Sports Medicine
Sports Injury Prevention & Rehabilitation

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Voted Best Sports Therapy Clinic in the San Francisco Bay Area 2010-2019!

Athletic Edge - Rehabilitation

Rehabilitation is the process of assisting someone to improve and recover lost function after an event, illness or injury that has caused functional limitations. Rehabilitation is a huge field within health, promoting recovery for people after events such as:
  • Orthopaedic surgery
  • Acute/Chronic injury
  • Accident
  • Sprains/Strains
  • Rotator Cuff Tendinitis
  • Back Pain
  • Neck Pain
  • Fractures
  • Joint Replacements
  • Knee Ligament/Cartilage Injuries
  • Arthritis
  • RSI
  • Carpal Tunnel Syndrome
Rehabilitation may consist of modalities like ultrasound and electrical stimulation, or manual treatments such as mobilization and stretching. Therapeutic exercise is used most frequently to improve performance through strength, endurance, flexibility and balance exercises.  Typically a progression of functional exercises is used as a means to return you to previous levels of activity or sports. 

Some of the common modalities used are:

When should you use heat or cold therapy?  Find out...  Hot Versus Cold Therapy...

Sports Rehabilitation:

Sports rehabilitation is a multi-disciplinary approach to treat injuries sustained through sports participation so the athlete can regain normal pain-free mobility. The team may consist of highly trained professionals which can include physical therapists, athletic trainers, chiropractors and massage therapists. The primary goal is to return to pre-injury activities, whether the athlete is a professional, amateur or casual player.

The most common injuries treated by the sports rehabilitation team is sprains and strains. A sprain is an injury to the ligaments caused by overstretching or tearing. A strain, on the other hand, is an injury or tear to the muscle itself. Other conditions that can be treated through a sports rehabilitation program are fractures, arthritis issues, joint replacements and generalized pain issues.
Sports rehabilitation typically begins with a pain management treatment program, usually given by a licensed physical therapist. Some modalities utilized for pain relief include ice or heat application, ultrasound and electrical stimulation. Ultrasound is an effective tool to increase circulation to the affected or injured area which assists in speeding up the healing process. It can also reduce the edema or swelling causing pain. Electrical stimulation, commonly known as TENS, or transcutaneous electrical nerve stimulation, utilizes electric waves that penetrate into the muscle and aid in the relief of pain.
A big component of sports rehabilitation involves a stretching and exercise routine. Stretching assists the muscles shortened by injury or pain to regain its normal length to optimize pain-free motion. Exercise routines encompass things like strength, endurance, flexibility and balance to improve performance. The final progression of the exercise routine is the utilization of functional exercises to help return the athlete to his former performance level. Functional exercises are often sport-specific.

Athletic trainers often can supply immediate intervention of an injury. They can also be an integral part of the healing process and the prevention of further injury. A massage therapist can supply the manual techniques to assist in the recovery of movement as well as the pain relief required for optimal participation in the sport.

Today many sports rehabilitation programs utilize massage therapists. Massage therapy is the practice of using touch to manipulate the soft-tissue muscles of the body. It is performed for a variety of reasons, including treating painful ailments, decompressing tired and overworked muscles, reducing stress, rehabilitating sports injuries, and promoting general health.

Sports rehabilitation begins with the treatment of the acute injury. It then follows the athlete through every step of recovery. From pain relief to optimizing muscle length to returning to pre-injury performance to injury prevention, sports rehabilitation is comprehensive rehab program that focuses on every facet of pain-free, effective, sports-specific motion.

After An Injury:
The following information is intended as background only and is not intended as a substitute for professional health care.
The first things to do after an injury:
  1. Stop doing what you are doing when you get hurt. This sounds self evident, but you would be surprised how many people make the problem worse by continuing the activity thinking, "it will just go away".
  2. Rest for several days after an injury...then get moving again. Rest takes stress off of damaged tissue and allows the healing process to begin. Rest is good for 2-3 days but prolonged rest can cause problems as it can worsen the injury by allowing inflammation to increase and consolidate.
  3. ICE - I can't stress this enough. I have actually had people come in to my office from the emergency room, where they had been told to heat an injured area!  Clinical and research has shown that icing after an injury cuts healing time.  If you ice promptly you will cut down swelling, pain, and speed healing. Always ice the first few days following an injury: 7- 10 minutes at a time, 3-4 times a day, for 3-4 days.
  4. If the pain continues unchanged or if it worsens after 3 days, seek professional care. Delays in diagnosis can be dangerous. Many serious health problems can give rise to back pain. It is important to rule those problems out. Finding the probable cause of the pain is important to proper treatment. Often there may be several potential causes of the pain or injury
  5. Once you begin a treatment plan under professional care, make sure to follow the orders of the doctor. This is important so that the treatment plan can be assessed for its effects on your condition.

