By Mary Finck, PT, DPT
There are many benefits of exercising after acute injury, or following an orthopedic surgery, that are preceded by the concept of rest for recovery. It is common for people to take time off to heal the involved body part, but often forget that other parts of the body have not been affected by the injury. There are multiple reasons why continuing high intensity whole body exercises is important, especially athletes who are conditioned and plan to return to playing a sport.
There are multiple physiologic benefits to exercise that facilitate the healing process. In general, strength and endurance levels can decrease over a 2-3 day period, so it is crucial to begin re-training from day one. Exercise, with proper modification according to the location of the injury, can help normalize movement patterns and maintain strength/endurance in the body as a whole. Additionally, exercise will cause an increase in heart rate and cardiac output, which will in turn increase oxygenated blood flow to the injured tissue and speed up the healing process. An interesting concept called the “Cross-over Theory” states that if an individual strengthens one extremity, the opposite limb will increase muscle strength through neurofacilitation. This concept explains why if you have a knee injury, it’s equally important to maintain strength on the opposite leg.
Another important part of exercise that helps with the healing process is the activation of the immune system. Exercise will cause a release of endorphins in the body, which will activate the sympathetic nervous system. This keeps the body in a heightened state of arousal and will give you energy to continue exercising. This increased immune response will help with inflammation of the injured body part as well.
Keep in mind there are other important factors that can affect healing. Factors such as proper nutrition, sleep, stress, immobility, high blood pressure, chronic use of NSAIDS, and psychological state play a roll in recovering from an injury. Continuing high intensity exercise after injury is especially important for the psychological well being of an individual. Rather than identifying with being “a person with an injury,” one can continue exercising with the proper modifications to stay in shape and avoid deconditioning with the intent to return to sport or prior activity level.
Here are some important things to remember. Be sure to check with your physical therapist before engaging in intense exercise after injury to make sure you are modifying things appropriately and prevent further injury. Begin with a 5-10 min warm up, so that the heart and circulatory system are not suddenly taxed. Cool down is important as well to reduce abrupt physiological alterations. Resistance levels vary based on each individual’s body type, prior level of fitness, and pain intensity. The two following circuits were designed to incorporate the idea of whole body work out for a high level athlete after injury.
Circuit #1 – Post-op Rotator Cuff Repair
3 rounds for Time
- Bike Sprints
- 20 sec on 10 sec off – 4 min total
- Single Arm Kettlebell in uninvolved arm
- X 10 reps
- Lunges with Kettlebell in uninvolved arm
- X 11 reps
- Alternating Step Ups
- X 12 reps each leg
- Single Arm Clean and Press
- X 13 reps
- Lateral steps with Kettlebell
- X 14 each leg
Circuit #2 – Hamstring Tear – Injury 3 days ago
Total Circuit for Time – 30 second rest in-between exercises
- Rowing Machine with Uninvolved Lower Extremity
- 100 meters with 30 sec recovery rest x 10 = 1000 Total Meters
- Pull-Ups
- 20 sec on and 10 sec off x 8 round with 30 sec rest
- Push Ups
- 1,3,5,7, 9, 11, 13,15 reps
- Abdominal Crunches
- 15,13, 11, 9,7,5,3,1 reps
- Uninvolved Single Let Squats
- 2 x 10 reps
- Overhead Press with dumbbells
- 20 sec on 10 sec off x 8 rounds
