Tuesday, 21 August 2018

Functional Injury Rehabilitation

Over the years I have worked with many clients who have required injury rehabilitation.  I have always used the functional rehab approach, which is to say, I encourage natural day to day movements using little although ever increasing resistance. Getting rehabilitation right is not an easy task nor is it an exact science. All our bodies differ and there are various degrees ad severities of injuries depending on how they occurred and your immediate treatment. Luckily with my knowledge and guidance, all my clients have seen huge improvements in their condition through carefully monitored supervised exercise rehabilitation.

Common injuries I have rehabilitated that you may recognise from your own experience are:

Shoulder and rotator cuff tears
Football (soccer) related knee injuries such as post cruciate ligament reconstruction
Lifestyle and posture induced wear and tear on the upper and lower back and hips
Shattered ankle and calcaneus (heel) bones.
General to severe tightness in back and shoulders

If I do say myself, I have an exemplary record when it comes to helping people get back to where they need to be. Here I am going to provide a few simple (and quite obvious) guidelines to help you help yourself or your client through the process of injury rehab. All these guidelines are based on the assumption that previous medical surgery or diagnosis and initial treatment have taken place and you have a doctor’s recommendation that you / your client should begin physical rehabilitation.

Know what you’re dealing with: Understanding the injury and how the injured body part moves / works is vital. You do not want to be moving or manipulating the area in ways that it is not designed to move! If you haven’t seen a particular injury or established solid tried and tested methods to improve it then do your research. I often consult my books if I haven’t dealt with a certain injury in a while. Never guess how to rehabilitate an injury and always have a plan!

Every case is different: Appreciating not only the injury but also the individual (when helping a client) is so important. Your client must be confident and comfortable with you. After all they are trusting you with their body. What’s more, a body that is already in discomfort. So listen to what they are telling you and communicate the rehab process to them.

Establish what you / your client can already do: So often with less severe injuries, physios give their patients exercises which place less stress on the client than the stresses they automatically place on themselves during everyday life. Don’t go mad but begin with controlled and stable movements or exercises. Try and place a small demand on the body part. Initially, I usually use two sets but that’s dependant on how the first set feels.
Don’t be scared of the injury: As long as you listen to your body / client’s feedback and you don’t force anything, you are half way there. By simply encouraging natural movements you are increasing mobility and oxygenated blood flow to the injured area. This helps to heal the injured area and builds connective tissues, muscle fibre and nerve ending resulting in improved strength. Don’t forget the human body is an ever evolving organism and is pretty robust. By applying functional rehab exercises you are encouraging the comprehensive growth and repair.
Slowly but surely: Never rush rehab. Keep progressions minor but constant allowing the muscles to acclimatise to the volume and intensity of work

Always listen to your body: If something hurts then stop. I never use the “no pain no gain” philosophy. I use the “no pain no gain no brain” approach. Pain is your body’s way of letting you know something is not right so listen to it or risk making things worse. I always go by the uncomfortable is fine, pain is not rule of thumb.

No machines: I never use machines simply because they do not stimulate comprehensive proprioception (the connection between brain and body and resulting balance, coordination, sensitivity and reactivity). Utilising body and free weight exercises, your brain must send millions of messages to all the relevant muscle fibres and nerve endings to effectively control movement in a smooth and supported fashion. The more off balance you are, the more nerve endings and muscle fibres are created to support the demand resulting in improved strength and coordination. This is vital when you consider that when you injure yourself you damage these very muscle fibres and nerve endings! The more you have the stronger, more balanced and coordinated you are! Balance and non-supported exercise is harder than you would imagine. Try standing on a bosu with one leg lifted in the air and just feel the twitches and involuntary stabilising movements through your lower limb.

Balance and core stability: I have just spoken about balance and how it encourages the brain to recruit and establish a greater quantity of nerve endings and muscle fibers for stability but the core has a very important role to play too. Activating the core (squeezing the pelvic floor and pulling / tightening up internally to the navel) will help you maintain a good posture and control during all your clients’ rehabilitation exercises. Especially with lower back issues, the core muscles work like a weight belt and if activated correctly will protect you and help you heal without imposing further damage to the area. I personally believe that your body heals from the inside out so having a healthy core will enable a healthy body and quicker recovery. For further information, I have written an article on this blog about core stability.

Progression: As with regular gym periodisation it is important that you continually increase the challenge and demand on the body. Once a good basis of strength and stability within the injured part is established, reduce stability and force the body to work hard. For example introduce exercises on the ball or bosu or lift a planted limb off the floor / away from the central line to challenge balance and core stability..  
Nutrition: By eating a varied, natural wholefood diet you are fueling your cells with lovely nutrient rich goodness which will promote healthy cell growth.

Ice treatment: Quite simply, after a rehab workout it is common to experience swelling (especially if it’s the knee) around the injured sight. Applying ice to the area will cause vasoconstriction, the process where your blood vessels constrict, reducing blood flow and therefore swelling and any residual pain.

I hope this article provides . Please feel free to visit my other online work.