What We Talk About When We Talk About… Exercise For Rehabilitation

For anyone who has had the misfortune of requiring treatment from a physiotherapist, you might have wondered why you have been given exercises for your injured body part rather than being advised to let it rest up and heal in good time.

There is an element of truth to the age-old adage that time heals all wounds. A calf tear will eventually heal and you will find yourself walking without any pain after some time. Without a full assessment and progressive treatment plan, it is difficult to say when this return to function/sport will happen.

However, if you are in the middle of training for an upcoming marathon, you might not have the luxury of putting the feet up for a few weeks. Also, we can safely say that long-term clinical outcomes greatly improve by engaging in active rehabilitation in the gym over resting.

Allow me to elaborate on the benefits of exercise as a rehabilitative tool for your most common types of injury.

For Muscular Injuries:
• Encourages correct alignment of new scar tissue collagen fibres with that of the surrounding muscle
• Faster and greater regeneration of injured tissue
• Minimise the loss of strength and muscle tone
For Tendon Injuries:
• Complex biochemical response (e.g upregulation of insulin-like growth factor – IGF-1) that leads to improved tendon healing
• Increased tendon stiffness (this is good – not to be confused with muscle stiffness), tendon size, and tendon elasticity (important for plyometric movements such as running)
For Bone Injuries:
• Improved fracture healing reducing the likelihood of a refracture
• Minimise the loss of bone density after a period of unloading (i.e. use of crutches, cast)
• New bone formation is improved leading to the maintenance of stronger, healthier bones
For Cartilage Injuries:
• Minimise cartilage wasting – more buffer for the underlying bone
• Improve cartilage stiffness thus improving it’s ability to protect the underlying bone

The key to successfully achieving these positive adaptations is to ensure the exercise load and type is appropriate to the individual. Everyone’s fitness and strength levels are unique to them. Injury treatment that works for one person possibly won’t work for the next. We have blueprints to work from but ultimately a progressive programme needs to be worked out between the physiotherapist and the individual, as we are treating the person, not just the injury.

Blog written by William Cuddihy MISCP, Chartered Physiotherapist at Dublin Sports Clinic.

Read about how exercise can help manage conditions such as Osteoarthritis here.

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