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Patient Assessment and Treatment Methods Always A Fire http://vimeo.com/48857883 Patient Assessment is done through evaluation of the injury and recording the accident ◦ SOAP Notes Phases of Treatment IMPRESS ◦ ◦ ◦ ◦ ◦ ◦ Initial Injury Mobility Restoration Proprioception Resistance Training Endurance Training Sports-Specific Initial Injury Primary goal: control inflammation ◦ Preventing further damage Inflammation is characterized by warmth, redness, swelling, and pain Pain-spasm-pain cycle ◦ Can cause muscle spasm, which causes pain, which causes muscle spasm PRICES/RICE Mobility Restoration Phase 3 phases ◦ Passive ROM Used to keep soft tissue from becoming tight Stop if it causes pain ◦ Active-Assisted ROM Athlete is strong enough to produce contraction of muscle, but not produce ROM ◦ Active ROM Necessary before strengthening can begin Mobility Restoration Phase Establishing Flexibility ◦ Flexibility and ROM are NOT the same Flexibility: Ability for joint to move through full ROM without restriction Achieved through stretching Proprioception Body’s ability sense position in time and space ◦ Addressed early in the rehab program and continued till the end Diving Fails https://www.youtube.com/watch?v=7EEpIeXhO54 Resistance Training Used to improve strength around joint Significant phase in Rehabilitation Accomplished through manual resistance, resistant tubing, machines, and free weight Endurance In addition to establishing and maintaining cardiorespiratory endurance, muscular endurance must be addressed Athlete should not RTP until muscles have the ability to perform movement over time ◦ Performed with weights – high reps, low poundage Sports-Specific Activities that mimic those that the athlete will perform on the field Progresses from light-functional to heavyfunctional, and then to limited practice. ◦ Athlete cannot begin Sport-specific until they have achieved full ROM, Normal Strength, Normal Flexibility, Normal Coordination, and Normal Cardiorespiratory Progressive Resistive Exercise Goal: Develop Strength Progressively increasing the load both during the training session and over a period of time Overload Principle In order to gain strength or endurance, the muscle group must be stressed beyond the demands of the previous activity ◦ Ex: benching 50lb daily for 3 wks vs. benching 50 lbs day 1, 55lbs day 3, 60lbs day 5 etc. Many variable beyond lb can be adjusted to achieve overload (i.e. frequency of workout, intensity of exercise, length of workout, type of ex performed. Types of Muscles Actions 3 types of Actions: ◦ ◦ ◦ ◦ Isotonic Isometric Isokinetic https://www.youtube.com/watch?v=4q19ChKpD Dc 2 types of contractions ◦ Concentric Contraction – Muscle shortens against resistance ◦ Eccentric Contraction – Muscle lengthens against resistance Isotonic – moving joint through ROM with fixed amount of resistance. Isometric – NO JOINT MOVEMENT. Maximum muscular contraction with no ROM (i.e. pushing against a wall) Isokinetic – movement at pre-determined speed no matter how much force is applied Rehab techniques for foot/ankle, lower leg Reestablishing AROM ◦ Ankle pumps ◦ ABC’s ◦ Calf Stretch Reestablishing Proprioception ◦ ◦ ◦ ◦ Single-leg ball catches Hop-scotch Single-leg cup pick up https://www.youtube.com/watch?v=8mTBsx0 TVNY Reestablishing strength ◦ Ankle 4-ways ◦ Lunges ◦ Calf raises Reestablishing Endurance ◦ Jump rope ◦ Jogging ◦ Stairs Sports specific Often, rehab techniques over lap ◦ hop scotch works proprioception & strength; ◦ jump rope works endurance (both muscular and cardiorespiratory) & Proprioception & Muscular Strength Progression Proprioception progress ◦ ◦ ◦ ◦ ◦ Flat ground double leg Flat ground single leg Unstable surface double leg Unstable surface single leg Moving through ROM in Sports Specific patterns Progression Over-load theory Muscular Strength Progression ◦ Heavy weight – low reps Methods 3x5 5x5 Pyramid Muscular Endurance Progression ◦ Light weight – high reps 8-15 reps per set Lab Time! ROM Proprioception ◦ Hop Scotch ◦ Cup Pick-up ◦ Single-Leg Ball Tops Muscular Strength Muscular Endurance ◦ Pull-up hang
