Rehabilition: Time To Assess
The rehabilitation period is vital. Time spent walking on crutches or with support will change the walking pattern. Within weeks a new pattern will overlay the existing one, a reconditioning to compensate for the injury. Following this type of injury, we may have a different manner of walking but remain unaware that anything is wrong. Before any progress can be made in returning to form, we must learn how to move naturally again. If this is not undertaken, all actions including core strengthening techniques and corrective exercise will use the new corrupt pattern as a foundation and impact upon performance.
Remedial exercise plays an important role in the recovery process. However, to benefit from the treatment, it is essential to first identify the cause and then to prescribe the appropriate exercise, and secondly to perform them correctly. Too many people do not take these exercises seriously and fail to complete the programme due to boredom or impatience. Those who do the exercises often do so incorrectly. An exercise to strengthen a recovering muscle should not be done with just the specific part in mind. For example a knee exercise should not be performed whilst stiffening the neck or other part of the body to achieve the position and movement required. In the process of performing an exercise in this manner, we set up a new pattern containing inappropriate muscular actions that may eventually lead to further complication.
Where a problem is identified before a sports injury occurs, corrective exercises to address it are prescribed in order to prevent it. However, this course of action is based on the assumption that the athlete has to do something new to offset the perceived problem. It is not generally considered that the athlete may already be doing something (wrong) that is causing the problem. If this is the case, they will continue to do this `something wrong` whilst performing the new exercises. If the condition that led the perceived problem is still present the effect of the exercise will be limited or consolidate the pattern further. The use of our whole body and the impact of the movement need to be considered when performing exercise.
A recent audit by The Football Association in the United Kingdom found 58% of injuries were non-contact injuries sustained during activities such as turning, landing, slowing down and sprinting. A small, but worrying, amount of injuries were sustained during mundane activities away from the game including climbing stairs, getting out of cars and even changing channel on the television.
The reasons why injuries appear to be increasing are up for debate. Issues such as diagnosis and treatment, using unfit players and the pressures of the modern game are probably factors. More research into the nature of sports injury will no doubt have an impact on the problem. However, whilst the emphasis is placed on corrective exercise for the symptoms, it will have limited success. If a player has lost poise through the application of excessive effort, the prevailing culture of exercise will only encourage more of the same regardless of new methods designed to strengthen the perceived weaknesses. Why do players sustain so many injuries during natural activities such as running and turning? Do existing exercises for improving fitness and sports injury rehab ultimately affect movement? Concentrating on individual muscle groups does not promote integrated movement. It is imperative that the whole concept is rethought before `new` preventative exercise programmes are devised for sports injury sufferers.
Where poor technique is considered to be a factor in the injury, an individual cannot be said to have made a full recovery, if they have not been made aware of what it is they are doing to cause the problem. Once the wrong use is identified, the important step of re-education must come next. It is not sufficient to simply instruct the individual to stop doing A or B. They are already unknowingly doing A or B because habit makes it feel right. The condition that allowed the poor habit must be addressed to bring about a full recovery. Absence of pain does not necessarily mean the process is complete.
A motorist would not tolerate the need for repeat visits to the garage with a faulty car, yet when it comes to health many seem prepared to follow the injury-treatment cycle.