REHABILITAT

ION OF SPORT
INJURY
Taufik Eko Susilo, M.Sc

Capaian Pembelajaran:
Mahasiswa mampu menganalisa mekanisme cidera
Mahasiswa mampu mengetahui prinsip dasar rehabilitasi lanjutan

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CONTENTS
• Rehabilitation introduction
• Overuse Injury classification
• ATC IS IT Principle
• Rehabilitation components
• Stages of rehabilitation

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INTRODUCTION
• Rehabilitation  restoration of optimal form & function
• Enables individuals
• maintain or return to their daily life activities,
• fulfill meaningful life roles and
• maximize their well-being

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TISSUE INJURY
• Macro-traumatic
• Strong force,
• Direct or non-direct trauma
• Micro-traumatic
• Chronic injury
• Overuse a structure

Buschbacher R, 2009 4
 OVERUSE INJURIES
• Repetitive microtrauma overloads
• high training loads,
• tight competition schedules
• insufficient recovery

INTRINSIC FACTORS EXTRINSIC FACTORS

• Age • Training errors
• Physiology • Equipment
• Anatomical • Environmental conditions
• Leg Discrepancy • Playing surfaces
• Others: genetic, endocrine, metabolic condition • Physiological factors
• Inadequate nutrition

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Brukner P et al, 2012; Clarsen. B, 2015
 OVERUSE INJURY CLASSIFICATION
SITE ACUTE INJURIES OVERSUSE INJURIES
Bone Fracture Stress fracture; Bone strain; Stress reaction; Osteitis;
Periosteal contusion Periostitis; Apophysitis
Articular cartilage Osteochondral/chondral fracture Chondropathy (e.g. chondromalacia)
Minor osteochondral injury/lesion
Joint Dislocation; Subluxation Synovitis; Osteoarthritis
Ligament Sprain/tear (grades I - III) Inflammation
Muscle Strain/tear (grades I - III); Contusion Compartment syndrome (chronic); Delayed onset muscle
Cramp; Compartment syndrome (acute) soreness (DOMS); Focal tissue thickening/fibrosis
Tendon Tear (complete or partial) Tendinopathy
Bursa Traumatic bursitis Bursitis
Nerve Neuropraxia Nerve entrapment; Minor nerve injury/irritation; Adverse
neural tension
Skin Laceration; Abrasion; Puncture wound Blister; Callus

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Brukner P et al, 2012
 OVERUSE INJURIES
Common cases

ACHILES TENDINOPATHY TENNIS ELBOW ILLIOTIBIAL BAND SWIMMING OVERUSE

SYNDROME INJURY

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 REHAB PRINCIPLE
ATC IS IT

• A: Avoid aggravation
• Prevent recurrent injury
• T: Timing
• Therapeutic exercise  ASAP  return full activity. Rest is necessary
• C: Compliance
• Inform the program and expected course to athlete
• I: Individualization
• Individual respond of physiological and chemical response of injury
• S: Specific sequencing
• Specific sequence of event
• I: Intensity
• Challenge the level
• T: Total Patient
• Whole patient, also at unaffected area 8
REHABILITATION COMPONENT
Pain management
Flexibility and Joint ROM
Strength and Endurance
Proprioception and Coordination
Functional Rehabilitation
Use of Orthotics
Psychology of Injury

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 ACUTE MANAGEMENT PROGRAMS
Current Concepts in Sports Injury Rehabilitation, Himmat Dhillon (2017)

• Aim of rehabilitations and planning

• Restore function and performance to a preinjury level
• Safe return to the sport
• Minimize risks of reinjury

KEY FACTOR
• Tissue healing  natural healing (during program construction)
• Remodeling phase (> 1 year)  monitor the athlete + continue ongoing strength

Prevention
Acute phase Reconditioning Return to sport
reinjury

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STAGES OF REHABILITATION

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 RECONDITIONING PHASE
• From day 5 to 8-10 weeks
• Ensure the optimal loading progressively
• Cardiorespiratory loading  maintain + improve aerobic capacity 
neuromuscular training  muscle strength + flexibility + proprioception
• Excessive training load  Return to Play preparation
JOINT ROM AND MUSCLE CONDITIONING TYPE OF EXERCISE

• Isometric exercise
• Isokinetic exercise
• Isotonic exercise
• Specific exercise
• Variation with eyes open close challenge
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RETURN
TO SPORT
strategic assessment
of risk and risk
tolerance (StAART)

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PREVENTION OF REINJURY
• A previous injury is the highest predictor of a risk of reinjury
• Monitoring  essential ?  load progression
• Programs:
• Training strategies: neuromuscular training
• ↑ balance, strength & agility
• Modification of sport rules and changes in policies
• Equipment recommendation

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THANK YOU
Email: taufikekosusilo@gmail.com

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