Rehabilitation and Return to Sport Following Upper Limb Injury
摘要
This chapter outlines evidence and expert consensus available for rehabilitation of acute and chronic traumatic injuries of the upper limb. It is not a comprehensive rehabilitation guide, it is more a guide for referring doctors. Upper limb mechanism of injury, diagnosis, classification, and the various conditions are listed in previous chapters in this book. The names for each condition were combined with “rehabilitation,” “postoperative,” and “therapy” to find the best evidence for rehabilitation of each condition. For the majority of conditions there were no clinical trials to suggest the efficacy of rehabilitation protocols, and there were no clinical trials to support best practice in return to sport. Therefore, this chapter is based on a mixture of clinical evidence and expert opinion. In many cases, postoperative treatment and conservative treatment are similar, having the goal of protecting the injured bone, ligament, or tendon while allowing motion of all other structures that do not stretch or stress the injury. Patient education is key for all conditions described, for protection of healing tissues to managing expectations. The principles in this chapter may be considered together with the athlete's history, injury, age, level of competition, sport or position played, time of the sporting season, pain, confidence in using the affected limb, acute or chronic nature of the injury, psychological health or understanding of rehabilitation. These factors must be assessed and may outweigh the principles of rehabilitation based on injured structure and phase of healing as presented below.