Info – Treatment Progression
Your rehabilitation/therapy will follow a progression that will allow you to reach your goals to improve your mobility and function, so you can return to a healthy, active lifestyle.
We go through 5 phases or levels as your body heals and recovers from your surgery/injury:
Phase 1 / Level I – Decrease inflammation, pain and swelling.
Examples: Using ice, elevating the extremity that is swollen, light massage, gentle exercises to make your muscles act as a pump to “pump” the fluid back into the lymph glands to “digest” it, and rest.
Treatments: Includes procedures such as gentle exercise movements, aqua therapy or modalities like ultrasound, electrical stimulation, microcurrent therapy, low level laser, cold/ice, compression, elevation and splinting/taping.
Phase 2 / Level II – Restore pain-free range of motion.
Examples: Increase your flexibility so that the muscles and other tissues don’t get too tight and cause pain or problems in moving normally.
Treatments: Mobility exercises are introduced to maintain any pain-free motion that you currently have, and to begin to improve on that range of motion to limits that are considered within normal or functional limits. Some of the guidelines used are as follows:
- Short arc range and slow movement → pain avoidance.
- Short arc range and fast movement → stimulate nervous system.
- Long arc range and slow movement → strength-stability.
- Long arc range and fast movement → normal function.
Sometimes your therapist will use manual procedures to assist you in getting back to more normal movement.
Phase 3 / Level III – Improve muscular strength.
Examples: So that you’re injured side is as strong as your other side and as a whole you are as strong, or stronger, than you were before surgery/injury.
Treatments: Exercise techniques that allow for tolerable loads or resistance to be used to begin stimulating muscles and the nerves that innervate them. A simple progression within this context is using light loads with small, slow movements and progressing to moderate loads with large, faster movements – kind of like a “super” Phase 2 / Level II!
Phase 4 / Level IV – Reconditioning for a complete return to normal function.
Examples: So that you can get back to doing what you like or need to do in a safe and efficient manner.
Treatments: Will involve more compound exercises that use multiple joints and large muscular groups. This phase of rehabilitation can also incorporate the use of sports medicine and training techniques to really get you moving. A lot of activities in Phase 4 would be more specific to achieve your personal goals – ones that you have set with your therapist. They also include what is known in physical rehabilitation as “Level IV” activities, which are designed to improve upon overall fitness.
Phase 5 / Level V – Independent wellness attainment.
Examples: Exercising at a level that will promote optimal well-being, and this would be like “working-out” on your own or with minimal supervision, like at a spa!
Treatments: Independent strength and conditioning exercise – like working out on your own at a local gym, or better yet, participating in ESO’s “Beyond Rx (Therapy)” program!*