Download Return to Sport

dr. Nilla Mayasari,Mkes, SpKFR
Instalasi Rehabilitasi Medik
RSUP.Wahidin Sudirohusodo
 Rehabilitation
involves reconditioning
injured tissue.
 If the healing tissue is mature the
emphasis to more aggressive
conditioning for the athlete to re-enter
the sports.
 Rehabilitation programs are specifically
tailored to an injury or surgical
intervention.
 The
effectiveness of rehabilitation during
the recovery period usually determines
the degree and success of future athletic
competition

Optimize the tissue healing and return
the athlete to competition as soon as
possible without compromising the
healing process.
Incomplete rehabilitation and
premature sports re-entry
predispose the athlete to reinjury.
Healing Process
Depends on the athlete’s age, health, and
nutritional status and the magnitude of
injury
Parameters should be monitored:
 Pain
 Tenderness
 Range of Motion
 Swelling
 Heat
 Redness
 Ability to perform exercises and functional
activities
Include :
 Progression of tissue healing where the
tissue is healed or sufficiently stabilized for
active motion
 Passive range of motion to 75% of the
opposite side
 Minimal pain or tenderness
 Manual muscle test strength in non
pathologic area 4+ to 5
 Control of the particular regions
 Continued kinetic chain function
Include:
 Full, non painful active and passive range
of motion of the joint
 No pain on tenderness
 Strength at 80% of the opposite site with
good force couple balance
 A normal kinetic chain
 Normal
arthrokinetics and multiple-plane
activities
 Isokinetic strength balance and work at
90% of normal
 Completion of functional progressions
and satisfactory clinical examinations
 Time
constraints for soft tissue healing
have been observed
 Pain-free full range of movement
 No persistent swelling
 Adequate strength and endurance
 Good flexibility
 Good proprioception
 Adequate
cardiovascular fitness
 Good regional skill
 No persistent biomechanical abnormality
 Athlete physiologically ready
 Coach satisfied with training form
Propioceptive training
on lower limb
After Injury altered joint position sense
Change to motor control
Altered latency onset of muscle contraction,
Inadequate sequencing / Patterning
Functional rehabilitation and return to
training and competition
Sport Skill :
 Agility training
 Sports specific drills
 Persistent
recurrent swelling
 Joint instability
 Loss of joint range of motion
 Lack of full muscle strength
The factors that effect Rehabilitation:
 Type of injury
 Circumstances of the injury
 External pressure (eq : fear of losing position
on the team)
 Pain tolerance
 Psychological attributes of the player
 Player-player and coach-player support system
1. Be reasonable in demands on time, energy &
enthusiasm
2. Children participate for fun & enjoyment & that
winning is only part of their motivation
3. Ensure that equipment and facilities meet safety
standards & appropriate to the age & ability
4. Consider maturity level of the children when
scheduling and determining the length of practice
times & competition
5. Follow the advice of a sport medicine
practitioner when determining when a injured
player is ready to recommence training or
competition.
6. Remain informed the principles of
growth & development
of children.


As age increases this leads to a decline in functional status,
and an increase risk of injury, joint stiffness, and reduced
independence (Buckwalter and Lane 1997)
Divided into three groups :
 Who has exercised throughout life, either at a
recreational or competitive level
 Who has active during his on her youth and is now
resuming athletic activity
 Who has never been physically active but commences
activity anticipating certain benefits




Rehabilitation of the injured athlete requires carefull
assessment and subsequent correction of the
athlete’s deficit
The rehabilitation program should be individualized
for the athlete’s need such as in younger athletes and
older athletes
Functional and sport-specific activities should form a
major part of the program
The injured athlete should be able to return to sport
without functional deficit and with any predisposing
factors to injury corrected