Rehab Scheduling

Career Interrupting Injuries
P lanning and Scheduling Rehabilitation

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Injuries
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History

So you've gone and hurt yourself and are out of action for at least a month. Your leg looks bad and you feel worse. You wish you could turn the clock back so you have one more chance to back off on trying to ollie that open manhole that was so inviting and challenging. You didn't mind swallowing a little sewer water, it was snagging your leg on the ladder on the way down that created a real problem.
But seriously. Those times that you're injured, especially at the beginning of the comeback trail, can be the darkest and most depressing days of your life.
If I'm serious about a sport, I usually go by the work ethic pattern that sports are 80% work and 20% fun. In the case of an injury, the pattern becomes 100% work, 0% fun. That is a dark realization, when something you do for recreation suddenly becomes nothing but work, and painful, tedious work as well. You can see why so many people can't come back from a career interrupting injury, or why their rehab is rushed or sloppy. They are trying to get back to the state where the sport was fun. It's a long road back, and much harder and more mentally demanding than normal training.
Some of the depression of the comeback trail can be alleviated by changing your attitude toward your goals. Your goals as far as your level in your sport have now been put on hold. Your goal is now to come back from this injury without reinjury. Accept the state of being injured, and look at it as a challenge. If you have any kind of longevity, you'll have to do this again and again. It isn't any easier the second time. But you do have experience on your side, and more will power from having gone through it before.
You can divide the rehab schedule into five parts. Let's assume this is a leg we're talking about, because with a wrist injury, you might be back skating with a cast the next day.
Patching and rest. You wear your bandage, cast, or tape and lay off it for a while.

Restoring range of motion. This is done mostly by stretching. No weights or skating in this period.

Exercise and strength building. Light weights are used. Slow skating begins at this time.

More aggressive training. Healing should be pretty far along and no reinjury should have reoccurred. Free weights are used. Exercise becomes more strenuous.

Testing the injury. Training exercise is directed at the injured area, but in a controlled situation. Skating is pushed toward the level where you were before the injury.

Let's take the case of a strained tendon in my left knee. The doctor or physical therapist finds that it is strained but not torn. No surgery will be needed, but painful rehabilitation will be needed to bring it back.
I pushed through the five phases of the comeback trail. It took about three months. As I remember it, this is what I did. I'll use present tense, like a journal, because this is how you'll have to look at it if you're going through it.
Phase One, patching and rest.

The only immobilization I use is a neoprene brace. I use ice to keep the swelling down. After a few days I don't see any swelling so I switch to warm compresses or hot showers to improve the circulation and make it feel better. I try to eat right. I walk on it as little as possible. The flexibility and range of motion is very poor. It is stiff. Walking is done with a stiff legged limp.
Phase Two, restoring range of motion.

I begin this after about a week of staying off it. I do a lot of these exercises in bed, where it's easy to keep the knee warm. I also use a mat on the floor. I simply fold the knee as far as it can go without extreme pain. Then I stretch it out. I do this repeatedly, using my arm strength to help the leg motion. After a while I use the leg strength only. After simple movement can be achieved, I change the angle that the knee moves, moving it to the side. The directions I exercise it include most directions that it would move in skating.
I find that there are certain movements that are incredibly painful. Obviously this is where the rehab is going to run into problems if there are any down the road. I try to work on these movements a little each day, stretching the tendons gently.
Phase Three, exercise and strength building.

After having restored much of the range of motion of the knee and reaching the point where I can walk comfortably, though not free of pain, it's now time to exercise with more than just stretching. In the case of this knee injury, this is after about a week and a half or two weeks of phase two exercise only.
I think this phase of the program is probably the most painful. It's excedingly boring too. It really tests your will. If you don't have a lot of natural discipline, try to gather what you have at this point. Personally, I think boredom is what causes reinjury and not fear of pain. Athletes have too much tolerance for pain and not enough sense to avoid it by sticking to boring technique and training methods. You don't have to push yourself through pain so much as you have to just keep at it, day after day.
Skating is a ways off. Depression lurks constantly in this phase. There's a lot of "what if", and "woulda shoulda" going through your mind. You just have to go through it, and try not to get discouraged.
You're unlikely to reinjure yourself during this phase. You're in more danger during phase four and five. But you're more likely to get bored and discouraged during phase three, which will lead to rushing and a reinjury during a hastily entered phase four. Just watch more TV while working out. Really get into that TV crap, while you're on the floor doing those exercises. Don't use your mind for much other than keeping track of sets. Don't watch skate vids. That may rush you. Try to not rush it. Don't be in a hurry, try to make the process thorough, and draw it out. Give yourself plenty of time to heal.
Rather than weight machines, I prefer to use weighted ankle straps. They are just a few pounds by themselves. I put on the weights and put the leg through some simple motions.
I use simple leg lifts and circles with only these light free weights. I do these exercises in sets of twenty and try to add more each day.
Once these exercises can be performed comfortably, I attach small weighted discs to the straps. Then I repeat the same leg lifts and circles. Gradually I add weight. These exercises with simple gear work better than complicated gym equipment, because you use a variety of motion and don't add weight too fast like you would in the gym. This routine works great to strengthen damaged tendons and joints without putting a lot of strain on them.
The details of these exercises are given in the routine section.
At this time I also use training exercises such as jumping rope, slowly. I walk fast or jog. I begin to skate slowly, on flat ground or a bike path.
Phase Four, more aggressive training.

