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Effective Orthopedic Rehab: Seven Steps to Complete Recovery

by Buck Willis, PhD, ACSM

141 pages; quality trade paperback (softcover); catalogue #03-0891; ISBN 1-4120-0522-1; US$18.50, C$21.95, EUR15.50, £11.00

Patients with injuries from sprained ankles to a traumatic "unsurvivable plane crash" have greatly benfited from Dr. Willis' Seven Steps to Complete Recovery from orthopedic injuries.

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about the book      about the author      sample excerpts or Table of Contents      catalogue info

About the Book After suffering a traumatic, "Unsurvivable plane crash" the author of this book used his Seven Steps to Complete Recovery to gain complete rehabilitation from his 16 major orthopedic operations, and this led to success in competitive mountain-bike racing and graduate school. This book shows the seven keys steps to achieving complete rehabilitation and recovery from any orthopedic injury (or surgical procedure) ranging from a sprained ankle to "comminuted fractures" (crushed long bones) that the author suffered. This patients' handbook also includes examples of rehabilitative protocols from 25 of the most common injuries such as tennis elbow to knee injuries. The chapters of this book range from injury analysis to designing an effective rehab program. It also includes chapters on proactive exercises with exercises that have been shown to effectively treat illnesses from osteoporosis to depression. This text will also reveal other peoples' success obtained from following Dr Willis' Rehab Steps. Reading this book will teach the reader how to design their own successful, complete recovery from orthopedic injuries, and if the injury is severe, this text will help you work for a better, more informed success with your medical care givers.

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About the Author My prgression from suffering a traumatic, "unsurvivable" plane crash in 1991, to competetive mountain-biking and success in graduate school, have given me a unique perspective on health, wellness, and complete rehabilitation. While in medical school I completed this book and my PhD in Health, Physical Education.

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Sample Excerpts or Table of Contents

   This book will reveal the seven key steps to obtaining complete orthopedic rehabilitation. These steps are effective for any orthopedic anomaly from a sprained ankle to rehabilitation from multiple, complex fractures and surgeries, which the author experienced after suffering an "Unsurvivable, traumatic plane crash."

   The introduction will describe the full picture of rehabilitation from designing one's rehabilitation program to proactive exercises for preventing injury reoccurrence. Then this chapter will reveal success that people have gained from following Dr. Willis' seven rehab steps.
The seven steps to complete rehabilitation are as follows:
     I Injury Analysis
     II Setting Rehab Goals
     III Determine the Components for Rehab Success
     IV Examine the Current Exercise Therapies
     V Design and Follow your own Rehabilitation Program
     VI Measure Progress to Determine Completion of goals and Rehab
     VII Proactive Exercises and Lifestyle Fitness

Components of Rehab Design

Components for rehabilitation design begin with prioritizing goals for immediate treatment, which include the following:
     1) Decreasing the symptoms,
     2) Regaining complete range of motion (ROM),
     3) Neuromuscular Control,
     4) Flexibility training, and
     5) Strength training.

   One must immediately treat the injury with techniques to reduce the pain, inflammation, and swelling if present after the injury.

   Rehabilitation must be done in different phrases to ensure safety and a logical progression in the rehabilitation so that the recovery is permanent and complete. A frequent question asked is "When does one start the rehabilitation after an injury" and "How fast should rehab progress?" The answers to these questions are "Immediately" and "For rehab, use the cadence of Safety First."

   For instance, after surgical repair of a torn Anterior Cruciate (knee) Ligament, the post-operative treatment begins before the patient regains consciousness. This book will show how to reduce the symptoms of an orthopedic injury and begin rehab with conservative motion protocols in the appropriate phases of rehabilitation.

Phases in Rehabilitation

   The Phases are the appropriate therapeutic exercises with proper timing for the best recuperation. In Chapter IV, the book will address common injuries/conditions, (with lists of the symptoms), and then it will thoroughly describe the Rehab Phases that are appropriate in treating each injury.

   Acute phase is the treatment suggested fort the first 1 to 3 days where the primary goals are focused on the reduction of pain, inflammation, and swelling. Techniques like Rest, Ice, Compression, and Elevation (RICE), will be used, and in this phase, one may only begin with gentle work on ROM. For example, in the case of treating Pitcher's elbow, the elbow would be wrapped with an elastic bandage, ice packs would be applied, and the elbow would be elevated above the heart's level. Then in specific training sessions, only would only gently flex the elbow through pain-free angles of motion, and utilize passive, static stretching.

   The Rehab phase normally occurs from day 4 to approximately day 14 after the injury occurred. In this phase, one works to regain complete ROM and neuromuscular control, while beginning light, progressive resistance, with continued flexibility training. in the case of an elbow injury, the Rehab phase would include stretching of the wrist, elbow, and shoulder muscles, and will begin regaining neuromuscular control, (which is select muscle activation and sensation from that muscle's contraction). In this Phase, unique beneficial exercises like controlled elbow extension exercises can be performed, and the exercise would be fully described with pictures. (See page 64-67.) One would also begin isometric contractions which are muscle contractions without moving the limb.