How to Improve your Performance:

There are several elements which make up your overall performance level. Depending on your sport or game, these will vary in proportion. Some of these elements include:
Endurance - Endurance involves the physical and mental ability to maintain a certain level of physical activity over a period of time. Cardio-vascular fitness is enhanced by maintaining your training heart rate for a sustained period of time. Both the training heart rate and duration vary from individual to individual. However, the training heart rate is generally between 70-90% of your maximum heart rate. (Max HR=220-age, although this figure is merely a rough estimate) The duration of time for a non athlete to achieve a training effect is 15 to 30 minutes daily. Depending on your sport or performance your duration at the training heart rate may be from 30 minutes to over and hour. There are many different types of cardiovascular training. These training types vary in the training heart rate, the duration at this rate and in the recovery time. This is a good place to mention that by increasing your cardiovascular fitness, you enhance your ability to perform for longer periods of time, even if you are an anaerobic athlete like a sprinter or basketball player.
Strength - Strength is the measure of force which you can produce. This may be the ability to lift heavy weights of the ability to move other athletes, as in blocking in football. The best way to increase strength is with consistent and GRADUAL overloading of muscles. It is important to go slow, it can take several months to achieve strength gains. "No pain , no gain" is an old and partially untrue saying. Pain should only be mild and should never be truly unpleasant. If you are pushing too hard you may risk injury. Always follow proper technique. If you have access to a strength coach learn from him or her. Learning proper techniques pays in the long run.

Power - Power can be described as strength/force applied over time. In other words, the ability to produce strength in a unit of time. Power is what enables quickness and explosive effort. Power can be developed by using strength training and specific drills utilizing maximum effort and full recovery. Such drills are now referred to as Plyometric Training.
Mental Concentration - Mental attitude and concentration play an important role in all physical challenges. Knowing how to perform the task is important, however it is equally important to ALLOW the body to perform the task. Often overlooked, the mental side of the game is most important, and increases in value as the skill level increases.
Game and Performance Skills - By knowing the rules or your sport or by gaining  knowledge of your art, you can increase your efficiency and decrease the likelihood of injury. Always ask questions of other performers, coaches or artists. Learn everyday. Learn all you can about the NATURE of your event or art.
Preparation - Preparation can be critical. This may mean such a drastic measure as moving to high altitude in preparation for a high altitude event. It may only require awaking early enough in the morning of competition to be physically and mentally prepared. Always prepare, but never forget to ENJOY what you are doing.
When soft tissues like muscles, tendons, ligaments, and joints are damaged they heal with scar tissue. Scar tissue, just like that on your skin from a bad cut is different then the tissue it replaces. It has several qualities that alter its nature:


Why am I taking so long to Heal?
When muscle, tendon or ligament ruptures the body repairs the area with scar tissue. (muscle and tendon strains, ligament sprains)

  • Scar tissue is less elastic, less flexible, less "stretchable".
  • Scar tissue is more pain sensitive.
  • Scar tissue is not as strong as the tissue it replaced, and is easier to re-injure.
Scar tissue will form along lines of stress. Therefore if you do not move the injured area the scar tissue forms in a more "hap hazard " manner, which makes it even less flexible and more pain sensitive.
One of the primary goals of any soft tissue treatment plan is to create the best quality of scar and healing possible. This is an important concept, because if the damaged tissue is not given early controlled motion, the scar tissue will be of poor quality and create more pain, less motion and be easier to re-injure.
Often pain can persist even when the tissue has "healed". This is because of many factors including the formation of poor quality scar tissue healing. The nervous system can also play a role in the continued pain. Nerves learn behavior, and continued pain can lead to the injured tissues responding to normal motion and stress as if it were a painful irritant. The nerves in the area have become used to sending pain information to the spinal cord and brain. This is one reason why motion helps ease pain in many cases. Pain and motion "compete" with each other to get the attention of your brain. Give it motion and pain is eased.


How can I heal faster?
Given time, the right combination of therapeutic tools and a large dose of tenacity, many chronic pain patterns can be helped. Often treatment plans may include co-operation with medical doctors to prescribe pain medications, or other methods of pain control. By giving this "window of opportunity" to move without pain, the patient can retrain the body to function with less pain.
Injuries can impact both lifestyles and incomes. Healing quickly is a very critical goal. There are some very tangible things that an injured athlete or non athlete can do to enhance the healing rate.
  1. Follow your rehabilitation and treatment plan strictly, but give yourself a chance to relax a bit as well. Worry and anxiety will never help speed recovery.
  2. Eat well. Avoid high fat and high sugar diets. Eat wide varieties of foods to ensure good nutrition. Eat many small meals instead of one large meal. A multi-vitamin/mineral will ensure that you are not deficient in any needed nutrient.
  3. Ice after you work out hard, or if you push yourself to far. Always ice is you feel throbbing pain, heat or notice swelling.
  4. Drink plenty of water. Many people (especially athletes) do not drink enough plain water. Water is important for digestion, kidney function, cooling the body and balancing the electrolytes of the body.
  5. Give yourself adequate rest. Too much rest is a bad thing, too little is a bad thing. As in training; Quality is important not Quantity.
  6. Avoid fads and "quick fixes". Often these lead to further injury and disappointment. There is no substitute for strongly healed, quality tissues. Balanced with trained and conditioned muscles and nerves, quality tissue healing is unbeatable.
  7. Stay optimistic and focused. Never give up.