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Rehabilitation of Sports Injuires

Rehabilitation of Sports Injuires

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Rehabilitation of Sports Injuires
Rehabilitation of Sports Injuires

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Published by: Surgicalgown on Apr 20, 2009
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01/31/2013

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Rehabilitation of SportsInjuires
 
Introduction
Principles of rehabilitation
Key concepts
Team approach
Diagnosis
Acute injury management
Drugs
Management
Passive physical treatments
Active physical treatments
Strengthening exercises
Flexibility
Endurance
Proprioceptive retraining
Functional training
Psychological
Biomechanical factors
Return to sport
Rehabilitation of four common injuries.
Tennis elbow
Sprained ankle
Hamstring
Stress fractures
Complications of rehabilitation
Prevention
 
 
‘Life is movement, movement is life’. Aristotle
Introduction
Rehabilitation is a generic term for the comprehensive treatment of injury and/or medicalconditions. It has active and passive elements. It focuses upon the whole person not just theinjury and aims to restore the greatest possible degree of function in the shortest possibletime. The factors implicated in the cause of injury should be addressed to prevent injuryrecurrence. Three concepts help with the understanding of the rehabilitation process these areimpairment, disability and handicap. Injury causes an individual an impairment. This is the injury at the tissue level e.g. rupturedmedial collateral ligament of the knee. Impairment usually causes a disability This is a loss of function e.g. walking with a limp andunable to run.This in turn may cause a handicap this is an individuals inability to perform tasks or engage inactivities. e.g. the professional footballer is unable to compete for the rest of the season due to theknee injury which causes loss of playing time, reducing his income and prematurely endinghis career. This causes some reactive depression. From this example the need for the physician to consider the medical, physical, psycho-social, vocational and leisure requirements of the injured athlete is apparent.The areas covered are1. the principles of rehabilitation.2. treatment modalities3. specific examples4. complications of inadequate or incorrect rehabilitation5. prevention
Principles of rehabilitation
The process of athletic injury rehabilitation aims to minimize tissue damage and allow a safereturn to activity. It is based on the science of tissue healing, knowledge of jointbiomechanics, physiology of muscular strength and endurance, and the neurophysiologicalbasis of skill retraining. Successful programs are based on an understanding of theseconstraints, which, when properly applied, permit the progressive activity of joints and
 
muscles. Muscular strength, endurance and power are redeveloped while flexibility andcardiovascular fitness are maintained. Precipitating factors are identified and addressed tominimize reinjury. (1) To understand, grade and treat injuries the physician needs to identify the tissues involved.This chapter focuses on muscle-skeletal injury and rehabilitation of bone, ligament, muscle,tendon, connective tissue and neuromuscular structures combining to produce coordinated,purposeful movement. The treatment of other injuries is covered in relevant chapters. The healing process involves inflammatory, repair and remodeling phases. There aredetrimental effects of immobilization, muscle wasting and weakness and subsequent jointdamage. This leads to further immobilization and reflex inhibition ‘a vicious circle’. Earlymobilization is usually indicated.Lack of motion of joints results in shortening of capsular and other connective tissuestructures supporting the joint, loss of lubrication and alternating compression between jointsurfaces deprives articular cartilage of nutrition.(2) There are detrimental systemic effects of immobilization, these begin within hours andbecome clinically important within days. They include cardiovascular deconditioning, nervoussystem depression, skin sores gastrointestinal complaints (constipation), thromboembolicgenesis, bone resorbtion and respiratory impairment.(3) Thus the expression ‘MOVE IT ORLOSE IT’ An understanding of the sport or activity is required, many injuries are sport specific andcommunication is enhanced if the physician has some basic knowledge of the sportsrequirements. ‘Profiling’ is a concept that matches an individuals physiognomy with the typeof athletic activity and in team sports their role.1 Kulund ‘The Injured Athlete’ Lippincott 19882 C Hubley-Kozey et al.1994.Rehabilitation Principles and Techniques.In JC Delee et al EdsOrthopaedic Sports Medicine Chapter 6 p 184-207.Saunders Philadelphia3 Krusen’s Handbook of Physical Medicine and Rehabilitation 3rd Ed Saunders1971
Key concepts
Team ApproachRehabilitation is facilitated by a team approach. The basic team comprises in order of importance
The injured athlete.
The physical therapist- physiotherapist have the most scientific training (other types

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