Rehabilitation and reconditioning involve
restoring an athlete’s physical function following
injury and preparing them to return safely to sport.
Team Physician roles
Provides medical diagnosis and oversees treatment
* Clears athletes for progression or return to play
* Coordinates with medical and performance staff
Athletic Trainer (ATC) roles
Manages daily athlete health
* Performs injury evaluations, taping, therapies
* Communicates injury status and restrictions
physical therapist roles
Specializes in restoring movement, function, and pain reduction
* Performs therapeutic exercise, joint mobilization, manual therapy
Strength & Conditioning Professional (CSCS) roles
Designs safe, effective, and progressive training programs
* Ensures exercises match healing phase and medical restrictions
* Must know diagnosis, indications, and contraindications
* Provides feedback to the medical team on athlete responses
Exercise Physiologist roles
Programs conditioning with consideration for metabolic demands and healing processes
Nutritionist / Dietitian
Guides macronutrient and micronutrient intake for tissue repair
* Ensures adequate caloric balance during recovery
Psychologist / Psychiatrist
Supports motivation, coping, identity issues, and fear of re-injury
* Helps athletes manage psychological stress of injury
Macrotrauma
Sudden, acute trauma to tissue.
Examples:
* Dislocation: Complete displacement of joint surfaces
* Subluxation: Partial displacement
* Sprain: Ligament trauma (1st–3rd degree)
* Strain: Muscle fiber tears (1st–3rd degree)
* Contusion: Direct blow causing swelling/bruising
microtrauma
Chronic or repetitive stress injuries.
Examples:
* Stress fracturesTendinitis / tendinopathy
* Overuse syndromes
when does healing occur
Healing occurs in overlapping but distinct phases.
Inflammatory Response Phase
Timeframe: Immediate → several days
Features:
* Redness, swelling, pain, warmth
* Loss of function
Inflammatory Response Phase goals
Protect tissue
* Prevent further damage
* Maintain conditioning of uninjured extremities
Inflammatory Response Phase exercise strategy
Aerobic training of uninjured limbs
* Resistance training of unaffected areas
* Avoid stressing injured tissue
Fibroblastic Repair Phase
Timeframe: ~2 days → up to 2 months
Features:
* Collagen (Type III) formation begins
* Decreased inflammation
Fibroblastic Repair Phase goals
Prevent atrophy
* Maintain ROM and function
* Begin light strengthening as tolerated
Fibroblastic Repair Phase exercise strategy
Submaximal isometrics
* Isokinetic training
Neuromuscular control exercises
* Controlled ROM activities
Maturation–Remodeling Phase
Timeframe: Up to 2–4 months
Features:
* Collagen fiber alignment and increased tissue strength
Maturation–Remodeling Phase goals
Restore full function
* Introduce sport-specific speed, power, and movement patterns
Maturation–Remodeling Phase exercise strategy
Sport-specific drills
* Velocity- and joint-angle–specific training
* Advanced strengthening and plyometrics
Principles of Healing and Progression(5)
Healing tissues must not be overstressed
* Controlled, progressive stress improves collagen alignment
* Each phase has specific goals and criteria for progression
* Rehab must be tailored to the individual
* Communication among staff ensures safety
Closed Kinetic Chain (CKC) training
Distal limb segment fixed
* Example: squat, push-up
* Enhances joint stability and functional movement
* Useful in later rehab phases
Open Kinetic Chain (OKC) training
Distal limb segment free
* Example: knee extension, biceps curl
* Allows isolated strengthening
Useful for targeted weakness or early-stage strengthening
De Lorme & Oxford Models
Classic progressive loading programs
* Relies on percentage of 1RM and structured sets/reps
