How long do I need to be in rehab for?
Injuries suck, no matter how hard you work, in the gym or on the track to prepare yourself for your sport, sometimes they just happen. You can be unlucky, but instead of getting lost and discouraged, you need to see this as an opportunity. There’s an opportunity from these situations to get better in other areas and make improvements that potentially might help you in the future to reduce the risk of injury again, or even work on areas that you might not have been able to work on prior. Therefore it’s important to get help. You need to get the right help from the right people. First point of contact should be a physiotherapist. The physio can also determine what other help might be needed, for example a Sports Doctor’s, Specialist’s help, and a Strength and Conditioning coach to help with that return to performance process.
It’s all about timing
Time frames depend on the injury, and we use timelines as a guide. The reason being, it that there are different healing times for different tissues, i.e. muscles have a 7 to 21 day healing capacity, depending on the severity of the injury), tendons take a little bit longer, potentially up to 12 weeks and bones can be similar, depending whether it’s an upper limb or a lower limb. Healing is only one part of the injury, most injuries don’t heal stronger than when they were before (bones are the exception here). Even when you have a bone injury the muscles around that bone, waste away due to the long periods of immobilization. The bone might be healed, but now the soft tissues that helps support that bone and that skeletal structure now might be seriously deconditioned, so you have to spend some time reconditioning those muscles and tendons. Unfortunately, a lot of people view an injury, like “how long is this gonna take?” and they just rest, waiting for that injury to recover. Early on rest is going to be necessary however, if you return straight to sport after that, without doing any rehabilitation, you are now going to be at a greater risk of re-injury, or even getting another injury. If you keep doing this process, you’re gonna get into this constant loop of getting injured, healing, play, injured, healing, play.
Work on the rest of your body
The first phase of injury recovery is repairing/healing, you do need to let the injured area actually heal. Having said that though, you still have other limbs that are not injured for example when you’ve hurt your ACL, that’s only one knee. You have three other limbs in our trunk that can still be worked out really hard, and you get really great carryover from working out those areas as well. This is very important for when you start the rehabilitation process, so your body can easily adapt to the har training you’ll be doing, plus, you don’t want to decondition the non-injured limbs. If you have a lower limb injury, it’s a great time to get strong and build your upper body up. If you have an upper body injury, it’s a great time to build the legs. This is why you need to see injuries as opportunities – a time to build other areas.
Build and Integrate
Once you’ve gone through this repair and healing phase, the physio can determine what you need to work on for your specific rehab exercises. The aim of this phase is to build the injured area back up so it can tolerate more load. The outcome goal for this phase is re-integration back into sport specific movements/training. You don’t want to just jump straight in, you’ll need to expose yourself to running, agility, speed, and sport specific skills in a controlled manner. When you feel comfortable you can start to introduce some low level sport specific training, and then slowly build that up until you get to full training. At the stage it is critical to be patient, you’ll be feeling really strong and fit but your going to need to spend some time completing full training, unrestricted, before you can return to play. Accumulate as many full training sessions as possible, when you and the Physio feel confident you’ve completed enough unrestricted training and neither of you have doubts, then you can return to sport. Do not underestimate the psychological side of an injury, it can play a huge role in determining whether someone is actually ready to return to sport. Ideally, you want to be returning either within 90% of where you were before, or even better again.
Return to Performance
You can use your goals and your targets for this return to performance, so if you’ve got pre-injury data, you can use this to determine whether you’ve done enough, (are you hitting good strength targets, are you hitting really good conditioning targets, and have you completed enough full training). The thing you don’t want to do is go purely off injury-recovery time. As mentioned before, you want to avoid the mentality of “I’m just gonna rest it and doc said it takes 3 weeks for this to heal”, and then jump straight back in. Use the process described above – repair/heal > specific rehab > integration > return to sport. This process is what determines your timeline, so it’s less about the pure healing of the injury, it’s more about, how long will it take you to get back to your best, to actually be able to return to sport, and be a low risk of re-injury, or injuring another body part.