   One's Recovery phase works for regaining full function of the injured area, and focuses on progressive resistance, which allows one to also pursue treating the cause of the injury. Flexibility training will be continued, this phase can continue for several more weeks. For the "Tennis elbow" injury, the Recovery phase will address strengthening the weaker muscles, such as brachioradialis, because an imbalance in the elbow musculature may have cased this disorder, (see figure #4, pg62). Training for muscular balance will be accomplished using unique exercises to include weight balancing, and hammer rotation for the Recovery phase.

   Then after each phases' exercises have been explained and illustrated with pictures, each section will close with a possible outline of treatment, such as this:

Tennis Elbow Rehab summary
Acute phase: FIRST 3 DAYS - Rest, Ice, Compression, Elevation (RICE); Passive, Static Stretching
Rehab phase: DAY 3 to SECOND WEEK - Isometric contractions; Elbow Extension across chest
Recovery: WEEKS 3 to 6 - Hammer rotation; Joystick rotation; Overhead Medicine Ball

Complete Rehabilitation

   Complete rehabilitation must include the prioritized goals listed below, and while the list may seem vast, these priorities are easily accomplished in harmony with the proper, consecutive Rehab Phases.

   1. Reduced pain, inflammation, and swelling

   2. Healing of the tissue

   3. Regain the joint's range of motion(ROM)

   4. Increase blood flow

   5. Restore complete neuromuscular control of the injured area

   6. Counteract tendencies for muscle atrophy

   7. Regain and increase strength and power

   8. Reactivate and ensure the proprioceptive abilities, (sensation of muscle contraction), and

   9. Regain and increase endurance for sport and normal activities

However, if these priorities for rehabilitation are not accomplished, the injured person may suffer from muscle atrophy (loss of muscle size and strength), and the decrease in muscle fibers' diameter, which will result in weakness, and decreased muscular endurance. If one chooses to treat an orthopedic injury with inactivity, it could yield significant muscle atrophy, such as a 40% decrease muscle mass in just three weeks.1

   Twenty-five exercise therapies prescribed for known, common orthopedic injuries will be described, and these therapies include 72 stretching protocols and 112 strength training protocols. If you have an injury other than what is listed, then you will be given the tools to design your own program. The list or protocols are also there for you to use when modifying the exercises in your final phase of Recovery rehabilitation.

Rehabilitation Success from Dr. Willis' Rehab Steps

   The following stories show the tremendous success from using the author's Effective Orthopedic Rehab Steps. The Author's initial experience was designing and implementing a rehab program for himself, following what the FAA called an "Unsurvivable, traumatic plane crash" and the resulting 16 operations that lasted over three years. (See cover photo.) This included rehabilitation following each of the 16 operations on his legs and a three-month duration of open wound, chloral-hydrotherapy to clean the tarsal bones of a frequently fatal bone infection, osteomyelitis

   The author's rehab efforts paid off. After the tremendous care from his team of physicians and surgeons, he achieved success in competitive mountain-bike racing and success in graduate school with research on the biomechanical components of orthopedic rehabilitation. His goal is to use his knowledge and experience to help and serve others.

   Another powerful success story from using the author's rehabilitation steps belongs to a woman who had a traumatic head injury with comminuted fractures of her lower legs, when she was 36. This woman took the rehab challenge with enthusiasm, and her success following the Author's Seven Steps has included placing in a Fitness competition, and completing her education to become a Registered Nurse. She now cares for older patients who have had brain damage from strokes (cerebral infarctions), and her background gives her the tools of empathy and rehab success.

   She also used the techniques described in this book to help her through another difficult and exhausting experience of regaining her fitness after pregnancy. She successfully regained her abdominal lines in just four months after delivering (post partum), and she credits the conditioning steps that she learned from the author, because it "fueled" her interest in continued exercise and now she is a successful, competitive tri-athlete.

   A few years ago, a woman who was in college to become a commercial pilot had a traumatic car accident. She had a severely injured ankle that required a total fusion of her medial anklebones for permanent immobilization (tarsal arthrodesis), just as the author required after his plane crash. She had abandoned her goals of becoming a commercial pilot, until she read of the author's success in the March 2001 issue of AOPA Pilot. She then contacted the author and followed his advice and "Steps" for complete rehabilitation through her operations and following physical therapy. This woman is now a commercial Pilot, and a Flight Instructor Pilot!

How will you design the Rehab for your own strong success?

To answer this challenging question, follow the key seven steps and ask yourself these questions:
I. Injury analysis: How severe is your injury, and where are you hurt the worst?
II. Setting your rehab goals: What do you want to accomplish and in what order?
III. Determine the components to be used in your rehab: Is regaining flexibility or strength your top priority?
IV. Examine the current therapeutic exercises: What protocols would be most beneficial and relevant to your injury and your goals?
V. Design and follow your rehab plan: Have you left room for changes in your plan, and are you prepared for the rehab plateaus and set-backs that will occur?
VI. Measure progress and completion of your rehab & goals: When have you reached the small and large goals, and when should you reset your goals?
VII. Proactive exercise and lifestyle fitness: What exercises will help deter reoccurrence?

   One will find the answers to these rehab questions in the following seven chapters.

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Catalogue Information

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