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During the acute period, it is very important to maintain overall conditioning while the injury heals. Creative techniques can be used to safely work around the injury. For example, a runner with a leg injury can often run in water or use a stationary bicycle to maintain conditioning. Even if one leg is in a cast, the rest of the body can be exercised by performing strength-training exercises. Do not wait until your injury is healed to get back into shape.
In the next phase of recovery, you should work on regaining full motion and strength of the injured limb or joint. For most injuries, gentle protective range-of-motion exercises can be started almost immediately. Muscle tone can be maintained with the use of electrical stimulation or simple strengthening exercises.
When strength returns to normal, functional drills can be started. For lower extremity injuries, this may include brisk walking, jumping rope, hopping, or light jogging. For upper extremity injuries, light throwing or easy ground strokes can be performed. Specific exercises for balance and agility can bring back the coordination that may have been lost in the injury.
Once you have progressed with motion, strength, endurance, and agility, and are tolerating functional drills, you can try higher levels of sport-specific movement patterns. This is monitored by your physical therapist or certified athletic trainer. You may find that tape, braces, or supports help during this transition time.
Only when you are practicing hard without significant difficulty, and the healing has progressed to the point where the likelihood of injury or harm is low, you are ready to return to play. During these final phases of recovery, you should be closely monitored. Special attention should be given to adequate warm up prior to the activity and icing after the activity.
depends upon the TYPE , EXTEND & SITUATION OF THE INJURED PART.
if its MUSCULAR OR TENDON injury IN THE ACUTE PHASE REST WITH
ULTRASOUND WILL HELP & STRAPPING will help.
If its BONE WITH FRACTURE related IN THE ACUTE PHASE AGAIN REST
WITH strapping; POP BUT ELECTRO THERAPY IS CONTRAINDICATED.
IN EITHER CASES(MUSCULAR/BONY) AFTER A PRE /POST OPERATIVE
IS INDICATED IN CHRONIC CASES and the Rehabilitation starts on the1st
day onward.
1)IF THE MUSCLE POWER IS03(SHOULD BE SINCE THE PATIENT IS AN
ATHLETE) REHABILITATION STARTS WITH MILD ACTIVE ASSISTED
MOVEMENTS
2)AFTER THE PERSON REACHES GRADE4+ AND FULL RANGE OF
MOVEMENT OF THE SEVERED JOINT WITH NO PAIN MILD
RESISTED EXERCISES SHOULD BE STARTED.
Is the process of restoring normal physiological anatomical tissue after injury using different therapeutic means in order to bring to the practice of sports activity after his injury and protect the affected area of a repeat injury.
Should be designed rehabilitation program individually in the short term and put
Long-term goals in mind, as it must be a program comprehensive and includes exercises stomach individually according to the type of injury and the status of the patient and other characteristics of the functioning of treatment through the stages of injury, and the integration of treatment modalities, exercises, and that is the progress the program safely and effectively, should also learn how to assess the state of the patient, and evaluation of the program and the results.
Can be divided into the rehabilitation process of the athlete injured in roles or stages each stage of the injury, but it must be noted that the boundaries between these stages are not clearly defined, as it can not be put biological systems in clusters within the separate units where dominated by the contrast and overlap and interaction which is the rule rather than the exception pathophysiologic tissue injuries and what is happening at the cellular level and complications that accompany them where they are determining the scientific basis of the program that can be built upon in the design of the rehabilitation program
Rehabilitation plan
It is very important that the plan is based on rehabilitation to understand the pathophysiology of the core for each stage of rehabilitation and treatments appropriate for each stage, which depends on the amount of damage and the progress of the healing process through the different stages of the injury and the theories and techniques available in order to get the results of appropriate treatment and quick.
We must understand the injury that is through knowledge and scientific background in science various most important anatomy and physiology and biomechanics, which are crucial in determining the rehabilitation program and promote selecting methods appropriate remedial for the athlete and the opportunities to return safe and fast for sports activity or competition.
The ways of implementing the treatment, rehabilitation and rehabilitation tools are not consistent approach, but is subject to Individual must therefore be avoided follow the programs prepared in advance they carry information about the foundations and can be adopted only in the planning for the development of rehabilitation programs and developed in accordance with the privacy of the patient and the type of injury
Since worth mentioning that the injury accompanied by several emotional responses must therefore understand the psychological aspect of rehabilitation which is essential to adapt the Sporting and prevention of injuries, as it should be considered to the psychological effects of injury, Hbut be a period after the injury very difficult for sports competition, which aims to return to the sport in as soon as possible, so it is important to explain to the mathematical details of the injury and the resulting damage and its complications, and the importance of the rehabilitation process and the time frame and to speculate on a return to competition.
Aims to treat sports injuries:
Building. Restore damaged tissue, hit by damage.
