Rehabilitation of extreme sports injuries

This paper will focus on a number of specific aspects relative to the type of exercises and the progression of the rehabilitative process for athletes who practice extreme sports. While extreme sport athletes can present with a myriad of conditions that can be rehabilitated and evaluated, for the scope of this chapter we have chosen to focus our attention on four conditions, commonly encountered in these athletes. For the purposes of selection we evaluated concussion, acute anterior glenohumeral dislocations, acute low back pain and the conservative and post-operative management of anterior cruciate ligament compromise in the knee. Extreme sport athletes have special considerations that may not be applied to general population and although literature is limited, generalization from athletic research can be applied. In each area, diagnosis and evaluation are brieflY discussed before transitioning into common rehabilitation principles. All injury sites maintain a common theme and most treatment principles are appreciated throughout the chapter. For example, patients are ruled in for appropriate management in a physical therapists’ offi ce and, if necessary, are referred for surgical consultation. Either once returned post-operatively, or maintained in offi ce non-operatively, principles and treatments should match goals of the athlete. These goals are broken down into primary principles of evaluating impairments and how they relate to participation limitations. Best available evidence based treatments are implemented originally to reduce and manage pain, infl ammation and psychosocial impairments. These are then advanced to progression of improving range of motion, strength/ stability, with fi nal phase of evaluating movement behaviors in area of interest. Finally, protection of injury site is evaluated in breaking down extreme athlete environment and qualitatively and quantitatively evaluated by a team of providers.

This chapter focuses on rehabilitation tactics specific to extreme sports participants and covers various aspects relative to the approach, type of exercises, and progression of the rehabilitative process. Since it would be unrealistic to provide systematic coverage of such a vast topic in the space of a few pages, this chapter aims to cover the fundamental aspects of extreme sports injury rehabilitation by illustrating a select number of conditions which commonly affect extreme sports participants. This chapter will deal with four conditions often seen in the rehabilitation clinic. For the purposes of variety, we have chosen to focus on four different areas of the body - the head, the upper limbs, the lower limbs, and the spine, looking specifically at concussion, traumatic anterior dislocation of the shoulder, rupture of the anterior cruciate ligament of the knee, and acute low back pain.