Nothing is more frustrating than being sidelined from our normal activities by injuries. From sprains and strains to broken bones and surgeries, the path to rebuilding our strength can be enhanced with proper physical therapy and post-rehab training.
Once doctors are done with us, we find ourselves in the care of physical therapists to restore mobility and movement in our healing limbs. But is that the green light to dive right back into our active lifestyles?
Each year, the number of Americans who end up in the hands of physical therapists is growing. And as Baby Boomers continue to age up and lead active lifestyles, the demand also increases for post-rehab strength training to bridge the gap to fully active lifestyles. More than 60% of injuries that occur each year in the United States are musculoskeletal in nature.
Road to Recovery
For 59-year-old cyclist Marian Pease, post-rehab training is a logical step.
She is in month seven of recovery following a bike crash in February that required extensive shoulder surgery. Even more recently, she is recovering from emergency abdominal surgery.
“I was in physical therapy within two weeks of the shoulder surgery,” says Pease. That process continued for more than five months, as she worked to re-establish range of motion to support everyday household activities. She describes the goal as “occupational mobility.”
“When I finished, I could accomplish all of those normal household activities, but I wasn’t fully healed yet,” she says. And she wasn’t nearly ready to resume her regular training as a road cyclist, an activity about which she is passionate. “I still didn’t have full range of motion and was told it would be about a year. If you are an active person, then you need to do something else.
That’s when she sought out a post-rehab physical therapy and strength-training specialist. “I recognized I can make a lot more improvement,” says Pease. “Where I’m at is not acceptable for what I want to do. I don’t want to sit in a rocking chair.”
Like many of us, Pease knows exercise supports healthy aging. And no matter what type of injuries we are recovering from, sometimes initial physical therapy isn’t enough.
That’s where a post-rehab trainer comes into the picture to bridge the gap between physical therapy and the conditioning necessary to return to an active, athletic lifestyle.
“Essentially, post-rehab training is the continuation of physical therapy without the physical therapist,” says Suzi Parmentier, a certified post-rehab trainer in Scottsdale, Arizona.
“When a patient undergoes weeks and months of therapy to recondition the body, ceasing therapy can send them backwards in all the progress they made during their time in physical therapy sessions.”
Goals of post-rehab training are tailored to the individual client and focus on getting back to the activities of daily living, the specific sport that they are involved in, and resuming a pain-free lifestyle, Parmentier says.
“Plain and simple, I have seen it time and again that clients are not performing the therapy or exercises properly when left on their own,” she says. “As a post-rehab trainer, I assist with proper form and biomechanics, adherence, motivation, and frequency. Sometimes that transition is hard for people when they don’t have a standing physical therapy appointment any longer.”
The bottom line is post-rehab training provides structure, a properly planned progression and the education people need to continue to improve strength and performance after an injury or surgery.
Ask the Doctor
Dr. Kevin Sherman, a sports Chiropractic physician, Active Release Therapy practitioner, and owner of IronCare Sports Therapy, agrees. When an athlete suffers a traumatic injury, the road to recovery can be a long one, he says.
“However, what I see all day long is people trying to speed up the healing process, and they tend to overdo it. The body is going to heal as fast as it wants; you can’t speed it up without risking re-injury,” says Dr. Sherman.
Dr. Sherman describes the body’s three phases of healing.
- Acute – Tissue damage, inflammation, swelling, bleeding are characteristics of the acute phase. Duration: 24-72 hours.
- Repair – Tissue begins the healing and repair phase. Duration: 72 hours to 16 weeks.
- Remodeling – In the remodeling phase, the body works to restore the tissue to normal tolerance levels. It is not yet strong enough for sustained physical stress. Consider it newly repaired tissue that must be retrained and strengthened. Duration: Up to two years.
Too Much Too Soon
Dr. Sherman warns that biting off too much too soon comes with risks. “If people re-injure the tissue during the repair phase, the healing response will not be as robust as it was after the initial injury. This can lead to incomplete healing, and permanent damage.”
At the same time, keeping healing muscle tissue in motion is vitally important to long-term recovery. “If tissue doesn’t move during the repair phase, it will be prone to re-injury,” he says. “It will not completely repair – or remodel – adequately enough for the repeated stress of training or other athletic activities.”
Dr. Sherman is a proponent for post-rehab physical therapy and strength training. He recommends that following discharge from traditional physical therapy, we continue the process under the watchful eye of a certified post-rehab trainer or coach.
Injuries are frustrating, no matter how minor or severe. In all cases, patience is key. “Some people get out of (traditional) physical therapy, and go straight back to 100 percent volume and intensity. Not surprisingly, they wind up getting hurt, and sometimes the new injury is worse than the first one,” Dr. Sherman says.
Rather, we have to slowly and safely increase our activities. And enlisting the services of a trainer who specializes in corrective exercises can be very beneficial. “These trainers can spot and correct imbalances and compensatory problems very quickly,” he says. “They have a lot of experience in gauging how much people can tolerate and they have experience with injured athletes.”
As strength gains return, also respect your body’s need for rest. “I always say to my patients that all of the changes our bodies make in response to exercise occur during rest. And that’s especially important as we age. Our bodies require programmed rest.”
Support Healthy Nutrition
If an injury forces you to take a break from exercise, Dr. Sherman also advises paying close attention to your nutritional needs. “Watch your diet and focus on remaining healthy in other ways while recuperating.”
Dr. Sherman recommends added Vitamin C while injuries are healing. “It’s essential to aid soft tissue recovery of an acute injury.” Megadoses are not required. Most healthy adults do not need more than 500 mg per day.
And finally, have a Plan B in place to get you emotionally through the down time. If running is out, then head to the gym and hop on an elliptical trainer or a stationary bike. Even a short walk will make a world of difference and help keep blood flowing to injured tissue.