Goals and Principles
As soon as tolerated after swelling/bleeding has been controlled, the athlete should do some slow circulation and range of motion exercises. This is to minimize, or if possible avoid secondary effects like muscle and leg stiffness, with these exercises being done several times every day.
After a major thigh injury, strain, and/or contusion, it is recommended to wait 3–5 days before starting more active exercises. The patient should then start with gentle stretching of the relevant muscle and joint, letting the pain guide the intensity and frequency.
Massage, stretching, and gentle mobilization may be indicated. As recovery ensues the exercise program should include various types of exercise including strength, range of motion, neuromuscular, and exercises replicating function, all aimed at the sport that the athlete is returning to. The progression of the exercises is controlled by pain and function.
In general, numerous repetitions and light loads (such as four series repeated 20–30 times) are emphasized early in the rehabilitation phase. Loads are then gradually increased, and the number of repetitions decreased as function improves. Exercises are done with light resistance during the start-up phase, and then the speed and degree of explosiveness are gradually increased.
Athletes with muscle strain injuries often experience recurrent injuries. The most common cause is that they have not fully recovered before they begin maximum training and competition. It should also be remembered that reinjury risk also occurs after the athlete has seemingly successfully returned to sport.
• Allow injured tissue time to heal.
• Achieve sufficient strength, including eccentric training.
• Regain, and possibly improve, range of motion through stretching.
• Improve neuromuscular function, coordination, and balance.
• Do sport-specific training, including maximum speed and explosiveness.
• Let the body recover between training and competitions. Avoid fatigue.
• Listen to your body, and be aware of mild symptoms and cramping in the area.