Sports Injury Rehabilitation
Post-operative Sports Injury Rehabilitation
If you had no choice but had the surgery already, but post-operative rehabilitation did not meet your requirements, and you want to get more comprehensive, more efficient and more systematic functional recovery, our physical rehabilitation specialists will help you recover the athletic ability you need as quickly as possible, so you can get back to your normal exercise, work and life.
I. Blind Spot of Healing: Post-operative Rehabilitation
Sports, especially competitive sports, is a challenge to the human physiological and psychological limits, therefore sports injuries are inevitable. With the vigorous development of China’s competitive sports and mass sports, sports injuries are also increasing, and the number of surgeries is rising each year. Sports medical specialist hospitals like the Beijing University Third Hospital are hard to find. After all, surgery is a quick and effective means to deal with certain sports injuries.
Unfortunately, most people focus only on the surgery, whereas for, they either do not pay enough attention to, or do not really understand post-operative rehabilitation, so they develop various misconceptions. This not only cannot guarantee the results of the surgeries, but also brings more pain to the patients. For example, a national champion accidentally injured his left leg during a match; his anterior cruciate ligament, medial collateral ligament and meniscus were torn. He was quickly taken to hospital, and underwent reconstruction of the anterior cruciate ligament, medial collateral ligament suture, and meniscus repair surgery. After the operation, he followed the traditional Chinese concept of “injury in tendons and bones takes 100 days to rest,” mainly convalescence, with a long-term cast to protect the joint from accidents, and the rehabilitation does not start until three months later. At this point, his limb muscles had already atrophied, scar hyperplasia, tissue adhesions, stiffness of joint, and he could not bend or walk properly. The more serious complications were that, due to the long-term cast, the lower limb had low blood circulation, and inside his calf blood vessels, thrombosis had set in, causing his ankle long-term swelling of the ankles. This not only made the post-rehabilitation very difficult, but also risked other deadly diseases: the thrombosis left in the blood vessels would flow with the blood, and if it had gotten into the lung, it would have caused pulmonary embolism; if it had gotten to the heart, it would have caused myocardial infarction; if it had gotten to the head, it might have caused infarction of the brain...
II. Misconception Comes from Vague Cognition
The lesson of the national champion mentioned above is not a special case-isolated example. The main reasons for this widespread phenomenon are negative and backward concepts, and vague, or even wrong cognitions. A large number of practices and bibliographical information found that the misconception of post-operative rehabilitation can be summarized as the following:
First, most people think that the most common treatment for injury is operation, and a successful operation means successful recovery, but that is not the case. Operation is only half of the sports injury treatment process, and the other half is the rational and scientific post-operative rehabilitation, which is the strongest guarantee for the effect of former. In addition, operation is a treatment of trauma, during which inevitably some nerves and blood vessels in the body are destroyed, causing a decrease of local sensation and exercise capacity. The incision can also cause scar hyperplasia, and post-operative inflammation can also cause tissue adhesions and so on. If one does not get scientific and personalized rehabilitation, these complications are bound to affect the success of the operation.
Second, patients lack knowledge of early comprehensive rehabilitation therapy. Many people regard rehabilitation treatment as the same as physiotherapy, such as diathermy, infrared rays, etc., and thus believe that this kind of treatment does not help much, so they have missed the best opportunity for rehabilitation. In fact, physiotherapy is just one method of post-operative rehabilitation, which also includes physical therapy, occupational therapy, and combined therapy of Chinese and Western medicine, psychological rehabilitation and so on. Moreover, at different stages, it also combines with special sports and conducts various functional recoveries, and each method contains abundant contents.
Third, many people are familiar with the idea that healing is “thirty percent treatment, seventy percent recuperation,’ but mistakenly interpret rehabilitation as recuperating, simply resting, therefore they do not want to take the initiative to rehabilitate, not to mention the scientific sports rehabilitation.
Fourth, many people neglect the proper rehabilitation methods. All operations have their corresponding post-operative rehabilitation processes and specific requirements. During these processes, under the guidance of their physical therapists, patients should complete their rehabilitation plans step by step. If they violate the rules of rehabilitation, either too early, or too late, or conduct their own inappropriate training, this could cause an unnecessary secondary injury, and might even cause post-operative complications to appear.