- Restore jobs in the affected tissue
- Restore Fitness Heart and circulation and endurance, speed and motor skill and psychological (ie restoration of components of achievement).
And take treatment and rehabilitation period of time determined according to the severity of injury, place and type of treatments used, where it should be complemented by treatment of his term specified in order to bring about a return to continue physical activity and achievement and overcoming the fear of a repeat of Alasabh.oukd put Aaltoqitat approximate necessary for healing and healing primary types of different tissues, as follows: -
(6 weeks). - Muscle
(12 weeks) - tendons and ligaments
(6-12 weeks) - bones and joints
You may need some injuries to longer periods of time to achieve maximum power, in cases of neglect and lack of first aid implementation of treatment and rehabilitation as appropriate to the type of injury before returning to the motion must be complete in order to treat the player will not be repeated reinfection.
The goals of rehabilitation
-tkulail Effects caused by the installation
-cfa Full
Maintain fitness
Restore-Almharhriadih
Physiological targets for rehabilitation
- To control the pain and swelling through the use of initial treatments
- Restore Control Awakaddrh control nervous - muscular and regain control of the situation and textures right balance
- Maintaining the motor run in normal joints
- Restore muscle strength, endurance and energy
Maintain cardiovascular fitness - Respiratory
. Restore stamina enough to resume activity
- Reverse the skill and ability to return to practice sports with or without modifications or equipment
Treatment plan
First - therapeutic exercises include: -
- Exercises and strength can be restored through exercises as follows:
Alaizumtre exercises (static)
Alazotonyh exercises (kinetic)
Alaazukntek exercises (exercises inhaler devices)
Progressive resistance exercises using Aldmpels, weights, medicine ball, rubber belts and other equipment
Exercises contraction central and decentralized
Albulayomtre exercises such as Exercise vertical jump for a distance
- Exercises to regain control of the situation and textures right balance
- Techniques PNF (flexibility exercises negative)
- Constant kinetic exercises neuromuscular system and special exercises to facilitate the tracks neuromuscular
- Exercises Alngzbh relapsing-mediated biological biofeedback planning electrical muscle EMG
- Exercises Altmtih (active, passive), and move the joints and flexibility exercises and elongation Aalmah PNF techniques
- The free kinetic exercises to maintain cardiovascular fitness - Respiratory
Treatment methods as used
- Almkmdat cold
- Hot Almkmdat
- Thermal treatments surface and deep
Surface thermal treatments
- Hot baths.
- Pillows hot.
- Comparative thermal therapy (Constant bath) (any use warm compresses and then cold).
- IR (Infrared).
- UV (U.v)
The deep thermal treatments include:
- Short-wave (SW) (Short Wave).
- Microscopic waves (MW) (Micro Wave).
- Ultrasound (US) (Ultra Sound).
- Exercise of all kinds
- Training to walk
- Exercises to retrain the neural paths Aladilah-
- Electrical stimulation
- Light therapy / Laser and Aionovariz i onophoresis Aquatherapy-
And Alfonovriz Phonophoresis Aquatherapy-
-altdlak) Manual Oboisth God)
- Treatment drag (drag manual or mechanical), as in the case of spinal injuries
- Chinese acupuncture therapy in the case of chronic pain.
There are still many curative and rehabilitative means that other uses in the field of sports injuries.
Stages of sports injuries and the foundations for rehabilitation:
1: the acute phase (inflammatory)
The first phase is characterized in most sports injuries inflammation reaction which involves pain, redness, swelling, and high temperatures topical tissue infected and can take this stage up to72 hours.
The therapy uses kinetic initial stage usually, which includes some of the ways that work to avoid Shell or restriction of movement, because it can cause negative effects in the early and tangible to various organs and systems physiological as a process of metabolism leading to the demolition, and atrophy and weakness of muscles and tissue damage shortly after the injury, and it prolongs the period of healing
Rehabilitation of the first phase
Rehabilitation goals during the first phase:
1) To protect athletes from further injury
2) pain control
3) the reduction of swelling
4) promote natural healing
Curative and rehabilitative methods appropriate for this phase include:
Pharmacological intervention Pharmacological Intervention
Medications may be used with the program to facilitate and assist in the healing process of removing the pain Alalltiam In histological and most commonly used medications include non-steroidal anti-inflammatory painkillers, and local anesthetics, in some cases, given by injection, according to medical advice
Installation immobilization
May require this stage installation in the detailed note that the installation accelerates the formation of granulation tissue and limits the size of the formation of the scar, and improves healing penetrate through connective tissue fibers, but also has a negative impact, mainly specifically motor which succeeded in Almqasal and prolong the period of installation lead to loss of muscle about20 % of its strength during the week and determine the kinetic during the six weeks where needs to be ten times the normal effort to return to the natural state also causes loss of cartilage glass and function and loss of articular ligaments force by46% during the8 weeks to a year where you need to go back to its natural state
And reduce the movement of these early influences and maintain normal range of movement of the joints where the vitreous stimulate and nourish cartilage and increase the strength of the ligaments and tendons around the joint (especially the movement indirect)
And stirring in the early limits of Althdd motor and cause an increase tensile strength of tissue, and improves blood supply to the tissue towards the renewal of muscle fibers, stimulates the resorption of scar tissue, and improves ischemic and reduces muscle atrophy and weakness.
