Sports rehabilitation: Physical therapy and athletic training

UW Health Sports Rehabilitation designed its Optimize sports injury rehabilitation program for athletes who want to continue their physical therapy and rehabilitation program after their medically-based physical therapy program has been completed by their insurance.

About Optimize

• Optimize physical therapy appointments are one hour.

• Appointments are not billable to insurance.

• The cost for Optimize physical therapy is $199, due prior to the appointment.

• Credit cards are accepted.

Post-rehabilitation exercise program

The post-rehabilitation exercise program is designed to meet the exercise, strength, speed, agility and endurance needs of athletes returning to sport after injury. This program is for patients who have completed their physical therapy but:

• Have not achieved all of their personal rehabilitation or sports goals

• Want ongoing guidance as they continue through their sport season or training

UW Health Sports Rehabilitation assists in “bridging the gap” by providing a guided and structured transition from your rehabilitation program to a safe return to sports and an active lifestyle. Our physical therapists have medical knowledge and extensive rehabilitation experience. They carefully assess and develop a safe and effective exercise plan specifically for you based on your individual needs.

Lower extremity performance testing

Our lower-extremity performance testing assesses recovery from injury, identifies future injury risks and allows a more detailed performance training plan/program. Tests include:

• Y-balance

• Biodex strength assessment

• ActiveForce sensor assessment

• Force plate jump test

• Force plate hop test

• Force plate running assessment

• Functional hop tests

Upper extremity performance testing  

Upper-extremity performance testing assesses recovery from injury, identifies future injury risks and allows a more detailed performance training plan/program. Tests include:

• Upper extremity Y-balance

• ActiveForce sensor assessment

• Force plate push-up test

• Functional throwing tests

• Biodex strength assessment

Athletic physicals/checkups

Athletic physicals are focused orthopedic evaluations that occur once or twice per year assessing your movement and joint concerns. Our physical therapists work with you to determine the best action plan. The plan may involve:

• Modifications or updates to your exercise and training program

• A referral to a sports performance, wellness, learning kitchen or spots nutrition program

• A course of physical therapy

• A referral to one of our sports medicine physicians or a primary care physician

UW Health Sports Rehabilitation offers a comprehensive Sports Concussion Rehabilitation Program. Our team, in collaboration with Sports Medicine physicians, evaluates athletes with prolonged concussion symptoms.

About concussions

Concussion refers to a mild traumatic injury to the brain without an associated structural abnormality such as bleeding. It may occur with or without loss of consciousness.

While concussions can occur from direct impact, many occur without any contact to the head. A sudden abrupt stop, such as a fall to the ground or two players running directly into one another without hitting heads, can cause a concussion. 

Statistics 

• Twenty percent of the estimated 1.7 million head injuries that occur in the United States each year are sports-related

• In high school athletes, more than 50 percent have reported a history of concussion and more than 33 percent of collegiate athletes have reported a history of multiple concussions

• Approximately 10 percent of sport-related injuries require hospitalization

• Those who have had a head injury are two to four times more likely to have another head injury 

• The majority of concussion patients recover quickly with rest, but as many as 33 percent may have continued symptoms

Post-concussion Syndrome (PCS)

Post-concussion syndrome (PCS) can develop after a single injury. Broadly defined, the hallmarks of PCS include prolonged fatigue, headache, dizziness, irritability, insomnia, and difficulty with concentration or memory, as well as intolerance to cardiovascular exercise.

The standard of care for PCS has been to rest, both from physical and cognitive activity, until symptoms are resolved. But recent research suggests rehabilitation as an effective way to address the potentially life-altering consequences of a concussion.

Rehabilitation evaluations

Evaluations include a thorough assessment of the whole athlete, with special consideration given to aerobic exercise tolerance, whiplash-like cervical spine dysfunction and problems with vision and balance. Graded exercise testing combined with a thorough examination can help properly classify the impairments underlying PCS. Since no two patients are identical, classification allows for a refined approach to identifying each patient's specific deficits and can lead to more appropriate treatment.

Treating post-concussion syndrome

Treatment is specific to each patient but often includes elements of closely monitored sub-symptom aerobic exercise, manual therapy and therapeutic exercise for spinal dysfunction, visuomotor retraining and balance impairment. Progressive aerobic exercise has been shown to be safe and effective in improving function in patients with PCS.

Most patients are prescribed an exercise program to be performed five to six days per week, with close monitoring of exercise intensity using a heart rate monitor. Exercise intensity is determined during the evaluation, and maintained at sub-symptom levels. Cervical range-of-motion, eye movement and balance exercises may be prescribed, as well.

As patients make progress, rehabilitation programs are fine-tuned to meet the demands of returning to full function in daily life and sport. Additionally, elements of injury prevention, such as cervical strengthening exercises, are incorporated as individuals return to pre-injury activities.

Spectrum is a lower-extremity, group rehabilitation program that combines philosophies of sports training and functional rehabilitation.

UW Health Sports Medicine Sports Rehabilitation and UW Health Spine Physical Therapy offer trigger point dry needling as an effective treatment for muscular pain from sport and orthopedic injuries and conditions.

What is trigger point dry needling?

Trigger point dry needling involves the insertion of a thin needle (monofilament) through the skin without the injection of any drug or solution. The movement of the needle deactivates painful trigger points (knots) in muscle tissue, called myofacial pain.

Trigger point dry needling targets nerve and muscle trigger points that are found in a spinal nerve root segmental pattern. The goal of the treatment is to create a mechanical stimulus – a twitch response – from one or more muscles that share the same nerve supply. The twitch response affects the biochemical and biomechanical properties of that muscle. Most people don't feel the needle penetrate the skin during treatment. Once the needle has advanced into the muscle, it responds with an involuntary twitch and/or muscle cramping sensation.

What is trigger point dry needling used for?

Trigger point dry needling can be an effective treatment tool for acute and chronic pain and rehabilitation from injury. Generally patients have few side effects. Common conditions include:

• Tennis or golfers elbow

• Muscle strains

• Upper- and lower-back pain

• Shoulder pain

Positive results are often apparent within two to four treatment sessions but can vary depending on the cause and duration of the symptoms and overall health of the patient.