Active movements are when the athlete is using his own muscles to generate (produce) movement, he is the one who is physically doing the exercises. In the post acute stage of an injury, the athlete will be needed to do exercises and activities by himself as part of his rehabilitation program. Keeping the athlete active is crucial part of this stage as without it he will not be able to fully recover from his injury.The benefits of active movements in the post-acute stage of an injury:enhance local circulation to the injured site which will provide oxygen and nutrition and will promote healingprovide proper blood flow and circulation to the injured site which is required for full recoverypromote lymph drainage which removes and clears out toxins and waste products which are accumulated in the tissues of the injured siteactivate the lymphatic systemenhance healing processhelp regain flexibility, strength, power, muscle endurance, balance, agility, coordination and skills that were lost as a result of the injuryhelp realigning scar tissue fibresprevent re-injury or injuriesWithout gentle activity in the post acute phase the lymphatic system will not be activated and healing processes will be impaired. Therefore an athlete should not wait for full anatomical healing, instead he needs to start his active rehabilitation by re-training his muscle, tendons and ligaments gradually as soon as the initial phase of swelling and pain has started to settle. Active rehabilitation includes very specific active movements like ROM, stretching, strengthening and stabilising and their major goal is to restore optimal function of the damaged structure(s).Example of active movement exercises and their benefits: ROM exercises – The first priority is the restoration of ROM as it will give a solid foundation for more intense and challenging exercises.
Without adequate ROM of joints and its surrounding soft tissues there will always be some compensations and inefficiencies within movement. Inefficiencies often lead to compensation of different structures and result in injury. Therefore the rehabilitation should begin with movement base exercises such as bending the injured area gently then straightening it. Then, when it is comfortable enough, rotation exercises can be added such as turning the injured area one side then the other side, then slowly rotating in circle it one way then the opposite way.
The aim of these exercises to improve athletes’ mobility. As rehabilitation progresses ROM exercises can be gradually intensified. This will re-establish flexibility, strength and tissue mobility in the injured structure. stretches: stretches at this point will further boost joint mobility, increase flexibility and strength which allow to introduce more demanding exercises. It will improve muscle tension and muscle tone, proprioception, neuromuscular coordination and reduce the risk of re-injury.
Example: wrist stretch, palm-out forearm stretch, rotating wrist stretch (for carpal tunnel syndrome) hold each stretch – for 20 sec minimum- count then repeat it 2-3 times.strength: Strengthening exercises can be introduced once ROM exercises can be done almost pain free. Starting with light overloading the injured site, then gradually and systematically increasing the load. Free-weights, weights machine or own body weights can be used. The benefits will be: improved muscle strength, improved stability of the joints and muscles, improved functionality of the injured area and surrounding tissues, improved quality of movement, reduced risk of injury or re-injury. Examples: Standing dumbbell press, alternate dumbbell curl, press-ups used as rehabilitation for frozen shoulder. isometric exercises: muscles contract without creating any movement such as holding plank or holding arms overhead. These exercises will help the athlete to regain, improve and maintain neuromuscular function.
The exercises do not distract scar tissues and can be applied safely. stability exercises: Balance and proprioceptive exercises can be introduced once full ROM, flexibility and strength has returned to the injured site. The aim of these exercises is to re-train the damaged nerves of the injured area, to improve proprioception and to strengthen the weakened muscles/ligaments.
Some example of balancing exercises: Walking along a straight line; balancing on a beam.