Lifestyle and Behavioral Modifications

After treatment of the acute injury with RICE and pharmacologic therapy, the final phase of therapy is rehabilitation and prevention of future injury. For most injuries, prolonged immobilization can lengthen the recovery time by causing wasting of the healthy muscle fibers.10,52 Rehabilitation starts with the development of range of motion via stretching exercises. Patient should warm the muscle first with light activity or moderate heat. 0 Warmth produces relaxation and increases elasticity. Next, the patient should start general strengthening exercises.11,52 Resistance exercises using resistance bands available at sporting goods stores are an effective method of strengthening.11 Strengthening exercises should be continued beyond the healing phase to prevent future injury.

After rehabilitation, the patient should be educated about behavior changes to pre-

vent reinjury or the development of chronic pain. ' ' The warm-up and strengthening routines learned in the rehabilitation phase should be continued. For overuse injury, correction of biomechanical abnormalities with proper footwear and changes in technique may correct misalignments and imbalances. Repetitive trauma can be decreased with proper training (e.g., by implementing a gradual increase in mileage in a running plan).

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