- Means of Physical Therapy
The most important means of physical therapy used in this phase is cryotherapy and private (cryotherapy motor) and is often accompanied by protection, rest, ice, compression, and lifting, and support, and this combination is called common b
P.R.I.C.E.S. The first treatment (protection, rest, ice, compression, elevation, and support)
Which is used in acute sports injuries.
The use of cooling helps to reduce the temperature of the tissue, and a decrease in blood flow and swelling as a result of vasoconstriction, also leads to relieve pain and muscle spasms in general and crushed ice must be used for this purpose.
And apply pressure using bandages flexible (crepe Bandj) with the lifting of the injured part to the maximum height above the level of the heart, and it helps control the swelling, and is currently using another way to ease the pain at this stage is the electrical stimulation through the skin to the nerve TENS which are applied in some cases with snow.
Therapeutic exercise therapeutic exercise
Useful exercise treatment during this phase early to reduce the deconditioning, and promote Jump to the second stage, if control symptoms, and practiced therapeutic exercises to increase range of motion is also used exercises Alaizumtre to help reduce the loss of muscle strength in the injured part may begin exercises early to reduce the losses and must prepare to adapt the body parts of others infected are also used as hydrotherapy, and that the transition to the second phase varies depending on the type and severity of injury, it is advisable to begin the second phase as soon as possible to promote faster healing and return to training and competition.
It is necessary to prepare a series of mobility as a functional unit, which includes an integrated operation of the muscles, tendons, bones, ligaments and articular nervous system in the body and that will be necessary for the assessment and rehabilitation of biomechanical devices for physical task, especially musculoskeletal system.
Phase II: (renewal and reform Oomhalh fibrosis)
This stage is called from injury sports rehabilitation phase or phase fibroblasts - collagen flexible and takes anywhere from48 hours and up to6 weeks and during this period are rebuilding restructuring renewal and begin building fibroblasts for synthesis scars of nature and the loss of jobs the choice of the necessary treatment and exercises that you need stage , and the identification and selection of methods and therapeutic exercises necessary for this stage accompanied by a lot of risk because of the absence of pain and this may tempt player (or coach) to return to training and competition prematurely before any rehabilitation full causing re-injury and re-qualification tissue again this thereby prolonging the recovery period
Rehabilitation of the Second Phase
Rehabilitation goals in the second phase are:
1) Allow for natural healing (an update of what has been in the first stage)
2) Keep the motor function in the region Agheiralamsabh
3) minimizing the deconditioning of the athlete
4) increase the kinetic term flexibility in the joints or joint
5) improve muscular strength and muscular endurance and localized energy
6) Increasing the amplitude aerobic and aerobic capacity
7) improve the functions of sensory receptors deep, balance, and compatibility
It can achieve these goals mediated by means of physical therapy and therapeutic exercise.
- Means of Physical Therapy
Can be used as means of physical therapy that are of great benefit in this Almrahlhomen most important heat therapy, because the increase in temperature and heating, blood flow, and extensibility in the soft tissue of methods useful in the beginning of this stage it is necessary to increase the temperature and heating before practice exercises Altmtih
- Use hot and cold Almkmdat
-use Laser
- Hydrotherapy (warm)
- Treatment with fluid and paraffin bath is used to increase the surface temperature of the tissue
- Ultrasound and short-wave is one of the ways where that deep thermal ultrasound enhances tensile strength tendons and cured.
- Electrical stimulation is used at this stage if the patient is suffering from pain and swelling together, and is also used in order to activate motor units, which may be less than the normal level, so it uses electrical stimulation to promote employment in the motor unit during practice sports and to facilitate the training of the muscles
Therapeutic exercises
The most important element in the rehabilitation during this stage and all stages, that the practice of training and the type of exercises used depends on the exercise flexibility and inflatables (elongation) and should be restored flexibility a priority in the design of programs therapeutic kinetic because strength exercises and air conditioning depends on the achievement of the normal range of movement in any joints require full extent of kinesthetic, and can Tmtih tissue more effectively after Thmatha Masqa before exercise, and sometimes that may require assistance from the processor and should be Altmtih general to include large parts of the body on a daily basis.
It can develop muscle strength using different types of muscular work and the equipment can be classified into muscle work:
Steady work and kinetic and kinetic codified isokinetic
It was found that all of the kinetic exercises and exercises Alaazukntek both affect the functions of the muscular system and skeletal systems which are useful in different clinical situations of dynamic muscles.
