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Recovering from injuries or surgery doesn’t happen overnight. Returning to an active lifestyle may require a conditioning and exercise program. Once your injury has healed sufficiently, your doctor may recommend a visit to a physical therapist in order to develop the proper program for you. Injuries to joints such as knees, ankles, and shoulders often require rehab to regain strength, stability, and range of motion. Of course, any exercise program should be approved by your physician and/or physical therapist since different injuries and surgeries may facilitate different approaches.
We all like to say we know our bodies better than anyone, but the truth is most of us don’t know exactly how everything works. After an injury or surgery we may feel free to exercise/rehab without limitations. This can actually lead to setbacks or even further injury. Depending on your injury, muscles will atrophy and joints will lose their range of motion. Physical therapists are trained to understand the body’s physiology and anatomy and can make your rehabilitation safer, shorter, and more effective. Plus they can monitor your progress and let you know when you are free to resume your active lifestyle.
A great deal of injuries or even surgeries involve knee, ankle, hip, and even shoulder joints. Many of these joints are crucial to our everyday activities. For instance, shoulder injuries can be extremely painful and limit our ability to lift/carry everyday items. Knee or ankle injuries can hamper our ability to walk. During the rehabilitation process these areas can be strengthened and the range of these joints may return to normal.
An injury to your shoulder area can be debilitating. A well-designed rehab program can help strengthen the shoulder/rotator cuff area. Strengthening the muscles that support the shoulder joint will help stabilize the joint, prevent pain, and prevent further injury. Once these muscles are strengthened, stretching is necessary to keep the muscles long and flexible. According to The American Academy of Orthopedic Surgeons several muscle groups should be targeted. These are the deltoids, trapezius and rhomboid muscles in the upper back, teres, supraspinatus, infraspinatus (all supporting the shoulder joint), subscapularis, and the tricep/bicep area. Patients should always warm up before exercising, stretch, and not ignore pain. Stretching exercises such as a pendulum rotation, crossover arms stretch, passive internal/external rotation, or the sleeper stretch are all good exercises for the shoulder area. You can strengthen your shoulder area by doing a standing row using elastic bands for resistance. An external rotation with the arm bent 90° also utilizes an elastic band and targets the infraspinatus and teres muscles. Simple internal/external rotation exercises can help strengthen other shoulder muscles and stabilize the joint. Bicep curls and tricep extensions can be done using lightweights. Of course, starting off with light resistance is always the proper approach.
Knee injuries are commonplace and require rehab to regain proper function. The strengthening of the muscles around the knee will help stabilize the joint and absorb shock. The main muscle groups that need strengthening are quadriceps and hamstrings, abductors (in the outer and inner thigh), and the gluteus maximus/medius. Before strengthening its a good idea to stretch out these muscles in order to regain the knee’s full range of motion. Standing quadricep and supine hamstring stretches are great starters since these are some of the larger muscles in the leg. Squats are great for strengthening the quads, hamstrings, and gluteus muscles. Leg raises (while on your back and prone) are great for strengthening quadriceps and hamstrings/gluteus muscles. Your doctor should be notified if you feel pain during any of these exercises. Resistance can be added with the use of elastic bands or ankle weights at the advice of your doctor/therapist. As your therapy progresses, an exercise bike may be recommended.
A hip rehabilitation program should last between 4-6 weeks. Once your doctor has given you the okay and your physical therapist has designed a program for you, strengthening and stretching of certain muscle groups will help facilitate a quicker recovery. Much like with knee injuries, stretching and strengthening the large muscles in the leg and buttocks as part of the routine. A standing iliotibial band stretch is great for stretching out the tensor fascia muscle on the outside of your hip. To stretch the piriformis muscle a seated rotation stretch is best (you should feel this in your buttocks). Lying on your back and pulling your knee to your chest is a great stretch for the hip as well as the supine hamstring stretch. To strengthen the hip area, hip abductor exercises can strengthen the abductors and the gluteus maximus. Hip extensions while prone strengthen the gluteus maximus muscle and can even utilize ankle weights to increase resistance. Internal and external hip rotations can help strengthen the medial hamstrings and the piriformis muscles respectively. Your physical therapist should make sure you are using proper form to effectively target the proper muscle group.
When rehabbing foot and ankle injuries, The American Academy of Orthopedic Surgeons suggests targeting the muscles in the calf, shin, and ankle area. A heel cord stretch is effective with the leg both straight and bent. Rolling a golf ball underneath your foot is a great stretch of the plantar flexors. Using a towel to stretch your foot and calf, while lying on the floor, is a good stretch for the muscles in the calf and ankle. Care should be taken if you feel pain during any of these exercises. In order to strengthen the foot and ankle area, calf raises (using a chair for stability) and ankle range of motion are great starts. To help your plantar flexors, picking up a marble with your toes and towel curls (picking up a towel with your toes) are low impact strengthening exercises. The use of elastic bands over the toes allows for ankle dorsiflexion/plantar flexion strengthening. You should feel this in your shin, calf, ankle, front and back of your foot.
During your rehabilitation and conditioning, your therapist may recommend exercises for home. Depending on your injury and rehab program, different equipment is necessary. For stretching/strengthening exercises elastic bands of different tension can be used. Exercise balls can be utilized as therapy progresses to regain full strength and range of motion. Ankle weights can be incorporated in order to facilitate resistance and build strength. Stationary bikes are great for rehabbing and conditioning leg injuries. Your therapist may even recommend braces to support recovering joints.
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