Dr. Kevin Yip

Dr Kevin Yip
Orthopaedic Surgeon
MBBS(UK), FRCS(EDIN), FAM(SING), FHKCOS(ORTHO)

Featured on Channel NewsAsia

Rehabilitation

Movement therapy and physical therapy

General exercises are part of the athlete’s warm-up before training sessions and competition and have an essential function in preventing injuries.The role of athletic trainers and physical therapists in sports medicine is one of participation in both prevention and treatment. As far as prevention is concerned each sport has its own pattern of movements which subjects various muscle groups to different types of load.

 A knowledge of these patterns is vital to the athletic trainers and physical therapists, whose tasks are to emphasize the importance of warm-up, make appropriate suggestions for strength and flexibility training with regard to the requirements of the sport in question, and recommend specific training based upon the needs of each individual athlete. When an injury has healed, the aim is to restore original function to the affected part.

The athletic trainer’s instructions are of the utmost importance in ensuring that the correct muscle groups are trained with the appropriate movements and with a well-balanced load.If surgery is contemplated, physical therapy can be valuable both before and afterwards. Prior to a meniscus operation, for example, it is essential for the patient to exercise the thigh muscles as they are responsible for stabilizing the knee, and if they are well trained before the operation, rehabilitation is facilitated.

Assessing an individual’s functional state is part of the athletic trainer’s and physical therapist’s work.Analyzing the causes and consequences of a functional impairment enables a program to be drawn up for the treatment of muscles, joints, and ligaments. The treatment methods used are flexibility, strength, and coordination training in prescribed proportions, together with encouragement, rest, and use of modalities to reduce pain and swelling.

The treatment of functional disorders, e.g. joint immobility caused by muscle damage, is based on neuromuscular stimulation, an improvement in the interaction between nerves and muscles. This interaction is disordered when joints are immobilized, and there is increased tone in the muscles surrounding the joint. Treatment aims to relax the muscles to improve the range of movement. Stretching should be carried out slowly and smoothly, in order to prevent a rapid reflex muscle contraction .In all strength training it is essential that the correct load is used.

 After an injury, training should be appropriate to the type and extent of the damage and to the stage of the healing process reached. No strength training should exceed the pain threshold. The first stage is usually isometric training without external load,after which the training frequency and subsequently the load can be increased gradually. When isometric training can be carried out without pain, dynamic training can be started.

Hydrotherapy allows earlier and more aggressive intervention to help physiologic recovery. Muscle training may be supported with electrical muscle stimulation when conventional exercises cannot be carried out.Exclusive training of an injured area should be avoided, and a comprehensive training program should be drawn up to include all the training elements relevant to the sporting activity concerned.It is important to monitor the healing process so that the injured area is not overused and healing delayed.

Athletes do not always have the patience to wait for an injury to heal, and it is common for intensive training to be started too early. This emphasizes the important role of the athletic trainer and physical therapist,who should oversee the training program to ensure that it is appropriate in both type and intensity.

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