Being injured can be both disappointing and frustrating. You may feel like you have no control over your injury or getting better. Working with an athletic therapist or physiotherapist can also be intimidating if you do not know what to expect. Here are some general principles of rehabilitation. These give you a better idea about the direction you and your therapist will take with your rehab goals.

No matter how you injure yourself there are many components of fitness that need to be addressed in your rehab. “Strength, flexibility, muscular endurance, power, agility, coordination, quickness, and cardiovascular endurance are all important¹.” As a general guideline for any injury:

• Begin as early as possible (first 24-48 hrs)
• Have a therapist evaluate you completely (first 2-7 days)
• Get involved in preparing the therapy plan so it is catered to you
• Progress exercises in stages
• Include rehabilitation specific to your injury and sport
• Be evaluated consistently

The exercises you do in rehab therapy are not used to reinforce strength and flexibility².  In fact, they are done to re-teach your muscles the proper way to function. Using the best progression of exercises these muscles are able to work more effectively during injury healing and prevention. The principles that help guide the progression of exercises to achieve goals include:

The SAID Principle (Specific Adaptation to Imposed Demands)

• For you to progress in your rehab program you need to be challenged in a safe environment.

Setting Therapeutic Goals (long and short-term goals)

• Long-term goals are made up of several short-term goals that help you progress towards pre-injury status.

Continual Evaluation

• SAID principle requires both an accurate initial evaluation and daily re-evaluation to determine your response to treatment and exercises.

Functional Progression

• Should progress from the easiest of activities to full sports participation.

Early Exercise

• Early safe exercise speeds healing and lack of appropriate exercise may cause permanent disability.
• Always be careful with any exercise and consult your therapist before you begin.

Rate of Reconditioning

• Redevelopment is much quicker than development.
• Much of the strength lost after injury is the result of pain-induced inhibition.

Pain Free

• All exercises should be pain free and no pain should stay around after exercise.

Feedback

• Your therapist will constantly give you feedback about technique and will periodically test you to see how you are progressing.

All of the above principles help you return to sport as quickly as possible. Your therapist will progress you through your rehab program safely and quickly. There are 3 stages you will go through during your program. They include acute (when it first happens), subacute (a few days after it happens) and maintenance (weeks to months after it happens). Here are guidelines your therapist will use during these different stages. 

During the acute stage of an injury it is important to control swelling and allow the body to heal itself. PRICE stands for pressure, rest, ice, compression and elevation. It is the basic principle for immediate treatment of most injuries. An injury may be bad enough that you require further treatment such as surgery, bracing, or casting³. Be sure to see the best health care professional to find out about your condition.

If you see an athletic therapist or physiotherapist he or she will help you modify your training using exercises such as water running or cycling. These are both considered cross training activities that help you make up for not being able to run⁴. The therapist will also help you “think outside the box” and modify various sport skills to keep you participating in your sport. This will help you stay motivated to return to play, mentally prepared for play and make rehab more interesting and fun⁵.

The sub-acute stage of therapy is the time to work on range of motion and strength. Your therapist will help you with a rehab plan that often includes maintaining muscle tone using simple strength exercises.

When your strength returns to normal, you can start to do functional drills. For lower body injuries, this may include brisk walking, jumping rope, hopping, or light jogging. For upper body injuries, light throwing or easy swinging can be done. “Specific exercises for balance and agility can bring back the coordination that may have been lost in the injury³.” After you progress your motion, strength, endurance, and agility, and you are tolerating functional drills, you can try higher levels of sport-specific movements with your therapist³. Tape, braces and supports may be used to protect the injury during this transition phase.  

The goal of any rehabilitation program is to improve functional movement. The drills and exercises that are used to heal the injury can also be used to prevent it. The maintenance stage is when you continue doing functional exercises that maintain the flexibility, strength, and endurance of the muscles. Adding some simple exercises used with rehab to your normal training routine can help with preventing the old injury from coming back or new injuries happening.

Seeing someone for help after you have injured yourself can be difficult if you do not understand the rehabilitation process. Having a general idea about the principles and stages of rehab help you learn what to expect and help you become an active participant. When an injury happens stay positive and focused on the goals you and your therapist have put together. Allow time for your body to heal and your mind will be ready to compete again soon.

For a list of sport therapists (athletic therapist and physiotherapists) in the province, check out the SportMed Directory of Practitioners >> click here

1. McGill Athletics. . http://www.athletics.mcgill.ca/sportsmed_interest_details.ch2?article_id=82. Accessed 7/7/2008, 2008.
2. Principles of Rehab. .http://www.healthsystem.virginia.edu/internet/pmr/prinofrehab.cfm. Accessed 7/7/2008, 2008.
3. Your Orthopaedic Connection: Return To Play. . http://orthoinfo.aaos.org/topic.cfm?topic=A00365. Accessed 7/7/2008, 2008.
4. Principles of Rehab. . http://www.healthsystem.virginia.edu/internet/pmr/prinofrehab.cfm. Accessed 7/7/2008, 2008.
5. AASP – Mentally Preparing Athletes to Return to Play Following Injury. . http://appliedsportpsych.org/resource-center/injury-&-rehabilitation/articles/mentally-preparing. Accessed 7/7/2008, 2008.

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