Transcript Rehab/Reconditioning

CHAPTER
Rehabilitation
and Reconditioning
23
Chapter Outline
Sports medicine team
Types of injury
Tissue healing
Rehabilitation and reconditioning strategies
Principles of Rehabilitation
and Reconditioning
Healing tissues must never be overstressed.
Athlete must fulfill criteria.
Program must be based on current research.
Program must be adaptable to each individual.
Rehabilitation is a team-oriented process.
Sports Medicine Team Members
Team physician
Athletic trainer
Physical therapist
Strength and conditioning professional
Exercise physiologist
Nutritionist
Psychologist or psychiatrist

The sports medicine team includes a large
number of professionals working together to
provide an optimal rehabilitation and
reconditioning environment. The relationship
among members requires thoughtful
communication to ensure a safe, harmonious
climate for the injured athlete.
Types of Injury
Macrotrauma: caused by a specific, sudden episode
of overload injury to a tissue; results in disrupted
tissue integrity
Microtrauma: caused by repeated, abnormal
stresses applied to a tissue through continuous
training or training with too little recovery time
Tissue Healing: Inflammation Phase
Pain, swelling, and redness
Decreased collagen synthesis
Increased number of inflammatory cells
Tissue Healing: Repair Phase
Collagen fiber production
Decreased collagen fiber organization
Decreased number of inflammatory cells
Tissue Healing: Remodeling Phase
Proper collagen fiber alignment
Increased tissue strength
Rehabilitation and Reconditioning
Goals and Strategies: Inflammation
Prevention of new tissue disruption and prolonged
inflammation.
Function of cardiorespiratory and surrounding
neuromusculoskeletal systems must be maintained.
No active exercise for injured area.
Rehabilitation and Reconditioning
Goals and Strategies: Repair
Prevention of excessive muscle atrophy and joint
deterioration.
Function of neuromusculoskeletal and
cardiorespiratory systems must be maintained.
Possible exercises include
- submaximal isometric, isokinetic and isotonic exercise
and
- balance and proprioceptive training activities.
Rehabilitation and Reconditioning
Goals and Strategies: Remodeling
Optimization of tissue function
Progressive loading of neuromusculoskeletal and
cardiorespiratory systems
Possible exercise options:
-
joint-angle specific strengthening
velocity-specific muscle activity
closed and open kinetic chain exercises
proprioceptive training activities

Designing strength and conditioning
programs for injured athletes requires the
strength and conditioning professional to
examine the rehabilitation and reconditioning
goals to determine what type of program allows
the quickest return to competition.
Resistance Training Techniques
Used in Rehabilitation
• DeLorme’s method
– Based on repetition maximum
of 10
– Designed for early rehab
– Designed for beginning rehab
– Introduced PRE –
“progressive loading”
– Builds in warm-up period
• MacQueen’s method
– Utilizes varying sets for
beginning/intermediate &
advanced
– Set of 10 RM
• Oxford method
– Used during early,
intermediate & advanced
levels of rehabilitation
– Percentages of 10 RM
– Diminishes resistance as
muscle fatigues –
“regressive load”
• Sander’s program
– Utilized in advanced stages
of rehabilitation
– Utilizes percentages of body
weight
• Knight (DAPRE)
– Daily Adjustable
Progressive Resistive
Exercise
– Adjusted based on
individual’s progress
– Based on 6 RM working
weight
• Berger
– Adjusts within individual’s
limitations
– Should allow for 6-8 RM
repetitions on 60-90 seconds
– Must be able to achieve 3 sets
of at least 6 RM and no more
than 8 RM
– Increases occur in 10%
increments
• For rehabilitation
– Base program on pain
and healing process
– Should be performed
daily early on
– Reduce workout to every
other day as progress is
made
Isokinetic Exercise
• Involves muscle contractions where length change of
muscle is set at a constant velocity
• Maximal resistance throughout the range of motion
• Variety of machines/manufacturers are available
• Can be used with eccentrics & concentric exercise
• Isokinetics as a Conditioning Tool
– Maximal effort for maximal strength gains
– Dynamometer will move at a set speed whether maximal or
half of maximal effort is put forth
• Athlete can cheat with machine and not put forth the effort
– Not cost effective
• Isokinetics in Rehabilitation
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Gained popularity in rehabilitation during the 1980’s
Provide objective means of athlete/patient evaluation
Training at fast vs. slow speeds
Functional speeds
De Lorme Program
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Uses 3 sets of 10 repetitions
1st set: 10 reps of 50% of 10RM
2nd set: 10 reps of 75% of 10RM
3rd set: 10 reps of 100% of 10RM
• The Oxford system is the reverse of De
Lorme, it progresses from heavy to light
Daily Adjustable Progressive Resistance Exercise
(DAPRE by Ken Knight)
• DAPRE involves four sets with repetitions ranging
from 10 to possibly 1 during the final set.
• 1st set: 10 reps of 50% of 1RM
• 2nd set: 6 reps of 75% of 1RM
• 3rd set: maximum number of reps of 100% of 1RM
• The number of repetitions performed in the 3rd set
determines the adjustments to be made in the
fourth set. (Table 23.2, p 542).