Recover Smarter: How to Rehab an Injury

Overview

Acute injuries are sudden events that cause physical damage to the body. They can happen from playing sport, collisions, falls, or overexertion. Common examples include:

• Muscle or tendon strains or tears

• Ligament sprains

• Bruises (contusions)

• Fractures (broken bones)

• Dislocations

With proper medical care and rehabilitation, most acute injuries heal over time. The new PEACE & LOVE approach is now commonly used to guide recovery.

When an injury first occurs, it’s important to rest or limit movement for the first 1–3 days. This helps reduce bleeding, swelling, and further damage. After this short rest period, rehabilitation is essential to promote healing, restore strength, and return to normal function. Every good rehabilitation program focuses on three key steps:

1. Load Management

2. Modify Aggravating Activities

3. Graded Loading

Load Management

The first goal of rehabilitation is to avoid doing too much activity that can trigger a flare-up of pain. We want to determine how much activity you can safely do without your symptoms worsening to >5/10.

A loading activity is anything that puts pressure or strain on a specific joint. For example:

• Vacuuming can be a loading activity for your back.

• Walking can be a loading activity for your knee.

Sometimes you might not feel much pain during an activity, but repeating it or combining it with other activities can lead to intense pain later.  

This process is all about reflecting and understanding how much activity is tolerable for your pain. Our aim is to reach a stable and manageable pain level, so you can stay active without causing flare-ups.

Modify Aggravating Activities

To help recovery, it’s important not to constantly aggravate your pain. Think of it as “don’t keep poking the bear.” We want you to stay as active as possible while avoiding flare-ups.

To do this, we want to modify activities that cause pain to exceed a 5/10. For example: if carrying a full laundry basket makes your pain worse than 5/10, this activity should be adjusted. A simple solution might be to fill the basket only halfway and place it on an elevated surface while hanging out clothes. It might take a little longer, but keeping your pain at a stable, manageable level is more important for recovery. This approach applies to any activity that significantly aggravates your symptoms. Experiment with different movements, positions, and ways of doing tasks, and make adjustments as needed to stay active without causing flare-ups.

Graded Loading

Graded loading is a rehabilitation process to build the injured joint and tissue ability to handle load. This helps your body adapt so it can tolerate movement and resistance. This graded loading process is the only therapy that will have long term improvements with your strength, mobility, physical capabilities. This crucial part of rehabilitation is completed through a graded and individualised exercise program. The focus of these exercises is to:

• Improve joint strength and endurance to better tolerate movement and resistance

• Build confidence with movement and reduce fear of re-injury

• Promote healing and restore normal movement and flexibility

Intensity of Exercise in Rehabilitation

When exercising, the goal is to challenge your body as much as possible while keeping pain to a minimum. To find the right level of resistance for each exercise, we monitor your perceived exertion (How hard you are exercising at) and monitor pain levels during the exercise. By balancing these two factors, we can safely progress your program while avoiding unnecessary flare-ups.

The Rate of Perceived Exertion (RPE) scale is used to measure how hard you feel you are working during an exercise. You rate the intensity yourself on a scale from 0 to 10. 0 means no effort at all and 10 means working as hard as you can. This intensity can change depending on your phase of rehabilitation and how your body responds.

Tracking pain levels during exercise is important, as we want to avoid flare-ups. Exercises should be done in a controlled setting, where we can adjust them as needed. As a guideline, you should not continue to exercise if the pain exceeds a 5/10. For example, if the pain during an exercise rises to 6/10 at 12 reps, we could reduce the weight or number of repetitions (e.g. 8 reps which had a pain level of 4).

Passive Treatments

If you are experiencing intense pain, treatments such as ice, heat, medication, pain relief gels, massage devices, or braces can help manage your symptoms. However, these treatments do not cure the injury or promote long-term physical recovery. Their main purpose is to help control pain so you can safely start or continue your rehabilitation exercise program.