Rehabilitation in the Gym
Gym sessions: much more than just physiotherapy
The rehabilitation gyms are the space where a large part of the rehabilitation process takes place. For this reason, in Isokinetic rehabilitation clinics we have done everything to make it an environment not only equipped with the latest technology and rehabilitation equipment to meet every therapeutic need, but also designed but also and above all a welcoming place. We want you to find a sanctuary where you can feel at ease, socialise and benefit from the exchange of energy and clinical experiences with other patients.
Studies show that having the right number and type of patients together stimulates the healing process. It is better than an isolated one to one session in a small clinical room. The gym is full of positive energy and it provides a little sense of competition to spur you along, alongside a feeling of empathy that helps to avoid the feeling of isolation and sense of overpowering despair when you are injured. Throughout your time in the gym you will experience personalised and individual care, in a group setting.
All of the Isokinetic rehabilitation centres are equipped with spacious and bright open-space gyms, equipped with medically certified Technogym machines, alongside other specialist Sports Medicine and Orthopaedic rehabilitation equipment to support the delivery of therapeutic exercise.
At Isokinetic London, located in Central London, on Harley Street, an historic street of the world of medicine, we have three well equipped and interconnected gym environments.
In the Isokinetic gyms, the rehabilitation physiotherapist will support you in every phase of therapeutic exercise, from the strength and flexibility based exercises, through to manual therapy and cardiovascular exercise.
Each rehabilitation session in the gym lasts from 120 to 150 minutes.
The fundamental role of exercise in the Isokinetic method
At Isokinetic, sports rehabilitation means bringing the patient back to their full functional recovery. This means you do not accept the simple resolution of the symptoms. We want you to be focused on the complete recovery of functionality, which of course is always different for each individual Patient.
To obtain the Maximum Possible Functional Recovery, it is necessary to focus on the patient as a whole, pursuing the recovery of function. We will involve the individual as a whole rather than focusing on a specific anatomical district or type of pathology. We do not treat the knee, we treat the patient with a knee injury.
The Isokinetic Method is mainly based upon the CENTRALITY OF THE EXERCISE as a medicine aimed at functional recovery. We strongly believe that therapeutic exercise is the way to obtain a real and lasting result.
We use technology and physiotherapy equipment (including laser therapy, tens, and therapeutic ultrasound) and manual therapies. Always focused on treating the symptoms and allowing the patient to perform the exercises correctly. Normally after a short time the exercise take its place: promoting a better recovery, improving the general physical fitness and therefore preventing a possible re-injury.
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Physical therapies
Manual therapies
Massage and soft tissue therapy in the Isokinetic rehabilitation path
Sports Massage is utilised in a variety of ways as part of the Isokinetic rehabilitation pathway. These range from preventive and curative action in case of muscle injury, muscle fatigue, tendon injuries and in case of swelling.
By massage we mean a system of dosed mechanical actions, practiced by physiotherapists, on the surface of the body and aimed at restoring the functionality of some tissues or optimising the healing process.
Indications
- Relaxation both at a general level and localised
- Decreased muscle tone
- Pain inhibition
- Increased vascularisation
- Decreased viscosity
Contraindications
- Acute inflammations
- Rheumatic skin symptoms
- Neoplasms
- Scars still open
- Varices
- Feverish states
- Advanced arthritis
- Psoriasis
- Severe heart disease
MASSAGE MOVEMENTS AND TECHNIQUES
The main massage manoeuvres and techniques are:
- the touch
- the clutch
- kneading
- pure pressure
- percussion
The combination, alternation and / or repetitions that the physiotherapist makes of these manoeuvres, allows to obtain a therapeutic effect.
THERAPEUTIC MASSAGE
The advantages of therapeutic massage are:
- preventive action
- curative action in case of muscle injury
- curative action in case of muscle fatigue
- curative action in case of tendon injuries
- curative action in case of swelling.
Massage Actions
Preventive action of massage
A good massage performed by the physiotherapist at the beginning of the session allows an efficient blood supply and stimulates the contractile units of the muscle, preparing them for work.
Furthermore, this type of massage, together with stretching exercises, drastically reduces the risk of more or less serious muscle injuries caused by poor muscle extensibility.
Curative properties of massage in case of muscle injury
- If the injury is in the acute phase, the massage should be avoided: the beneficial action it would have on the muscle scar or oedema is little compared to the risk of causing the wound to bleed or further worsening the situation.
