How Fitness Aids in Rehabilitation

by Bill Sonnemaker, MS, PES, CES, CSCS
2007 IDEA International Personal Trainer of the Year
2007 NASM Pursuit of Excellence Award Winner
IDEA Master Trainer, NASM, NSCA, ACE, ACSM

It is overwhelming to experience an injury that disrupts your life, whether you are suddenly sitting on the sidelines or simply unable to function as you previously had on a daily basis.  The road to recovery is long and rough; along the way you may encounter surgery, a regimen of physical therapy, and lingering uncertainty about your ability to return to physical activity.  Many people feel that their physical therapy was discontinued before they were fully recovered.  Unfortunately, this is a common problem that can suspend the healing process.  If you completed a thorough course of physical therapy but are still concerned about your level of rehabilitation, a new option exists for pursuing further rehabilitation in a fitness setting through a specialized personal trainer. Fitness professionals with specializations in post-rehabilitation, corrective exercise, and biomechanics are trained to understand the conditions leading to your injury, the surgical techniques involved, post surgical complications and their specific role in the rehabilitation continuum.  These innovative health and fitness professionals have the knowledge and skills to effectively develop and implement corrective exercise strategies for impairments of the foot and ankle, knee, lumbo-pelvic-hip-complex, low-back, shoulder, etc.

Many personal trainers work precisely at picking up where a physical therapist stopped, leading you through appropriate progressions safely to improve strength, mobility and flexibility. This is an invaluable resource for individuals following rehabilitation.  Considering the time and financial investment made in your surgery and recovery, if you do not feel 100 percent recovered it is wise to seek post-rehab training with a specialized personal trainer. Look for trainers who possess advanced degrees and credentials such as a CES (Corrective Exercise Specialist) or PES (Performance Enhancement Specialist) from the National Academy of Sports Medicine (NASM). These individuals have had special training in biomechanics and muscle imbalances.  By taking the extra time to do so, you will reinforce, strengthen, and help prevent reoccurrence of injury.

Qualified fitness professionals join forces with physicians and other health professionals to decrease the number of “couch-potato patients.” Your physician may recommend pursuing a fitness program as a pre-operative or post-rehabilitation option rather than simply awaiting surgery or recovery.

Through the combination of exercise, advice, and support, participation in exercise can replace patients’ initial fear with confidence, enabling them to become healthier and modify other risk factors.

Some examples of how a qualified personal trainer can help you recover include: inhibitory techniques such as self myofascial release; lengthening techniques such as static stretching; activation techniques such as positional isometrics; and integration techniques such as integrated dynamic movements.

Supervised exercise programs are highly effective at improving health and rehabilitation outcomes for elderly persons following major joint surgery.

Tasks demonstrating physical function, performance, and positive health outcomes improve through individual training and group training.

Patients recovering from many injuries actively respond to exercise during dynamic weight bearing, which induces physiologic and neuromuscular responses in individuals and may serve as a preparatory program for more advanced rehabilitation.

Restoration of muscle eccentric strength and coordinated antagonist muscle activity should be key points in postoperative rehabilitation following surgical repair.

Forward-backward weight shifting may be preferable in initial rehabilitation after ACL injury compared to body weight shift from side to side.

Balancing exercises on unstable bases (sensorimotor training [SMT]) are often used in the rehabilitation process of an injured athlete to restore joint function. SMT is able to enhance rate of force development (RFD) in a maximal voluntary muscle contraction. Specific neural adaptations indicate that SMT might be used complementarily to BST, especially in sports that require contractile explosive properties in situations with high postural demands, e.g., during jumps in ball sports.

Performing core and back exercises at home together with rehabilitation treatments might be effective and improve function for patients with chronic low back pain.

Flexibility training improves range of motion significantly in patients.

When combined SMR (Self Myofascial Release) and Static stretching result in a significant decrease of the passive resistive torque.

Functional training can help prevent impairment and disability among elders who practice correct execution of locomotor activities of daily living, (including gait, stepping, and sit to stand) or progressive resistive using elastic bands with varying degrees of intensity. Elders can significantly improve their combined lower-extremity strength (hip extension and abduction, ankle dorsiflexion, knee flexion, ankle plantarflexion, and knee extension).

Intensive functional training intervention results in strength improvements of comparable magnitude as those attained from strength training and functional training also confers greater improvements in dynamic balance control and coordination while performing daily life tasks.

Muscle atrophy is clearly related to a loss of muscle torque, but the reduction in muscle size cannot entirely account for the decrease in muscle torque. Reduced neural input to muscle has been proposed to account for much of the remaining torque deficits after disuse or immobilization. Voluntary muscle activation failure and muscle atrophy contribute to loss of muscle torque after immobilization. Both increases in voluntary muscle activation and muscle hypertrophy contribute to recovery in muscle strength following immobilization, with large gains in activation during the first 5 weeks of rehabilitation. In contrast, muscle CSA (cross-sectional area) showed fairly comparable gains throughout both the early and later phase of rehabilitation.

Muscle atrophy is a major impairment that occurs early after reconstruction of the Anterior Cruciate Ligament and can persist for several years. Eccentric resistance training has the potential to induce considerable gains in muscle size and strength that could prove beneficial during postoperative rehabilitation. Eccentric resistance training can induce structural changes in the quadriceps and gluteus maximus that greatly exceed those achieved with a standard rehabilitation protocol. The success of this intervention can be attributed to the gradual and progressive exposure to negative work through eccentric exercise, ultimately leading to production of high muscle force.

If you are searching for a qualified fitness professional in the Atlanta area visit Catalyst Fitness or call (770) 499-9143.  Catalyst Fitness is Atlanta’s only fully-accredited and medically-recognized personal training and performance enhancement facility, designing scientifically-based fitness programs for individuals, groups, and corporate wellness programs.