functionally able to do skills

~ In good Cardiovascular shape Mentally Ready Physician Clearance

Rehabilitation Process

Each program needs to be unique Healing process is universal Three phases of Rehabilitation

Phase 1 ~ Control pain and damage Phase 2 ~ Repair damage Phase 3 ~ Rebuild healthy tissue

Objectives of phases interlinked

Safety Guidelines

Monitor any type of pain or edema increase

Advise pt on need to regain strength in a controlled manner

Review limitations of ADL with each pt Ensure pt can do exercises properly on

own

Phase 1

Immediately after the injury (2-3 days) Primary Goal: decrease inflammation Secondary Goal: prevent additional loss of

function by protecting injury Establish a baseline for future evaluations Maintain currently levels of fitness

Phase 1 Plan

Decrease blood flow to tissues Protect the injured area to prevent further

damage Bracing, splinting, or taping area Suggest use of supportive devices (slings or

crutches Evaluate strength, ROM, and amount of

edema

Phase 1 Plan Cont’d

Maintain strength and flexibility in injured area as well as rest of the body

Educate athlete on safe and effective methods that can be done at home

Instruct athlete on how to safely modify ADL’s to help avoid further injury

Use motivation techniques

Phase 2

Occurs after inflammation and pain controlled

Repair of damaged tissue through strength and ROM exercises

Promotion of self-sufficiency to return to ADL’s

Phase 2 Plan

Evaluate strength, girth, and ROM Compare results with results from phase 1

Increase functional use of injured area Increase blood flow prior to strengthening Continue to decrease pain and edema Begin gait training and improve weight

bearing activities for lower extremity injuries

Phase 2 Plan Cont’d

Increase patients ADL’s as appropriate Continue to increase confidence and self-

esteem Be as creative as possible No cook book way to do rehabilitation

Phase 3

Remodeling: retraining muscles to function in normal capacity as close to “normal” as possible

Prepare the athlete to return to daily life Exercise Modalities ~ rehabilitative

treatment involving use of physical activity to increase strength and flexibility

Phase 3 Plan

Increase endurance, strength, and flexibility in the injured area

Teach athlete how to use treatments at home safely

Prepare athlete to return to play Evaluate strength, girth, and ROM

Compare to previous evaluations

Phase 3 Plan Cont’d

Enhance coordination and balancing skills Make them sport specific

Assist patient in organizing and developing a plan to meet his/her fitness goals

Released by physician to return to play