Low-Tech Rehab Methods Get Results

It doesn’t take expensive physical therapy equipment to help injured athletes recover--the job can be done with stuff found around the home, trainers and therapists say.

“As athletic trainers and physical therapists, we can get stuck in the rut of ‘rehabbing to our equipment,’ ” said physical therapist Jennifer A. Stone. Common household items can substitute for some of the high-tech equipment, she said.

Scientifically calibrated rehabilitation machines are worthwhile, but to use them, patients have to make trips to the clinic, and the right equipment is not always available, Stone wrote in Sports Medicine Update, a publication of HealthSouth, an international hospital and rehabilitation corporation.

Home activity keeps people active between therapy visits, she said, and when the patient has to shoulder some of the therapy costs, home activity can keep the patient active for less money.

“I have my person in the clinic once a week or twice a week,” said Stone, former senior manager for clinical programs with the U.S. Olympic Committee. “How can I take some of these concepts and put them in a home?”

For instance, balance exercises can be done on a skateboard, and resistance can be added by hooking elastic cords to a doorknob, she said. A person trying to recover from a leg injury can balance and strengthen at the same time by pulling on a cord while standing with one foot on a skateboard, she said.

Such home exercise can teach people with joint problems valuable lessons in finding their footing-- lessons they might not even know they need, said Stone, of Boulder, Colo. “You don’t just injure joints, ligaments and muscles; you injure nerve endings,” she said.

Without retraining, diminished balance skills could set a person up for re-injury, Stone said. “I put my foot down wrong, but the brain was getting an erroneous signal, saying, ‘My foot’s flat; step down on it,’ ” she said.

And using equipment that requires no technical understanding lets the patient get more involved in planning the therapy, Stone said. She recalled an example from her 23 years at the USOC, in which a freestyle skier who had received several knee operations was using a ball about 2 1/2 feet in diameter to improve balance.

He knew what he should be doing, and was using uncomplicated equipment that let him figure out how to help in his own recovery, Stone said.

Stone wouldn’t recommend that for an ordinary athlete. Home exercise programs have to be set up by an expert, she said. “The average person doesn’t have a concept of how much is enough, how much is too much, how often, how intense,” she said.

Techniques have to be so simple that they are hard to do wrong, or a patient could aggravate the original injury, said Perry Esterson, clinic director at Physiotherapy Associates in Vienna, Va. So patients might ride an exercise bike they already own, or do calf raises on their stairs, he said.

The home program must not feel to the patient like too much time and trouble, Esterson said. “If we get a few key exercises, most people will do that,” he said. “If you have a complex program, compliance drops significantly.”