And can be divided into muscle work to other groups Kaltvls (central and decentralized) and both are useful for conditioning, and recent evidence suggests that the contractions decentralization may be more effective, but must be used with caution because of muscular pain triggered.
The rehabilitation of the air force requires the development of a training plan in accordance with the type and intensity of exercise and the duration and frequency, and the air force is the maximum voluntary methods and equipment including:
- Maximum contraction at different angles without any joint movement of the joints (exercises Fixed)
- Electrical stimulation during voluntary contractions
- Therapeutic exercises, Aagazbah resistance, the resistance of the wizard, free weights, pulleys and equipment such as pipes and variable resistance devices and various types of resistors in hardware,
- Exercises and kinetic Alaazukntek
The choice of appropriate therapeutic devices depends on the clinical condition of the athlete, for example, if there is swelling and pain exercises using fixed with electrical stimulation.
To achieve Ttorkber in force must be the exercise intensity of60-80% of the maximum for repeat and usually is performed three sets of8-10 repetition of each exercise, including muscle contractions centralization and decentralization.
When using free weights, weight lifting occurs in muscular contractions centers, and the decentralization of both, and usually are trained each muscle group three times a week.
The early strength gain is the result of neurotrophic factors, while inflation gain muscle not taking place only after several weeks of training, and that may restore optimum power
Require3-6 months, whereas the endurance training are at the lowest frequency and should sustain the continuity of the program, and can be developed using local muscular endurance training and equipment similar to those used to develop power.
To develop withstand fatigue loads using lighter than those used in the development of power (less than60% of the maximum repetition) and the highest recurrence (20 or more).
The air-conditioning contributes to the ability to raise and muscular endurance athlete can lift the load of absolute for a longer period of time to develop maximum power.
The muscular endurance topical great importance depends where in workouts that require this ability which is more important for runners and middle-distance runners of the long-distance runner.
It should be aerobic conditioning capacity is part of the rehabilitation program for all
At this stage is the use of the following means:
-aldrajat (Fixed)
, Aasbahh kayaking
- Movement and various activities to improve aerobic capacity and promote full recovery
- Full movement of the joint
The program determines the type of exercises, and density that must Being Blindsided (60-85% of maximum heart rate), duration (20-60 minutes), and repeat (3-5 times per week).
- Should include a means of rehabilitation during this phase of the exercises to develop sensory receptors deep, harmony and balance, especially when injuries joints that could affect the status of the body, as in the injured ankle and knee, and despite the fact that the vast majority of these exercises are in phase the third, but it can also begin at this stage.
Restore tissue healing
The goal of the treatment of soft tissue in the healing process for the purpose of re-control
The tension and imbalances occurring due to injury in an attempt to influence the final shape of the fabric and function of any influence on the scarring and function.
The lack of movement weaving Almtndb makes cured in the formation of irregular, while tissue trainable heal with modified Fibre Arrangement in parallel and this arrangement parallel to the fibers, making them more flexible, and also that they contain folds trailing allow movement without irritation or pain, and that along the strings and slide and stretch Altsaqatha the examples of the good and heal the strings on the contrary, the tendons and restricted short and dense adhesions with examples of ill-healing injury.
The exercises work on the soft tissue scar removal, and help to restore
The natural characteristics of the tissues larger.
The exercises are soft tissue by several means, including massage and Saúld but after identifying the most affected areas, and to monitor changes in the tissue, and then implement treatment
It uses massage Nakkari several fingers after touching the area to know the needs of the region to determine the density of the excess, then highlight borders of the feeling of tissue density and ability to load, and this will give an idea of the level of interaction and stage of healing when applied exercises soft tissue as a treatment option,
Two methods are used in soft tissue exercises are:
- Download the application to change the low density tissue gradually and renewal.
- High load and forced to break the adhesions in the tissue, and this is more on the application of the old scars and dense.
When you perform any of these techniques, you must use oil or cream to reduce skin irritation and should be sure to clean the skin after treatment with alcohol to prevent possible skin irritation.
If the practice was a form of therapeutic effective means Kaltmarin early to control kinetic affects effectively in reducing adhesions during healing.
Exercise may cause injury, however, the control of the exercise will contribute to the restoration and healing to effectively help prevent further injury
. The third stage (re-planning)
And called on the third phase of the rehabilitation of sports injuries stage (re-planning). This stage lasts from3 weeks to12 months.
This stage is characterized by re-formation of collagen and to increase the functional capacity of the muscles, tendons, or other tissues.
At this stage is to address the deficit in force Abed muscle, and the imbalance between muscle groups Almtaxh from side to side and asymmetry, and the loss of skills, special sports, and the emphasis on the need to return to training and competition gradually, as determined by the severity of the injury during the previous two phases.
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