Step #3

Injury Rehabilitation


3. Restoring  physiological functional capacity and individual skills to return to play.

The single most important ingredient in the rehabilitation of any bone or joint injury is safe and appropriate exercise at each stage of tissue healing (early, middle, late). The earlier a patient is able to start exercise and the   more rehab exercise a patient can do at home, the faster they’ll return to work or sports.
The Importance of Exercise Rehabilitation

There are two phases to managing any musculoskeletal injury; (1) the restoration of anatomy (repair tissue formation and maturation to withstand load) and (2) restoration of physiology (rehabilitation to return to full function).

In order to allow tissue healing to take place, there is always a period of protection at the site of injury.

Protection typically takes place through some form of immobilization (sling, brace, cast, etc).

The purpose of protection is to create the right environment for sufficient primitive healing to take place before removing the protection.

Unfortunately protecting an injury results in disuse atrophy (weakness & loss of mass) of surrounding muscles,loss of muscular power and endurance,  joint stiffness, loss of proprioception and motor program performance (individual work or sports skills).


Returning to work or sports without restoring full motion, flexibility, strength, endurance and motor skills increases the risk of sub-par performance and the risk of re-injury.

Warning: Inappropriate exercises for your condition can cause re-injury and make your injury more severe (worse).
Active exercise is required to restore the effects of protection (see above).
As a rule, the earlier that exercise can be re-introduced at the site of injury, the better.
Unfortunately doing inappropriate exercises or too much exercise can actually cause more tissue damage and delay healing.
Exercise selection and dose is determined by a variety of biological factors related to the diagnosed condition, time and a patient’s profile.  One type of exercise may help one patient but make another patient worse.
Personal Training is not Physical Therapy.
Your safety is always the top priority when exercising, especially with a known medical condition, if you are taking medications, after an injury or after surgery.
Regrettably, one  of the most common causes of recurrent pain and injury, is performing inappropriate exercises and/or exercises at an inappropriate dose to early after injury. This often occurs when patients download rehab exercises off the internet or hire a personal trainer.
Personal trainers are not licensed healthcare professionals and there are no educational requirements  to call yourself a personal trainer. Personal trainers are not governed by a licensing body, there is no medically recognized certification and trainers not required to carry professional (malpractice) insurance. In other words, anyone can call themselves a personal trainer.
Although personal trainers can be very helpful there is a difference between ‘exercises to get fit’ and ‘rehabilitative exercises’.
The science of rehabilitative exercise is;

  1. Knowing whether an exercise is appropriate or inappropriate for a given condition and a client’s medical profile at a given stage of tissue healing or
  2. Knowing whether the dose of a given exercise is appropriate or inappropriate  for a given condition and a client’s medical profile at a given stage of tissue healing.

Rather than trusting exercises from a website or a friendly personal trainer, we strongly encourage you to ask your family physician or physical therapist for the name of an individual personal trainer  in your community that they trust and recommend you to work with.  Ask your family physician or physical therapists to write your personal trainer a note outlining your condition, your medical profile and any contra-indicated exercises they feel are too risky to perform for your condition.