Late Postoperative Rehabilitation Stage

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During this phase, the drudgery of rehabilitation takes its toll. The physician must help the patient and the sports medicine therapist continue on a direct course to recovery. Continued goal orientation, provided by steadily increasing levels of activity, allows sustained patient input, and helps the patient to feel in control throughout rehabilitation. This emphasis on setting and achieving goals parallels the patient's preinjury mind set. For example, the athlete's preinjury goal may have been to run 5 miles in 30 minutes, and if he or she achieved this, confidence was increased. During rehabilitation, it is necessary to focus on different goals; for example, the completion of three sets of one-third knee bends becomes the mark of achievement. If goals are met, the patient feels empowered and enjoys a definite sense of accomplishment.

Achieving rehabilitation goals requires several elements. First, the milestones should be challenging but realistic and should be designed by the physician, sports medicine therapist, and patient working together. Second, goals should stretch the limits of what the injured area can tolerate (without causing deformation or further injury) but should not extend beyond these limits. This requires a thorough understanding of the physiology and biomechanics of the injured area. Third, the patient should strengthen uninjured parts of the body in aerobic training, which helps prevent reinjury while providing more goal orientation. In the case of a leg injury, this training can include well-leg biking or swimming with or without a float. The positive psychological effects of aerobic training are an important aspect of treatment during this period.

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