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Indiana University Rehabilitation Program

Athlete: ___________________________ Injury: ________________________


Date:
Sunday Monday

Pre
Ultrasound
Graston
-Up. Trap
-Scalenes
Stretch
-Corner Stretch
-Scalene Stretch

Post
Ice







Tuesday

Pre
Combo







Post
Ice Massage
Wednesday

Pre
Ultrasound
Graston
-Up. Trap
-Scalenes
Stretch
-Corner Stretch
-Scalene Stretch

Post
Ice

Thursday

Pre
Combo







Post
Ice Massage
Friday

Pre
Ultrasound
Graston
-Up. Trap
-Scalenes
Stretch
-Corner Stretch
-Scalene Stretch

Post
Ice


Saturday

Indiana University Rehabilitation Program

Athlete: ___________________________ Injury: ________________________
Date:
Sunday Monday

Pre
Ultrasound
Graston
-Up. Trap
-Scalenes
Stretch
-Corner Stretch
-Scalene Stretch

Shoulder Shrugs
(3x10x15#)
Bent Over Rows
(3x10x15#)
Chicken Wings
(3x10xManual)

Post
Ice








Tuesday

Pre
Ultrasound














Post
Ice Bag
Wednesday

Pre
Ultrasound
Graston
-Up. Trap
-Scalenes
Stretch
-Corner Stretch
-Scalene Stretch

Shoulder Shrugs
(3x10x15#)
Bent Over Rows
(3x10x15#)
Chicken Wings
(3x10xManual)

Post
Ice

Thursday

Pre
Ultrasound














Post
Ice Bag
Friday

Pre
Ultrasound
Graston
-Up. Trap
-Scalenes
Stretch
-Corner Stretch
-Scalene Stretch

Shoulder Shrugs
(3x10x15#)
Bent Over Rows
(3x10x15#)
Chicken Wings
(3x10xManual)

Post
Ice


Saturday

Indiana University Rehabilitation Program

Athlete: ___________________________ Injury: ________________________
Date:
Sunday Monday

Pre
Ultrasound
Graston
-Up. Trap
-Scalenes
Stretch
-Corner Stretch
-Scalene Stretch

Arm Slide on Wall
(3x10)
Thumbs Up T
(3x10x15#)
Push Up +
(3x10)

Post
Ice








Tuesday

Pre
Ultrasound














Post
Ice Bag
Wednesday

Pre
Ultrasound
Graston
-Up. Trap
-Scalenes
Stretch
-Corner Stretch
-Scalene Stretch

Arm Slide on Wall
(3x10)
Thumbs Up T
(3x10x15#)
Push Up +
(3x10)

Post
Ice

Thursday

Pre
Ultrasound














Post
Ice Bag
Friday

Pre
Ultrasound
Graston
-Up. Trap
-Scalenes
Stretch
-Corner Stretch
-Scalene Stretch

Arm Slide on Wall
(3x10)
Thumbs Up T
(3x10x15#)
Push Up +
(3x10)

Post
Ice


Saturday

CIP-9
# Code Description
1 845.02 Calcaneofibular (ligament)
2 97005/97006 Evaluation and Reevaluation
3 97110 Therapeutic Exercise
4 97124 Massage (15 mins)
5 97140 Manual Therapy
6 97035 Ultrasound (15 mins)
7 97032 Electrical Stimulation
8 97010 Cold Pack
9 97016 Compression Pump

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