One of the main things we do here at Stack St Physio is sports and injury rehabilitation. In this post Ben will explain a little about the rehabilitation process and how to approach it the right way.
What exactly is rehabilitation? As a physiotherapist working with sports and musculoskeletal pain and injuries, rehabilitation is the process of restoring yourself to full function after an injury, surgery or pain or functional problem. Let's look at a few examples.
Post-operative rehabilitation - for example, following ACL reconstruction or shoulder rotator cuff repair. The primary concern here is allowing for biology to do its thing - in other words, you need to offload tissues initially (hence why you might spend time in a sling, or in a boot non-weightbearing) before a steady, graded return of mobility and strengthening exercises. This process is guided by the healing timeline of the tissues in question, so if you've only had a minor arthroscopic procedure of the knee, your rehab process will be much quicker as we're not waiting for significant tissue healing. If you have had an Achilles tendon repair, you will follow a slow, graded return from no weightbearing and having your heel elevated, through to gradually increasing the amount of movement and load through the ankle - and as this connective tissue is slow to heal, your time away from sport or regular activity is going to be notably longer.
Injury rehabilitation - think here an uncomplicated lateral ligament sprain of your ankle, or a hamstring strain. Injuries that do not require surgery and that the body has good capacity to heal, provided you do the right thing. Here lies the key - many of us do not look after these injuries as well as we should, as there is a grey area around severity. This is bread and butter work for a physiotherapist, as we will advise on appropriate progressions in movement, loading (strengthening), return to running and high level function in a logical sequence. One massive take home point is that in these injuries, almost without fail you need to LOAD the tissue in order for it to heal well. In other words, REST is not the answer! Get professional advice early in the piece so you know you're on the right track.
Pain rehabilitation - so you can't remember when your back pain started, but it is now a real problem in your life. You've changed your hobbies, your sport, your work; you might be taking more medications and want to get off them; or perhaps you're just soldiering through it and hoping it will go away. Back pain is one example of a pain problem that often needs to be addressed with a rehabilitation approach. More and more research is showing that exercise is one of the most effective treatments for back pain. However, it is really important to get a clinical assessment of your problem, as what will work well for one person may not for the next. When I see people with back pain that is sticking around, rehabilitation involves finding out the thing(s) really driving the pain, figuring out ways to minimise these stresses on the back, then going through a graded process that may involve movement, stretching, strengthening, cardiovascular exercise, and even things like meditation, positive strategies and breathing exercises. So here it can be a case of going back to basics, and building from there.
Often in a rehabilitation process, there are patterns and behaviours we humans have picked up and held on to which we may have to unravel in order to move forwards. Pain is a sneaky beast, and we have to outwit it!
So what helps you do the best through your rehabilitation?
- Own it. You have to take control of the situation and commit to being the one to get yourself back to your best. As long as my patient is motivated, I can do everything in my power to make sure they get back pain-free in the shortest amount of time.
- Find a routine. Rehab can be hard! It really helps to find your own way of slotting it into your day, and making a dedicated routine of it.
- Stay positive. Sounds obvious, but rehab can be slow and will have its ups and downs. Extremely rare is the rehab that goes perfectly smoothly from start to finish - it is more like a stockmarket graph that is generally on the up (although hopefully without the crashes!).
- Set mini goals. As a physio it is my responsibility to help you with this. Coming back from an ACL reconstruction, your big goal may be, "I want to play footy next season". However this does not help you 3 months into the rehab. A goal such as, "I'm going to be able to squat my body weight (equivalent) on the bar at 4 months" is far more helpful at that stage!
As you can see, I am passionate about rehab as I have seen the difference a well run rehabilitation makes - both physically and mentally. If this post stirs up any questions, drop me a line on email@example.com. Or pop into the clinic here in Fremantle and see if our rehab gym here could work for you!
All the best!