What exercise to do after an injury or a surgery?
Here is a typical example of an exercise progression for the rehabilitation of any movement following an injury or a surgery. Here, as shown in the orange box, we have chosen the rehabilitation of the ankle dorsiflexion movement, which consists of pointing the foot towards oneself (green arrow). In our progression, there are four different ways to work on the same movement. In ascending order of level of difficulty, we have 1) passive range of motion; 2) active range of motion; 3) isometric strengthening and 4) dynamic strengthening. It is important to choose the right level of difficulty according to the healing phase. If the level is too high, we risk reinjury. If the level is too low, we will not progress fast enough to quickly return to work or sport. Depending on the type of tissue that is injured (bone, ligament, tendon, muscle), as each type of tissue regenerates at different speed, a person can spend two to four weeks per level. Happy rehabilitation!
1) Passive range of motion: Elbro uses a rigid belt to pull his foot. The foot must remain relaxed and it is only the arms that do the work (orange arrow).
2) Active mobilization: Elbro points his foot towards him (green arrow).
3) Isometric strengthening: Elbro presses his foot (green arrow) against the head of the crutch (orange arrow) that pushes back on the foot with equal strength. It's like arm wrestling and no one wins.
4) Dynamic strengthening : Elbro pulls his foot towards him (green arrow) against the resistance of an elastic band attached to the table leg. Elbro is able to point his foot at him as the rubber band stretches and let the foot win the tug of war.