Rehab--Are You On The Road To Recovery?

by Greg Siller


Note: This article comes primarily from the hockey/sports perspective, not the medical perspective. You should consult with a professional medical provider/certified personal trainer during your rehabilitation and post-rehab conditioning program.

This article is very important to all athletes who have been injured and are wondering what it takes to get back into game shape. As you should know, injury is a part of participating in any sport (hopefully a small part). Although sports programs should strive to make safety their number one consideration, there will always remain risks while competing.

In the sport of hockey, players feel the effects of risks in the form of minor injuries--such as bruises, sore muscles, and cuts--all the way to severe injuries, such as concussions or broken bones. Typical hockey injuries that fall between these two extremes include the Unlucky Seven. They are:

  1. Torn ligaments/tendons in the leg
  2. Sprained knee
  3. Pulled groin muscle
  4. Abdominal muscle tear
  5. Pinched nerve or herniated disk in the back
  6. Broken arm or leg
  7. Dislocated shoulder

If you have ever had one of these injuries (my injury was #5), you know that your priorities get rearranged for a period of time. You also have come to the disheartening realization that you won't be playing hockey (or even skating) for several weeks or months. So now that your equipment is collecting dust, how can you focus on healing?

The full road to recovery is defined by four phases. These four phases are diagnosis, initial recuperation, physical therapy, and competitive conditioning. At a minimum, players will progress through the first two phases. These are usually players who were not seriously injured (don't require surgery or physical therapy) or don't feel the need to improve over their pre-injury condition. Players who were more seriously injured, required surgery, or feel the need to improve are more likely to progress through either three or all four recovery phases; allowing them to become more physically and mentally prepared for future competition.

Phase 1 - Diagnosis. The seven injuries identified above (Unlucky Seven) are all serious enough to require professional medical attention. The diagnosis phase marks the point at which your medical provider assesses your current condition and helps establish your short and long-term rehabilitation goals. In addition to the initial medical evaluation, an X-ray, MRI, ultra-sound, or physical testing may be required to complete your diagnosis and to ensure that a proper course of post-injury care is determined. In some cases, a cast or other supporting/containment device may be required, and surgery may also be needed if your body cannot heal by itself. This phase may last from 1 day to two weeks or more (if surgery is required).

Phase 2 - Initial Recuperation. Once your condition has been diagnosed and your medical provider has helped set the healing process in motion, you will need to make some changes in your life to allow your body time to properly heal. These changes can sometimes be mentally difficult for players because of their confidence and feelings of invincibility (this could never happen to me!). Phase 2 should not only allow your body time to heal but also give you time to think about how you can improve, both physically and mentally. This phase can last a couple of days to several weeks or months, depending on your specific condition. The three most important steps in this phase are; rest and temporary immobilization of the affected area, proper nutrition, and evaluating and setting personal goals.

  1. Rest and temporary immobilization of your affected area(s) are extremely important steps in the initial recuperation phase (they also take some time to get used to). By not relying on or using your injured area(s), you are giving your muscles, ligaments, tendons, bones, etc. the opportunity to repair themselves and get stronger. If your nervous system is functioning correctly, your brain will be spoken to loud and clear (through the feeling of pain) if you try to work your affected area. Listen to your body and try not to use your affected area until you have given your body time to initially heal.
  2. Proper nutrition is very important to the healing process because it provides your body with the vitamins, minerals, and other essential ingredients it needs to heal as quickly as possible. During your recuperation phase, examine what you are putting into your body, and think about whether it will help your body get stronger. By giving your body what it needs to more effectively facilitate the healing process, you will find that you may get better faster and, as a side benefit, develop some better eating habits. If you want more information, check out my nutrition web page.
  3. Evaluating and setting personal goals provides you with two things. First, it is a positive outlet for dealing with the frustration and anxiety of being injured (a form of mental recuperation). Second, by establishing goals, you are thinking about how you can improve yourself. This is an important and positive step in the rehabilitation process. By thinking about your future goals, you will not spend too much time thinking about the past (something you can do nothing about). If you want more information on mental conditioning, check out my web page.