Fifth, many people neglect self-exercise outside of rehabilitation. Patients often feel that rehabilitation is the responsibility of hospitals or rehabilitation centers, therefore, they rely entirely on their doctors or physical therapists. In choosing the means and methods of rehabilitation, they also lean towards passive physiotherapy-based measures, while they are not interested in sports therapy and functional training that require personal involvement and physical strength and sweat. Some even do not complete self-rehabilitation programs outside of the hospital or rehabilitation center on time, which would make the post-operative rehabilitation ineffective.
Sixth, many people do not pay enough attention to post-operative psychological adjustment. Injuries and operations often cause psychological trauma to patients. For example: They worry about not being able to resume proper training, competitions, their career and life in the future; they worry or have doubt whether or not they will be fully recovered. At times like this, people often do not understand them, or even think the patients’ thinking is twisted, and the emotional and psychological confrontation has adversely affected the rehabilitation of the patient.
III. Post-operative Rehabilitation Should Pay Attention to Effectiveness (Timeliness)
A widely recognized modern scientific concept in developed countries indicates that post-operation rehabilitation of sports injuries cannot be just resting and passive recovery; it should be involved with sports activities as early as possible and take the initiative to recover. A large number of examples show that when traditional practices are used, several months of resting after surgeries, due to a long time being bandaged and in a cast, the injured parts could have many complications, such as swelling of joints, tissue adhesion, muscular dystrophy, decreased articulation range of motion, or even loss of articulation moving function, and so on. This kind of scenario can often be seen, after the cast is removed from a limb, when the patient cannot even do normal flexion movements. At that point, the first thing they need to do is to get rid of the adhesion of the joint soft tissues. The method of this is to press open the joint with force, and this “breaking the joint” looks simple, but in reality, it is both time consuming and extremely painful. In order to avoid this painful procedure, some people even give up the operation altogether. Moreover, during this period, if the rehabilitation methods are not used correctly, it will prolong the rehabilitation period, and in real life, there are a lot of people who cannot restore their normal joint function for as long as a year or two.
Modern rehabilitation concepts and means can effectively prevent these consequences brought on by traditional practices. It suggests to do joint activity training at the right moment before the soft tissue adhesion after the surgery, which maintains muscle activity, and lays a good foundation for resuming normal activities and sports in the future. In the mean time, it also saves time, and improves the recovery efficiency.
In many counties, these modern rehabilitation concepts and methods are not only being used in sports, but are also being used in people’s daily lives. In hospitals in the United States, every department is supplied with rehabilitation therapists, and active rehabilitation activities start soon after the patients are returned to their rooms from the operation room. For example, after the joint replacement surgery, the rehabilitation therapist would place a “Continuous Passive Motion Machine” under the affected area of a patient to help them move, in order to avoid soft tissue adhesion of the injured part. Even for those who are dying, the therapists still go there to help them do various kinds of activities, move their stiff joints to prevent thrombosis. In their view, rehabilitation is exercise. In order to recover quickly, one must exercise early.
IV. Scientific Rehabilitation Emphasizes on Individuality
When is it the right time to start active rehabilitation? This should be based on the location of the injuries, their surgical methods, and the individual’s physical conditions. It also must be safely and effectively carried out under the guidance of specialist doctors and experienced physical therapists. Some means of active recovery can start when anesthetic’s effect has passed right after the surgery, but for those who underwent anterior cruciate ligament reconstruction surgeries, they need to wait until ligaments grow strong, then start to excise. To start rehabilitation early does not mean to move ahead blindly.
Therefore, the importance of post-operative rehabilitation is just as important as the operation itself. Something is worth mentioning here, the active post-operative rehabilitation is closely related to pre-operative preparation. If a patient minimizes the extent of swelling of the affected area, and keeps the strength and range of motion of the affected area before the operation, this will greatly benefit post-operative rehabilitation exercise. In addition, active rehabilitation exercise requires “30 percent reliance on others, and seventy percent reliance on the self.” The help and guidance from the doctors and physical therapists are, after all, limited; most of the time it depends on our own consistent exercise in strict accordance with the requirements. It also depends on a healthy lifestyle combined with good exercise habits, which requires personal perseverance and conscientiousness to complete.
★ Liu Qiuhong’s Post-operative Rehabilitation Case: http://www.drbobchen.com/2014/cases24_0205/424.html
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