Utilizing Pain and Dysfunction as a Guide to Rehabilitation Progress

Abstract

Musculoskeletal pain, known as musculoskeletal disorders, is debilitating and can adversely affect patients in many ways.  Challenges faced by patients with musculoskeletal disorders can include lower levels of physical activity, fear of re-injury, fear of lifelong pain, fear of inability to return to activity, anxiety, depression, and altered muscle recruitment strategies that can ultimately lead to reinjury.  However, Athletic Trainers have several tools to reduce the risk of re-injury.  Graded exposure, patient education, and goal setting are all ways for Athletic Trainers to help mitigate the speed bumps along the rehabilitation path back to activity.  When Athletic Trainers want to reduce their patient’s pain, they often look for movement restrictions (either soft tissue or joint) and couple them with isometric strength exercises to start their rehabilitation program.  Progressing through concentric, eccentric, and functional movements can prepare a patient for plyometric exercises.  The implementation of plyometric exercises should also consider ensuring a smooth transition into functional activities.  A gradual progression into activity will ultimately help a patient return to activity with a limited risk of reinjury.

Learning Objectives

Knowledge: Understand how pain can affect the human body and the psychological factors that may further complicate a patient's condition.  Additionally, how to differentiate between pain and soreness.

Skill: Finding the most painful and limiting restriction in movement.

Ability: Critically appraise the information provided in an evaluation to integrate exercises to help the patient progress in a rehabilitation program.