- When the lesion is healed, massage is very useful in the surrounding area, where a reflex contracture of the muscles close to the lesion often forms.
In the event of contracture, the decontracting massage has an excellent healing function
The mechanical action of pressure on the contracted area, in addition to allowing relaxation of the muscle fibres remained in a state of contraction, has a pumping effect on the blood and lymphatic vessels: this effect determines the elimination of catabolites and the recall of new oxygenated blood. The mechanical action of the massage also acts on the pain receptors by inhibiting the painful sensation linked to the pathology.
Curative properties of massage in case of muscle fatigue
Muscle fatigue results from excessive or prolonged effort that causes a feeling of heaviness and, sometimes, of pain.
In this situation, the muscle can no longer supply the energy (ATP) necessary for muscle contraction and tends to remain contracted. Also in this case the massage has a curative action since it promotes the supply of oxygen and energy substrates to the tissues and simultaneously acts mechanically promoting relaxation.
Curative properties of massage in case of tendon pathologies
As a rule, in case of acute inflammation of tendons and ligaments, massage is contraindicated since it risks worsening the inflammation already in place. However, massage upstream and downstream of the lesion is useful.
Curative properties of massage in case of swelling
Swelling is a complication that often occurs after an injury or surgery, and often lasts for a long time.
The swelling (oedema) is addressed with a specific massage, lymphatic drainage, which with slow and superficial manoeuvres stimulates the lymphatic system to reabsorb excess fluid.
To be effective, the massage technique must be performed correctly by the physiotherapist, respecting both the direction of flow of the lymph towards the lymph node stations and the pressure in the various manoeuvres, this must be adequate for the patient’s tissue.
Types of Massages
Types of therapeutic massage
- Myofascial massage
- Reflexogenic massage
- Treatment of trigger points
- Deep transverse massage
Myofascial massage is used in case of contractures and in many other situations
- Hypo-extensibility and muscle contracture
- Muscle injuries from indirect trauma
- Degenerative tendinopathies
- Cicatricial outcomes (fibrosis and interfascial adhesions)
- In the presence of reduced joint mobility
THE REFLEXOGENIC MASSAGE
In particular, reflexogenic massage is prescribed to stimulate and reactivate a specific muscle that would be difficult to reinforce with traditional methods. It is basically an external neuro-motor stimulus, caused by the hands of the re-educator who is used to “awaken a muscle".
TREATMENT OF TRIGGER POINTS
The reported pain represents one of the characteristic features of the “trigger points". Precisely because their stimulation, palpation or compression can cause punctual pain or in an area adjacent to them, these points are called “trigger points" in the sense of “trigger".
Trigger points are localized areas of deep pain and increased resistance. Manual pressure on the trigger points often causes contractions and fasciculations and prolonged pressure produces reported (projected) pain in a predictable area.
Treatment: There are numerous methods for deactivating trigger points. Isokinetic Know How involves the following two techniques.
The first technique is implemented with muscle stretching (Stretching), associated with the friction of the area with ice (Ice).
The second technique consists in the use by the re-educator of manual techniques associated with muscle stretching techniques.
“Ischemic compression" is the most used technique and consists of an intense, continuous and direct pressure normally carried out with the thumb perpendicular to the trigger point as if to crush it.
Another technique involves an inhibitory pressure of 5 seconds, sufficient to reproduce the projected symptoms, followed by a short rest phase 2-3 seconds, again followed by the initial pressure. Once the symptoms are controlled, the muscle that contains the trigger point must be gently but constantly stretched (stretching); in the absence of this the symptoms will inevitably recur
Targets:
- Maintain the mobility of traumatised tissues by safeguarding physiological movement, inhibiting the formation of scar tissue and avoiding the formation of cross-links between the various fibrils. The collagen fibrils that are formed during the treatment period develop correctly and more closely to the functional needs of the body, preventing any recurrence.
- Produce local hyperemia (increased blood flow in a certain area of the body) to decrease pain and regulate the flow of substrates and metabolites.
- Orient the collagen fibers in the most suitable way to resist mechanical stress.
- Stimulate the mechanical receptors to inhibit the nociceptive afferent messages (Gate Control theory). With this technique it is possible to prevent self-perpetuating inflammation from being generated in the injured fibrous tissue. So the purpose of this technique is to help the formation of strong, but also functional healing.
Indications:
- In muscle injuries, where it has the purpose of limiting the formation of scar tissue.
- In long-standing trauma, where a fibrous scar has already formed
