Principles of Rehabilitation and Return to Sports Following Injury

https://doi.org/10.1016/j.cpm.2014.11.009Get rights and content

Section snippets

Key points

  • Rehabilitation of athlete after lower extremity injury requires thorough evaluation and understanding of the demands of the sport.

  • Few protocols exist to guide the physician in helping the athlete returning to sport.

  • Protocols and plan of care must be individualized and constantly reevaluated to maximize return to sport and decrease the incidence of re-injury.

  • A multidisciplinary team is often required to better treat athletes and permit a prompt return to sport.

Goals of rehabilitation

Rehabilitation after a sport injury is the process needed for a timely, safe return to sport participation, whether the patient is a recreational or professional athlete. Restoration of the preinjury function serves as the primary goal, or baseline objective, but it is to be understood that some patients may never achieve preinjury level of sports participation. Therefore, every rehabilitation protocol or program should be individualized to the specific patient’s need.2 Even though the protocol

Basic sciences

As previously mentioned, the phases of rehabilitation closely follow the stages of healing tissue and should be understood in order to have a better understanding of the process that each athlete must go through before advancing to the next level.

Healing stages include

  • 1.

    Inflammatory stage

  • 2.

    Reparative stage

  • 3.

    Remodeling stage

Phases of rehabilitation

Phases coincide with general principles and time frames of healing tissue. It is also important to understand there is no absolute transition from 1 phase to another, and phases may overlap. It is therefore imperative to have proper intervals between clinical follow-ups to assess the correct progression of the recovering athlete.4 Each phase has specific goals to achieve before advancing to the next, rather than being based on a specific time frame. A clinician must be willing to adapt

When is the athlete ready?

Rehabilitating the athlete back to sport in a timely manner is the goal of any successful injury management. One should want to minimize the time needed, yet, too early of a return to sport can also mean a risk for reinjury. Having the knowledge of a proposed and sound return to sport protocol and knowing how to execute it can be 2 different and separate matters.12 A study published by Gajhede-Knutson in 2013 showed an increase in reoccurrence rate of Achilles tendon disorders in elite male

Psychological aspect of the athletic injury

Numerous studies have examined the psychological factors associated with sports-related injuries. Sports psychology as a recognized specialty began in 1960.8, 21, 22 When an athlete is injured, there is an immediate assessment of the actual physical injury and the impact it will have on the athlete’s participation in sport. One also needs to realize that sport itself is often a primary coping mechanism of an athlete’s stressful life events. Not only is the injury causing anxiety, but the loss

Summary

Returning to sport after treating an athletic injury can be challenging with the goal to returning the athlete to his or her preinjury level in the shortest amount of time without further risk of injury. Treatment guidelines and protocols for the lower extremity athletic injury rehabilitation are sparse. This article has outlined the phases the athlete requires to successfully achieve a safe return to sport, based on the current available information.

First page preview

First page preview
Click to open first page preview

Cited by (0)

Disclosure: Nothing to disclose, no conflict of interest reported.

View full text