Dengan Nama Allah,yang tidak memberikan mudarat sesuatu di bumi dan juga di langit dan dia maha mendengar lagi maha mengetahui..

Monday, December 7, 2015

Physiotherapy and Return to Sport after injuries


Tips for return to sport

Bismillahirahmanirahim..
Return to sport is both the ultimate goal of rehab
A source of doubt and worry about the uncertainty of injured athlete’s abilities to return to a level at or above where they performed prior to the injury

Approaches
It can be threat
·         Low confidence
·         Decreased adherence to rehab
·         Increase in pain
·         Display avoidance behaviors
·         Increases anxiety
·         Reduced motivation

It can be challenge
·         Positive attitude
·         High motivation
·         Excitement
·         Increased effort in rehab
·         Greater desire to return to sport
·         Over adherence to rehab
·         Greater risk of reinjured due to premature return

Stages of Return to Sport
1.      Initial Return to Sport
2.      Recovery confirmation
3.      Return of Physical & Technical Abilities
4.      High Intensity Training
5.      Return to Competition

Initial Stage
·         Considered to be the most difficult
·         Athlete quickly determines the effectiveness of the rehabilitation
·         Entire stage should include a series of tests of the healed area
·         Athlete’s expectation are:
·         They will perform at the same level as prior to the injury
·         Pain will not be present
·         Discussion with the athlete are needed to examine their expectations.
·         A concern of AT is that athlete become “overzealous” in their approach to train and compete.
   
Recovery Confirmation
·         More psychological than physical
·         Involves the athletes’ obtaining evidence from initial stage that the injury is healed and ready to face the demands of the sport participation
·         This is considered the make or break period
·         Athlete’s initial play will confirm their attitudes and approaches
·         Success will lead to higher levels of self-confidence and motivation
·         Injury does not swell, no pain, full range of motion,
·         Self-confident and motivated
·         Not being successful will lead to doubt if they will be able to return.
·         Swelling occurs, unexpected pain, little range of motion, decrease strength
·         Highly anxious and depressed

Return of Physical & Technical Skills
·         High intensity training marks the absolute conclusion of athlete’s identification that they are fully healed.
·         Re-establishment of their regimen of physical conditioning and technical training
·         Major psychological concern is their level of perceived preparedness:
-                      Provide a safe,
-                      progressive conditioning program developed by the AT or physical trainer

Return to Competition
·         First post-injury competition is key concern:
·         Athlete is usually more anxious than at any other time
·         Initial uncertainty
·         Athlete may have a distorted perception of the probability of the injury occurring again.
·         Need to discuss with the athlete’s their attitude and feeling about the upcoming competition
·         Athlete should not be thinking negatively
·         Athlete needs to redirect their focus to their skills, game strategy, and goals.


Fear of Injury: A Major Concern
·         Perception that recovery is incomplete,
·         returning to sport to soon,
·         impatient in returning to sport,
·         lack of acceptance of the risk of the sport,
·         low confidence,
·         highly anxious,
·         and preoccupied with being re-injured
  
Prevention of Fear of Reinjury
·         Continue involving in the sport during rehab
·         View rehab as a form of athlete performance
·         Becoming involved with a coping model
·         Performance imagery
·         Give the athlete time to progressively regain their physical, psychological, and technical skills.

Treatment of Fear of Injury
·         Need to take a proactive approach to alleviate the fear
·         Athlete needs to face a similar situation as when the injured occurred.
·         Rational self-talk helps the athlete refocus
·         Simulation practice
·         Relaxation techniques
·         Athlete establish pre-competition and competition routines

Self-Determination Model & Return to Sport
Ryan & Deci (2000) focused on:
·         Competence,
·         Autonomy, and
·         Relatedness in explaining the athlete’s return to sport.
·         From the self-determination perspective, the success of an athlete’s return to sport from injury is related to meeting these psychological needs

Competency Issues
·         Athlete’s fear and concerns of returning to sport
·         Loss of enjoyment because they could not participate in the sport
·         Injury blocked their short & long term goals
·         Letting down others, teammates, and coaches          

Issues
Competence Issues
  -  Fear related to returning to sport
  -  Injury blocked  their sport goals
  -  Overcoming their fear of reinjury
Relatedness Issues
 -  Feels of separation from team
 -  Support in re-entry into sport
 -  Having role models
Autonomy Issues
 Sense of personal control
- Pressure to return to sport

Implications
Regarding the assistance and management of athletes returning to sport following an injury:
Rehab environments meet these three basic needs of the athlete by:
1.      Implementing goal-setting
2.      Giving the athlete choices when to return to sport
3.      Provide role models
4.      Rehab progress should be safe and successful

wallahuaklam

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