Athletes from a range of sports are routinely referred for rehabilitation following upper extremity injuries and surgeries. Regardless of the age or performance level of an athlete, injuries— especially those requiring surgery—can be devastating in a multitude of overlapping ways.
For elite and professional athletes, a single day away from training or competing can negatively impact goal achievement, financial status, and future athletic seasons. For school-based athletes, whether they are at the elementary, high school, or college level, injuries can impact peer relationships, as well as overall athletic performance and future opportunities. For weekend warriors and hobbyists, the inability to participate in sports can have psychological and social ramifications.
Confidently returning an athlete to their sport as quickly and safely as possible can be daunting for any rehabilitation professional. The challenge often lies in designing a therapy program that meets the athlete’s sport-specific needs while also adhering to timelines dictated by the healing tissue.
Embracing Athletes’ Common Traits to Design Therapy Programs
Athletes tend to be intrinsically motivated and determined, possess an exceptional training attitude, and—most importantly—respond to purposeful training. Additionally, one of the most universal traits athletes share is that they are competitive.
A multifactorial approach to upper extremity therapy requires incorporating these unifying traits into treatment and embedding elements of their sport, all while creating innovative programs founded in rehabilitation expertise. Simply put, athletes benefit from programs that are goal-driven, sports-minded, competitive, and ultimately, purposeful.
Upper extremity therapists have the knowledge and ability to implement numerous strategies, provided that they are appropriate for the athlete’s healing tissue and the referring doctor has cleared participation. The following are several examples that can be put into clinical practice immediately:
1. Incorporate competitive games into your treatment sessions for targeted upper extremity range-of-motion goals. For example, you could use a foam basketball, darts, bean bags, or ring toss for larger joints and muscle groups, or board games for smaller joints and muscle groups. Regardless of specific therapy goals, athletes are usually motivated for challenges that involve winning.
2. Integrate purposeful graded sport simulation into your therapy sessions to meet neuromuscular retraining goals. For example, this could mean simulating components of swinging a golf club, baseball bat, or tennis racket. Initiating subcomponents of the athlete’s sport in their own natural upper extremity movement patterns is a powerful clinical intervention.
3. Introduce the athlete’s equipment and sports tools into your therapy sessions to proactively address potential compensatory concerns. Have the athlete bring their own sports equipment to the session, such as a baseball glove and ball or a hockey stick and puck to determine first hand if the upper extremity is compensating in any obvious way. Incorporating their tools into the clinical session, which helps directly engage the athlete in the problem-solving process, is a powerful and purposeful intervention.
4. Clinicians skilled in orthotic fabrication have the unique ability to incorporate an empowering tool for accelerated sport integration. Through activity analysis, clinicians can collaborate with the athlete in creating a tailored upper extremity orthosis that protects the healing tissue while simultaneously creating an opportunity to resume sport-specific components safely. This may also require the athlete’s sports equipment, such as a volleyball or basketball. Additionally, the athlete can be an active participant in designing the optimal orthosis for their hand or arm.
5. Balls of various sizes and weights are an innovative treatment option for addressing upper extremity therapy goals ranging from graded movement patterns to hand dexterity and strength. Balls are an excellent tool for incorporating proximal retraining sooner; they can be held in the palm rather than requiring a grip, and they offer automatic movement pattern progression from catching to picking up, bouncing, dropping, tossing, passing, and so on. Balls are a powerful, psychologically stimulating, and fun intervention for advancing an athlete’s rehabilitation program.
6. In late-stage rehab, consider designing treatment sessions that are mentally challenging as well as physically challenging in order to increase confidence for returning to sport. Athletes often respond to difficult tasks, so creating complex sessions with timed or high reps that require internal motivation to complete can help decrease your athlete’s anxiety or fear. More importantly, this can increase personal certainty in the injured extremity.
7. Create leaderboards with innovative competitions for both upper extremity range-of-motion and strength-based events. Athletes often enjoy seeing what others are capable of within the rehabilitation setting and may feel driven to beat the records, get their accomplishments up on the board, and even earn bragging rights for being clinic champions. If you decide to go this route, just be sure to do so in a way that is HIPAA-compliant and remove all traces of identifying information on your leaderboard.
Regardless of age, level, type of sport, or the nature of the upper extremity injury, athletes want to return to their sport with confidence as quickly and as safely as possible. The athletes you serve will benefit from rehabilitation programs that are goal-driven, sport-minded, competitive, and purposeful. As a rehabilitation specialist, feel encouraged to be creative and innovative when planning therapy sessions with your athlete patients!