Reconditioning After Injury
Injuries are extremely frustrating to athletes, forcing them to modify their lifestyle while they’re healing. Following rest and healing, they often discover that they’re still not able to participate in an activity without risking further injury. This injury/rest/re-injury process is all too common for many athletes. The key to stopping this vicious cycle is to understand the aspects of reconditioning.
Conditioning and Reconditioning
Reconditioning after an injury requires the athlete to modify his/her conditioning program in two ways:
- Carefully control work intensity.
- Use residual pain to monitor acceptable levels of intensity.
The Intensity Window
Conditioning requires the athlete to select an appropriate level of exercise that will allow sufficient overload to produce conditioning effects. If the intensity of this exercise is excessive, injury could result. There is a range of acceptable exercise intensity from which the athlete can select to condition. This is known as the 'Intensity Window'. The window for an uninjured athlete is very wide. For an injured athlete, the window is extremely narrow. Excessive increases in intensity of exercise may stall your recovery or even result in re-injury.
Type I Versus Type II Pain
Type I pain (immediate pain) is the pain perceived during exercise, and Type II pain (residual pain) is the pain perceived about 1-1/2 hours after exercise. Both must be monitored to assist in the selection of an appropriate Exercise Window. The healthy athlete can use Type I pain to monitor exercise intensity. The athlete exercises to the point where slight pain is experienced, then exercises a bit further. In fact, the athlete must continue to challenge the pain of exercise to maximize effectiveness (no pain, no gain). Successful athletes must, therefore, continue to challenge pain and push through Type I pain. Type I pain is relieved very soon after exercise and does not produce lasting effects.
Type II Pain and Injured Athletes
The injured athlete becomes frustrated during the reconditioning program. Instead of strengthening, the athlete encounters re-injury. Type II pain is intense, even though the athlete experienced minimal pain during exercise. When pain is intense, the athlete must rest for 1 to 3 days and then re-initiate the reconditioning program at a lower level of intensity.
The Reconditioning Process
Flexibility - Strengthening -Functional Rehabilitation
- Start the reconditioning program with exercises that involve static, pain-free stretching.
- When flexibility has improved, use a program of progressive resistance exercise (weight lifting) to increase muscle strength.
- When sufficient strength has been obtained, gradually add intensity within the movement of your sport.
Within each stage of the reconditioning program the athlete must be very careful to select an intensity level that does not increase the Type I or Type II pain. As an athlete continues to recover from injury, the Exercise Window will widen and the athlete will find that he or she can once again challenge Type I pain with minimal Type II pain.
Following these procedures will allow the injured athlete to break out of the injury/rest/re-injury cycle.