The literature describes 4 basic phases in terms of rehabilitation. These phases are of course influenced by the current injury status, whether there was some surgical involvement, and any restrictions that could be associated with the recovery process. Each phase has characteristics, goals, precautions and criteria for progression onto the next phase of rehab.
Phase 1 is immediate rehabilitation. This is where we have some tissue and or joint inflammation, pain, a de-training effect, loss of muscle performance, certain injuries may require immobilisation, and we have an initiation of the tissue repair or regeneration phase. Here we need to protect the injured area and restore range of movement within reason, reduce pain and inflammation and prevent any reduced nerve input to the area. The aim of this phase is to regain around 75% range of motion in a pain free range and have good muscular control in basic movements.
Phase 2 is intermediate rehabilitation. Here our injury is continuing to repair and regenerate. We are looking to increase the use of the body part, decrease the inflammation and improve muscular performance. The main goal in this stage is to restore normal function to the involved body part. When the patient is near to full range of movement and 60% strength compared to the uninjured side then you are ready to progress to phase 3.
Phase 3 is the advanced rehabilitation phase. This phase is characterised by restoring full kinematics and movement of the joints and improving the muscular performance. We are looking to restore muscular endurance and strength, cardiovascular endurance and neuromuscular control. You can progress from this phase when you are at 70-80% of strength and you can demonstrate coordinated and symmetrical movement of the injured area.
Phase 4 is the return to function phase. This area focuses on the activities that are related to the demands of the patient. The goal here is to return to previous functional ability and prevent re-injury.
About the author,
Michael is an Osteopath, trainee strength and conditioning coach and competitive powerlifter.