In some cases, this phase may be the end of the road for your rehabilitation. If your medical provider has given you the green light that your injury has sufficiently healed, you may feel that you are ready to play hockey again. However, even if physical therapy (phase three) is not required for you, you should consider jumping to phase four and evaluating whether (and how) you can improve your physical/mental conditioning.

Phase 3 - Physical Therapy. Following your initial recuperation period, you may be required by your medical provider to participate in some form of monitored physical therapy. Physical therapy (PT) is designed to help you improve your physical functioning (mobility/movement, strength, flexibility, balance, coordination, etc.) via such methods as exercise, heat/ice therapy, and electrical stimulation. PT for a recoverable injury may last from two to eight weeks or longer.

During your PT sessions, your therapist will assess and work with you to determine your levels of movement, strength, flexibility, etc. and design a program to improve your weakened area(s). You should remember that during this phase you are still recuperating, which means that you will be limited in your capabilities and will feel some discomfort and pain as you are recovering. As your pain diminishes and your physical condition improves, your therapist can gradually increase your activity level; getting it closer to normal. Be patient and mentally strong during this phase; challenging yourself to constantly improve, but not too quickly.

Although PT is used to help you improve, it is usually only designed to get back your normal body functioning. However, when playing sports, you need more than ordinary or normal functioning; you need to be extraordinary! What I mean by extraordinary is that during a typical hockey practice or game, you will work your body well beyond what you would put it through during an ordinary day (more than just sitting, bending, standing, or walking). You are extraordinarily stretching your muscles, ligaments, and tendons; twisting and applying extreme forces through your entire body, and working your heart and lungs at rates far above normal. To accomplish this, while minimizing the stress on your body, you need to be in extraordinary condition.

Phase 4 - Competitive Conditioning. Following the completion of your monitored PT phase, you will come to a crossroads in your fitness future. Although you now may be medically cleared to participate in sports...are you ready to be competitive? Are you strong, quick, flexible, and do you have the stamina it takes to fully handle the stresses that come with playing your game?

Competitive conditioning plays a vital role in the development, ability, improvement, and success of every hockey player. It prepares your body, as well as your mind, for the demands of each hockey event; whether it is a practice, game, or national championship. Three elements of competitive conditioning that will improve your overall ability to reach your best include flexibility conditioning, muscular strength and endurance training, and cardiorespiratory conditioning. Establish a competitive conditioning program with a certified personal trainer to get the most out of your program.

Flexibility Conditioning is designed to improve your muscle, tendon, and ligament range of motion, lubricate your joints, and reduce the risk of injury by warming up (increasing blood flow to) muscles and support tissue. This translates into providing your body with the ability to start and stop, turn, contain an opponent, or get off a quick shot. If you want more information on flexibility conditioning, check out my web page. 

Muscular Strength and Endurance Training. Getting the most from your muscles will allow you to develop the ability to play strong hockey for extended periods of time (such as through a multi-game tournament). It also helps protect a player from injury and is essential for developing power, quickness, agility, and speed. Upper body strength and endurance are important for shooting, puck control, and agility. Leg strength and endurance are important for balance and powerful skating ability. If you want more information on muscular strength and endurance training, check out my web page.

Cardiorespiratory Conditioning. Your muscles and lungs must be well conditioned to process oxygen and fuel required by the body throughout the entire game. A strong cardiorespiratory system performs the following roles:

Improvements in your cardiorespiratory conditioning will allow you to quickly move past opponents, win face-offs due to quicker reaction time, and help keep your energy level up during overtime.

It's All Up To You. The full road to recovery is more than just getting back to where you were--it means getting even better!

Contact Greg Siller @ Pro Learning Systems