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Therapeutic Exercises
Chapter 7
Therapeutic Exercises
Goal is to return injured athlete to
pain-free full function participation.
 Areas of Focus:

Pain Modulation
 Normal ROM
 Kinematics
 Flexibility

Muscular Strength
Endurance
Coordination
Power
Rehabilitation Areas
Psychological
 Physical
 Emotional
 Social
 Performance

Cognitive Model

Personal Factors








Performance Anxiety
Self-esteem/motivation
Extroversion/
Introversion
Psychological
Investment
Coping resources
History with stress
Previous intervention
Cognitive Responses
Outcome of the

Situational Factors








Type of Sport
Relationship with coach
and team
Timing of the injury
Level and intensity of
the player
Point in athletes career
Role on the team
Emotional Responses
Behavioral Responses
Rehabilitation
Kubler-Ross Emotional
Stages
 Denial
 Isolation
 Anger
 Bargaining
 Depression
 Acceptance
Goal Setting




Specific and
measurable
Positive rather
than negative
Challenging yet
realistic
Established time
table for
completion




Integration of
shortintermediate- and
long term goals
Personalized and
internalized
Monitored and
evaluated
LINKED TO LIFE
GOALS!!!
Factors that Inhibit Progress
Lack
 Lack
 Lack
 Lack

of
of
of
of
Knowledge
Skill
Risk-Taking Ability
Social Support
Psychological Influences
Confidence
 Motivation
 Anxiety
 Focus
 Management of Pain

Confidence
Program Confidence
 Adherence Confidence
 Physical Confidence
 Return-to-sport Confidence

Motivation





Poor Attendance
Incomplete
Exercises
Low Effort
Low Intensity
Lack of
Attentiveness to
Instructions



Undefined Goals
Using Pain to Avoid
Exercise
Unsupportable
Excuses
Anxiety


Caused by pain, slow healing, low
confidence, pressure, lack of familiarity,
predictability, and control
Signs:





Physical
Cognitive
Emotional
Social
Performance
Focus
Ability to perceive and address
various internal and external cues.
 Athlete should focus on:

Positive attributes
 Present time
 The Process of their rehabilitation
 Their individual Progress

Pain
Benign pain
 Harmful pain
 Use a variety of methods to deal
with pain.

The Rehabilitation Process
Phase I
Assess the Patient
 Interpret the Assessment
 Establish Goals
 Develop and Supervise the
Treatment Plan
 Reassess the Progress of the
Program

Inflammation Control
CRIPES
 ROM
 Cardiovascular Fitness
 Affects on:

Muscle
 Articular cartilage
 Ligaments
 Bone

Remobilization
Phase II
Wolff’s Law
 Affects on:

Muscle
 Articular Cartilage
 Ligaments
 Bone

Restoration of Motion




Cryokinetics
PROM
AROM
Joint Mobilization





Grade
Grade
Grade
Grade
Grade
I
II
III
IV
V
Flexibility





Agonist
Antagonist
Ballistic Stretching
Static Stretching
Proprioceptive Neuromuscular Facilitation
(PNF)



Active Inhibition
Contract-Relax
Reciprocal Inhibition
Muscle/Movement Reeducation
AAROM
 AROM
 RROM
 Proprioception
 Closed kinetic chain exercises (CKC)
 Open kinetic chain exercises (OKC)

Muscular Strength, Endurance and
Power
Phase III
Muscular Strength
 Isotonic
 Isokinetic
 Muscular Endurance
 Muscular Power
 Functional Exercise

Rehabilitation Guidelines
Intensity
 Duration
 Frequency
 Specificity
 Speed
 Progression

Sport Specific Functioning
Phase IV
Coordination
 Sport Specific Skill Conditioning
 Cardiovascular Endurance
