What is the goal of rehabilitation
-to create an environment for a functional scar to form that can cope with all the normal stresses that are placed on it as well as the original tissue did
What are the three principles of rehab following acute injury
-relative rest
-early mobilization
-early strengthening
What does relative rest include
-avoid tensile stress
-maintain health related fitness/function of uninjured tissues with non-aggravating activity
What does early mobilization include
-progressive, controlled ROM exercises performed in a pain free range
What does early mobilization aim to do
-promote collagen deposition along usual lines of stress
-minimize risk of cross linking, adhesions or contractures
-maintain connective tissue joint and muscle mobility
-assist circulation
Types of early mobilization
-passive ROM
-active ROM
-active assisted ROM
Best practice recommendations for early mobilization
-begin with muscle in its inner range (shortened)
-slowly mobilize toward its outer range (stretched)
-stop prior to pain
How will you know if the injured tissue becomes stressed during mobilization
-swelling
-heat
-altered function
-redness
-pain
What is early strengthening
-progressive controlled strengthening exercises performed in a pain free range
What does early strengthening aim to do
-avoid/minimize disuse muscle atrophy
-maintain and improve (bone mineralization, circulation, connective tissue strength etc.)
-contribute to whole body adaptations
What are isometrics
-contraction while muscle stays the same length
Isometrics best practice recommendations
-begin with muscle in inner range
-voluntarily tense muscle
-stop prior to pain
What are isotonics
-when muscle contracts and changes length
Isotonics best practice recommendations
-begin with endurance FIT-VP
-progress as clients function/goals require (endurance->strength->power)
What to do if resisted isometrics are strong and painless
-consider multiple angle isometrics
-if multiple angle isometrics are strong and painless
-consider isotonics
What to do if resisted isotonics are weak and painful
-consider isometrics
What is the value of eccentric loading
-those who had weak short hamstrings had more risk of injury
