Rehabilitation: Treatment, Exercise and Training Following Injury

With simple first aid methods you can modify the body’s normal response to an injury, thereby achieving earlier return to function.

In a running injury, for instance a sprained ankle or pulled muscle, applying ice and compression directly to the injury immediately or within the first 10 minutes will result in less swelling. This in turn retains good blood circulation which reduces pain and promotes a better range of movement and mobility.

In general compression should be applied continuously for 24 hours and crushed ice, wrapped in a wet towel, for 15min, 3-4 times per day. Keep applying both of the above for 3-5 days. Additional rest and elevation are further important elements when dealing with an injury in the first few days.

The above treatment modalities are also known as RICE: Rest, Ice, Compression and Elevation. The overall aim is to keep the swelling in control which will result in a faster return to activity. Do not take a hot shower or drink alcohol on the day of the injury as this will cause further bleeding and swelling.

The next step would be to see a sports physician with a view of establishing a firm diagnosis. For this you might need further tests such as an MRI scan or an ultrasound.

Treatment with a physiotherapist should commence once you know what you are dealing with. Too often do we see patients who have had treatment for a considerable amount of time but when the symptoms do not start to improve a diagnosis is being sought. This approach doesn’t just eat up a lot of financial resources but more importantly will result in longer rehabilitation with delayed return to activity.

Anti-inflammatories are frequently used and although they help with pain and swelling, they often interfere with the body’s own healing response, meaning that the injury can potentially become weaker and prone to recurrences. Discuss this with your sports physician.

Once the acute phase has subsided the next step is then to decide what to do to re-attain a normal function. There is a strong overlap between the different phases of rehabilitation – treatment, exercise and training.

The initial focus of treatment will be on achieving full range of movement as well as improving muscular activation and support around the injury but also of the entire limb. Over time specific exercises will be introduced which will increasingly be weight bearing. These will contain balancing and reaction type of work before running drills will be added. Initially the exercises will be executed in a linear or straight line direction but in time more
multi-directional movements such as cutting and turning will be introduced.

It is important to adhere to this progression but the exact content of the rehabilitation program depends on the type of injury, how long ago the injury has happened and the type of sport you play.

Every part of the program must be geared towards function, however basic strength and conditioning needs to be regained simultaneously. Resting an injury will result in weakness and will cause you further problems down the line. It plays no role in injury rehabilitation.