Injury Recovery Part 3: Activity Specific Rehabilitation
7th July 2014
Getting back to exercise.
In the last couple of articles I discussed the ways in which you can recover from injury in an efficient and effective way using basic First Aid principles and by keeping the muscles mobilised. There comes a time however that you need to break free from the early rehabilitation stages and become confident in your body again, because Sports Injuries and Workplace Injuries have a bit of a habit of recurring if you don't make a plan for getting strong again.
One of the major causes of re-injury comes through a lack of confidence in your body. It is understandable that many people become very aware of their previous injury site and develop compensatory patterns to avoid the injury in the future. Tennis players may stop hitting backhands or lunging onto the correct foot, keen gardeners will avoid a particular tool or position in which they got injured. All in all avoidance of one particular movement always leads to others being over used. Overuse injuries, aka Repetitive Strain Injuries, are well documented in the workplace but we rarely recognise them when they apply to sports injuries or, even more so, lifestyle injuries. None the less, the over use of movement places extreme strain on the system, which often leads to break down.
So how do we go from injury rehabilitation to normal activity?
Well, we train ourselves into it. Activity Specific Exercise is so important when it comes to confidence in your ability to get back to normal function and stop compensating. Take the tennis player with an ankle sprain for example. All too often they will stop lunging on to the affected foot which over uses the other leg. So we need to start the rehabilitation at a point that the tennis player can build confidence.
Balance and Motor Control exercises come first. These exercises stimulate what is known as the proprioceptive system. This is the system that goes haywire when you’re drunk. One minute you have full control of your body then 2 pints later (most of you will take more than I do!) you start to lose confidence in your step. This system feeds information back to the brain about where your body parts are in relation to the rest of your body. This is why you can lay on your bed with your arms out wide, eyes shut and still be able to know what position your arms are in when you move them. From a rehabilitation point of view this system allows you to know what angle your ankle is at and if it is safe in that position. Balance exercise helps with this because it challenges this system in a safe environment.
Activity Specific Exercise comes in next when you are looking to integrate your newly fixed ankle into the patterns of movement you require for your activity. For our ankle injured tennis player this includes jumping, running, side stepping, turning and the all important lunge.
Each movement can be broken down into simpler exercises that challenge the client only to the level for which they are confident and capable. Once these exercises are mastered, more and more complicated ones can be performed. As the exercises get harder, they become more like the movements found in the activity until they become more complex than those movements themselves. This way the rehabilitation has exceeded the requirements for the activity and the person is fully rehabilitated.
Make sure to get exercise advice from a trained professional and be sure to continue your training through to the advanced stage. That way you’ll become stronger from your injury, not weaker.