This starts after close to a month after getting hurt. I'm now pretty confident that I'm going to restore the knee to better than it was. The tendon still feels sore, and I can feel the ligaments when I rub the area. It feels pretty strange, but it is tolerable. I now have full range of motion and can stretch up into a jumping motion.
I build my routine around exercises that involve jumping for rehab. I use jump rope and elaborate jump rope patterns. I like to jump using a basketball backboard for a target. I also start to use benches or curbs to begin easy jumping exercises to build knee and surrounding muscle strength.
The details of these exercises are given in the repetetive exercise routine section.
This sort of jumping is very controlled. It's boring, but it's pretty safe. It's a lot safer than just going back to jumping on a skateboard, where a loss of control is likely.
I am back to skating three or four times a week, under control and at moderate speed.
Phase Five, testing the injury.

Skating begins more intensely at this point. Braces or other forms of limitation of movement are used. Where I would normally wear shorts, I wear pants, to check some of my range of motion.
I begin intensive jumping exercises, using benches, picnic tables, and logs or parking blocks to jump onto or around. I specifically put pressure on the injury, but in a very deliberate and controlled way. I want to see how it's holding up in a very controlled situation. As it passes each test, I loosen up and try the manuever with more energy.
The details of these exercises are given in the repetetive exercise routine section.
Eventually I take the braces off, put on shorts, and try to use the leg under normal workout conditions.
Another method I use is to wear the brace through the warmup and peak of the workout. Then I take off the brace for the warmdown section of the workout. This prevents against developing too much dependency on the brace, thereby weakening the joint. If the joint is taped, I cut the tape off 2/3 of the way through the session and warm down untaped.
Weekly schedule

It is probably a really good idea to try to schedule your rehab. Write it down on a piece of paper, or at least keep in mind where you are in your schedule for the week.
Making a schedule occupies your mind and forces you to treat the rehab as work and not some kind of failed play which will hurt and not satisfy an urge for recreation. It's not recreation, it's tedious work. But it has a purpose. There will be a reward.
A rehab schedule, like any training schedule, should be orderly. It should probably be more orderly and disciplined than a normal schedule because it is so crucial that you not push yourself in an inconsistent way and risk reinjury. The patterns do not specify the types of exercise you do, but control the intensity of the workout.
Here are some daily patterns. These schedule patterns span several days. Examples are given from Phase Three, exercise and strength building, Phase Four, more aggressive training, and Phase Five, testing the injury.
Phase Three, Three day pattern. Exercise only. No skating.
Day 1: Light workout. Several sets of twenty. Stretching and range of motion.
Day 2: Heavy workout. Double the number of sets. Good warm down.
Day 3: Day off. Stretching only. No weights.
Start pattern over.

Phase Four, Three day pattern. Exercise and skating.
Day 1: Light workout. Good warm down.
Day 2: Heavy workout. Push it to fatigue, but don't overdo. Good warm down.
Day 3: Day off. Stretching only.
Start pattern over.

Phase Four, Four day pattern.
Day 1: Light workout. Good warm down.
Day 2: Heavy workout. Push it to fatigue, but don't overdo. Good warm down.
Day 3: Day off. Stretching only.
Day 4: Light to medium workout. Push it a bit in the middle. Warm down.
Start pattern over.

Phase Five, testing stage rehab, nearing normal training pattern. Five day pattern.
Day 1: Long warm up. Light workout. Good warm down.
Day 2: Medium workout. Lots of technical work and basics. Good warm down.
Day 3: Heavy workout. Push it to fatigue and muscle pain (not injury pain). Risk taken in exercises, but not in skating. Free skating included. Good warm down.
Day 4: Day off. Stretching only.
Day 5: Light to medium workout. Push it a bit in the middle. Warm down.
Start pattern over.

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