15 Concepts of Rehab to Fix Any Injury

I've worked in sports medicine for nearly 10 years and treated athletes at the highest level there is.

I've boiled most of what I've learned into 15 concepts of rehab that will fix any injury

These are what I use daily to fix athletes of all sports and any injury

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— BowTied Kobra, Rehab Guy (@bowtiedkobra) March 18, 2023

1. Pain in rehab is ok

Rehab should not be pain free. Some pain is fine and expected

Anything above 5/10 is counter productive

The key with pain is how it feels the next day.

5/10 during rehab but 2/10 the next day?

Perfect

— BowTied Kobra, Rehab Guy (@bowtiedkobra) March 18, 2023

2. Movement is key

There is not a single injury in which movement does not benefit

Movement activates the lymph system which promotes healing

Move as much as possible and tolerable

— BowTied Kobra, Rehab Guy (@bowtiedkobra) March 18, 2023

3. You can't fix an injury in one rehab session but can make it worse. It's not always a race

Just because you can tolerate the workout does not mean it is beneficial

If you do too much, you exceed the capacity for the tissue to recover and delay healing

— BowTied Kobra, Rehab Guy (@bowtiedkobra) March 18, 2023

4. ROM is improved under load

Static stretching will not improve motion

Tissue needs to be loaded through a FULL ROM to restore function and motion https://t.co/6pKWSBEdzb

— BowTied Kobra, Rehab Guy (@bowtiedkobra) March 18, 2023

5. Placebo is very real

If someone believes a treatment is beneficial to them, then it is

It should not be discouraged from use unless it will slow down healing or worsen the injury (ibuprofen for a stress fracture)

— BowTied Kobra, Rehab Guy (@bowtiedkobra) March 18, 2023

6. Strength fixes everything

There has never been a single instance in which improving overall strength and power has ever not been beneficial

Improving strength should be the goal of all rehab

— BowTied Kobra, Rehab Guy (@bowtiedkobra) March 18, 2023

7. Rehab should emulate the weight room

Aside from the very early acute phase where an injury is isolated, all rehab should look like a traditional gym session

Some exercises will need to be tweaked to bias certain muscles but the exercises shouldn't vary much if at all

— BowTied Kobra, Rehab Guy (@bowtiedkobra) March 18, 2023

8. Tissue needs to be exposed to all forces

The goal of rehab should prep the tissue for the demands placed on it

Sprinting athlete? Rehab must involve sprinting

Jumping athlete? Rehab must involve plyometrics

— BowTied Kobra, Rehab Guy (@bowtiedkobra) March 18, 2023

9. Diagnosis is not that important

There are a million special tests for the shoulder. Them being positive or not doesn't matter much

What are your limitations? How can we fix that?

Avoid tunnel vision on being concerned with exactly what hurts when it won't change the rehab

— BowTied Kobra, Rehab Guy (@bowtiedkobra) March 18, 2023

10. Systems matter more than injury

The body works in systems. Rehab should be focused on that

Example. The exercises you do to rehab tennis elbow and a wrist sprain are identical

Ankle sprain vs Achilles strain rehab are virtually identical

Rehab the joint vs the injury

— BowTied Kobra, Rehab Guy (@bowtiedkobra) March 18, 2023

11. Mobility over flexibility

Young clinicians obsess over ROM measurements

If you don't have textbook 140 degrees of hip flexion but are able to move through squats and deadlifts with no issue, is that something that needs correction?

I say no

— BowTied Kobra, Rehab Guy (@bowtiedkobra) March 18, 2023

12. Stability comes from strength

The more you can recruit motor units the greater strength you will develop for stabilizing muscles

If you try to train them in an unstable environment, you decrease work output and have less strength gainshttps://t.co/LFeDb3PcYk

— BowTied Kobra, Rehab Guy (@bowtiedkobra) March 18, 2023

13. Unilateral training fixes all

Imbalance? Do single leg training

Injury? Single leg training

This exposes weakness you wouldn't otherwise notice and builds on themhttps://t.co/LTMvFGoAab

— BowTied Kobra, Rehab Guy (@bowtiedkobra) March 18, 2023

14. Don't change too many variables at once

You can change reps, sets, weights, rest time

Change one variable at a time. This allows you to know what was therapeutic

— BowTied Kobra, Rehab Guy (@bowtiedkobra) March 18, 2023

15. Rehab is eval

My first rehab session is always an evaluation

I can get all the info I want from special tests and strength tests but that won't tell me what someone can actually do

Get someone moving, find the limitations and then fix them

— BowTied Kobra, Rehab Guy (@bowtiedkobra) March 18, 2023