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Rehab Phases For The Athlete

Anyone suffering from an injury knows the pain of not being able to perform the activities or sports that they love doing.  As manual therapists (osteopaths, phyiotherapists) we can play an integral role in getting our clients back to performing the activities and sports that they love by guiding them through the different rehab phases.  This can include a combination of manual therapy, exercise prescription and advice around management.

The article titled “Rehabilitation phases and program design for the injured athlete’ that was published in the strength and conditioning journal in 2001 summarises this well from a strength and conditioning perspective.  For those clinical therapists out there, we will perhaps work within this guidance in addition to any clinical hands on work that we may also perform within these phases.

Below is a summary of the key take home messages from the article:

It defines the phases of rehab as being:

  1. Phase 1 – Immobilisation
  2. Phase 2 – Range of motion
  3. Phase 3 – Strength
  4. Phase 4 – Return to activity

Phase 1 – Immobilisation

This phase should focus on tissue healing and maintenance of cardiorespiratory fitness.  In the early phases of the injury 48-72 hours the focus will be on pain management and swelling.  When and where possible depending on the injury, start with proprioceptive exercises from a stable position and progressing to a more upright functional position.  Strength work can focus on isometric exercises in an open and closed chain.  Depending on the site of injury, dont forget to train the aerobic system through the use of an upper or lower body training equipment.

Phase 2 – Range of motion

The aim of phase two is to get the client back to the normal range of motion that existed pre injury.  Proprioceptive exercises can be progressed from non weight bearing to weight bearing.  Strength training is performed through the same type of exercises as phase 1 and progressed in resistance and repetitions.  Aerobic fitness should also continued to be trained.   Once the individual has achieved 80% or more ROM compared to the uninvolved extremity, then progress to phase 3.

Phase 3 – Strength

The aim of phase 3 is to develop the individuals strength and power to that of pre injury.   Have the individual work on joint range of motion exercises and multi joint exercises, beginning with low weight and progress as tolerated.   Aerobic training should continue throughout this phase.  Once the gait has returned to normal and strength is 80% of the uninvolved extremity, start with straight line running.  Once the individual has demonstrated an ability to perform straight line running without any issues, progression through to sport specific drills can be incorporated. Once the individual has achieved a range of motion and strength that is 90% of the uninvolved extremity, progress to phase 4.

Phase 4 – Return to activity

The aim of this phase is to incorporate specific specific fundamentals.  Continuation and progression on range of motion exercises and strength exercises should be continued. Aerobic training should continue through this phase. Sport specific drills should begin at 50% and progress through to full speeds.   Once the individual has demonstrated near 100% of range of motion, strength and ability to perform sport specific drills, the individual is ready to resume their pre injury activities.

This blog post was written by osteopath Heath Williams at Principle Four Osteopathy.  At Principle Four Osteopath we provide a range of services, including osteopathy manual therapy consultations, functional movement screening, exercise prescription, strength and conditioning and rehabilitation.

Principle Four Osteopathy is one of Melbourne City CBD and Docklands leading osteopathy clinics.  Both clinics are equipped with training equipment so that we are able to get you actively involved and moving towards a better moving you.

Principle Four Osteopathy CBD clinic is located at 29 Somerset Place, Melbourne 3000.

Principle Four Osteopathy Docklands clinic is located at 717 Bourke St, Docklands, 3008.

Book an appointment online at www.principlefourosteopathy.com or call 03 9670 9290.