After most injuries, patients benefit from therapeutic exercises to minimize pain and restore movement. Initial treatment may focus on controlling pain and improving healing of the bone, tendon, or muscles, with the use of ice or other modalities. Once appropriate, exercises will be introduced to gradually stretch and strengthen the surrounding musculature, usually in the form of formal physical therapy or a Home Exercise Plan (HEP).
HEPs are provided with most visits to help initiate the recovery process. These programs are designed to help loosen up and stretch overactive musculature and to strengthen underactive or impaired muscles. They may also target the surrounding area to help improve the stability around the involved joint. HEPs can be beneficial for most patients either in supplement to formal physical therapy or for those that do not need access to more specialized equipment to reach their goals. In some cases, Physical Therapy may be recommended instead of an HEP to provide the patient with a more hands-on approach, in which case a referral will be given.
Range of motion exercises are often prescribed to patients to help improve joint function after an injury. The goal of these exercises is to maintain flexibility and gently increase the range of joint and muscle movement while decreasing pain, swelling, and stiffness. The exercises may vary depending on the part of the body that was injured. There are are three common types of range of motion exercises:
- Passive range of motion exercises are performed while the joint is moved by an assistive device or by a healthcare professional
- Active range of motion exercises are performed solely by the patient moving the joint without any assistance
- Active assistive range of motion exercises are performed by the patient with the assistance of a healthcare professional
Strengthening exercises may also be used to facilitate the healing process. During the earlier stages, motions against gravity and isometrics can be used to activate the target musculature in a safe environment without stressing the involved structures beyond their limit. As range of motion and strength continues to improve, progressions may be made to the individual program. These exercises will be designed to strengthen the impaired tissue and surrounding joints to improve functional strength and stability.
Recommendations may also be made to help alleviate the stress to the injured muscles and avoid re-injury. Formal physical therapy and HEPs are utilized with a focus on helping the patient return to all usual activities. Depending on the severity of the initial injury, the recovery period may vary.
