Sports specific rehabilitation aims to restore optimal form and function through a multidisciplinary approach. The rehabilitation process involves several stages from initial treatment focusing on pain/swelling reduction to intermediate strengthening and range of motion exercises to an advanced stage of sport-specific training. The ultimate goal is a safe return to sports following medical clearance and gradual exposure to competition through monitoring of the athlete's well-being.

1. SPORTS SPECIFIC
REHABILITATION
DR. NIDHI SHUKLA
Assistant Professor
RAMA University Kanpur

2. INTRODUCTION
• Rehabilitation is the restoration of optimal form (anatomy) and
function (physiology)
• Rehabilitation means-
• Re- again
• Habilitate- make fit
• It is a process designed to minimize the loss associated with the
acute or chronic disease, to promote recovery, and to maximize
functional capacity, fitness and performance.

3. • Tissue injury from sports can be classified as:-
• Macro traumatic injuries usually due to a strong force
• Micro traumatic injuries are chronic or overuse injury.

4. REHABILITATION PLAN
• GOAL OF THE REHABILITATION-
• Limit the extent of injury
• Reduce or reverse the impairment and functional loss
• Prevent
• Correct or eliminate altogether the disability.

5. Multidisciplinary approach
• The rehabilitation of the injured athletes is managed by a
multidisciplinary team-
• Sports physicians,
• Physiatrists
• Orthopaedists
• Physiotherapists
• Rehabilitation workers
• Physical educators
• Coaches
• Athletes trainer
• Psychologist
• nutritionists

6. PRINCIPLE
• The seven principles of rehabilitation which can be recommended
by the mnemonic: ATC IS IT.
• A- avoid aggravation
• T- timing
• C- compliance
• i- individualization
• S- specific sequencing
• i- intensity
• T- total patient

7. COMPONENT
• PAIN MANAGEMENT-
• Medications are a mainstay of treatment in the injured
athletes- both for the pain relief and healing properties.
• Therapeutic modalities play a small but important part of
the rehabilitation of sports injury
• They may help to decrease pain and edema to allow an
exercise based rehabilitation program to proceed.

8. • Flexibility and joint ROM-
• Flexibility is an important component of rehabilitation in
order to minimize the decrees in joint ROM ,
• Also a variety of stretching technique can used in improving
range of motion, including PNF, ballistic stretching and static
stretching.

9. • Strength and endurance-
• Injuries to the musculoskeletal system could result in skeletal
muscle hypotrophy and weakness loss of aerobic capacity and
fatigability.
• During rehabilitation after a sports injury it is important to try
to maintain cardiovascular endurance. Thus regular bicycling ,
one leg bicycling or arm cycling
• General major muscle exercise programmes with relatively
high intensity and short rest period can be major important.

10. • Proprioception and coordination:-
• Proprioception- a special type of sensitivity that inform about
the sensations of deep organs and of the relationship
between muscle and joints.
• Proprioception re-education has to get the muscular
receptors working in order to provide a rapid motor response.
• Coordination- the capacity to perform movement in smooth
precise and controlled manner.
• Rehabilitation technique increasingly refer to neuromuscular
re-education.

11. • Functional rehabilitation-
• Goal- the return of the athlete to optimum athlete to
optimum athletic function.

12. • The use of orthotics:
• The use of orthotic device to support musculoskeletal
function and the correction of muscle imbalances and
inflexibility in uninjured areas should receive the attention of
the rehabilitation team.

13. • Psychology of injury:
• Mental skills in sports are often viewed as part of individuals
personality and something that cannot be taught.
• It is important for sports medicine physicians to assist patients
in setting goals related to performance process rather than
outcomes, such as returning to play.

14. SATAGES OF REHABILITATION

15. INITITAL STAGE OF REHABILITATION
• This phase lasts approximately 4-6 days.
• Goals-
• Limitation of tissue damage
• Pain relief
• Control of inflammatory respondent injury
• Protection of the affected anatomical area

16. • CONTROL PAIN AND SWELLING-
• RICE- 24 – 48 hours after many muscle strains, ligament
sprains, or other bruises and injuries.
• Therapeutic modality and medications are used to create an
optimal environment for injury repair by limiting the
inflammatory process and breaking the pain spasm cycle.
• The power, strength, and endurance of the musculoskeletal
tissue and function of the cardio respiratory system must be
maintained.
• Active ROM is performed under one’s own control, while
passive ROM ocuurs when another person or device produces
the movement.

17. • Isolated exercises that target area proximal and distal to the
injured area may be permissible provided that do not stress
the injured area.
• Isometric exercises are used for strengthening when ROM is
restricted or needs to be avoided due to fracture or acute
inflammation of the joint
• Isotonic strengthening can begin with in the painless arc of
joint motion.

19. INTERMEDIATED STAGE OF
REHABILITATION
• This phase lasts from day 5 to 8-10 weeks.
• JOINT ROM AND MUSCLE CONDITIONING:
• Goal:
• Limitation of impairment and the recovery from the
functional losses.
• Early protected motion hastens the optimal alignment of
collagen fibers and promotes improved tissue mobility

20. • Physical modalities are used to enhance tissue healing
• Strengthening of the uninjured extremity and area proximal
and distal to the injury, aerobic and anaerobic exercise, and
improving strength and neuromuscular control of the involved
area
• Isometric exercise may be performed provide that it is pain
free and otherwise indicated.
• Sub maximal isometric exercise allow the athlete to maintain
neuromuscular function and improve strenthgth with
movement

21. • Isokinetic exercise can be important aspect of strengthening.
this type of exercise uses equipment that provides resistance
to movement at a given speed.
• Isotonic exercise involve movements with constant external
resistance and the amount of force required to move the
resistance varies, depending permeability on joint angle and
the length of each agonist muscle.
• Specific type of exercise exist to improve neuromuscular
control following injury and can be manipulated through
alteration in surface stability, vision and speed.

22. ADVANCE STAGE OF REHABILITATION
• This phase begins at around 21 days and can continue for 6-12 months.
• Goals:
• Return to sports training and compition.
• FUNCTIONAL TRANING
• Joint angle specific strengthening
• Velocity specific muscle activity
• Close kinetic chain exercise
• Exercise designed to further enhance neuromuscular control
• Cross training

24. RETURN TO SPORTS
• Return to play is defined as the process of deciding when an injured
or ill athletes may safely return to practice or competition.
• Sports specific functional rehabilitation should be focused on
restoration of the injured athletes ability to have sport specific
physiology and biomechanics to interact optimally with the sports
specific demands.
• Once the athletes has been medically cleared to return to play
there are some fundamental steps that need to followed:

25. • The athletes has to fulfil the fitness standard of the team he is
returning to.
• The athletes need to pass some skill specific test applicable to
his playing position
• The players then begin practicing with the team
• Exposure to the match situation should be gradual, with the
match time gradually increase.

26. MONITORING
• Monitoring athlete well being is essential to guide
training and to detect any progression towards negative
health outcomes and associated poor performance
• There are a number of external load quantifying and
monitoring tools-
• Power output measuring device
• Time motion analysis
• Internal load unit measures-
• Heart rate
• Blood lactate training impulses

27. • Other monitoring tool:
• Heart rate recovery
• Neuromuscular function
• Biochemical/hormonal/ immuniological assessment
• Questionnaires and diaries
• Psychomotor speed
• Sleep quality and quantity