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Keyword: rehabilitation

How many times have you heard or said: “New year, new you”? Probably too many times to count. About this time of year, many have started their New Year resolutions. But research shows that only 19 percent of people who make resolutions are successful. Since one of the most common resolutions involves exercising, I am here to give you a little insight into how we use resolutions in sports medicine.

In rehabilitation of injuries, the sports medicine team works with the patient to create goals for returning to function and activity. We never just say, “Your goal is to return to sport.” That is not specific. Likewise, you should never set nonspecific goals such as “I am going to exercise more” or “I am going to lose weight.” In rehabilitation, we use the SMART framework to formulate goals for our patients. It is an acronym for the following components of a goal:

Specific – Keep goals simple. They should clearly define what you plan to do.
Measurable – How are you going to determine progress? How are you going to determine if you achieved the goal?
Achievable – The goal is realistic given the timing, conditions, and environment.
Relevant – You actually care about the goal. It directly relates to your life and well-being.
Time-Bound – Set very specific timelines to meet your goal. Remember it is okay for those timelines to adapt and change. Focus on the progress.

An example of a SMART goal for an injured basketball player: Return to basketball with no limitations or restrictions within 6 months, so he is ready in time for varsity tryouts.

This goal is much more specific and measurable. It also sets us up to create hundreds of short-term goals along the way, such as “patient will gain 10 degrees of active range of motion of knee flexion within 2 weeks following surgery.” The SMART framework provides the athlete with actionable steps and enhanced motivation.

Here are a few additional points that are important when making goals for injured athletes. They're also applicable to your resolutions.

  1. Form a tribe.
    When our patients are recovering from injuries, they have a support team behind them here at MUSC. Find your support team and encourage it to keep you motivated.
     
  2. Don’t be restrictive.
    During rehabilitation, we focus on the abilities of the patient, rather than the disabilities. Focus on all the abilities you are creating for yourself with your new resolution. If you focus on the restrictions (“I can’t eat sweets,” “I can’t watch TV because I’m exercising”), you are setting yourself up for failure.
     
  3. Be passionate.
    Athletes are generally very motivated people. Why is that? It’s because they love what they do. If your resolution is to incorporate more cardio into your exercise routine, find a cardio-based activity that you love. Don’t spend hours on the treadmill, if it is not something that gets you fired up.

It’s not too late! If you have a resolution in this new year, stop what you are doing right now, and ask yourself: Is it a SMART goal? If not, get out your pen and paper and make a plan by writing down the S-M-A-R-T of your goal. Make sure you are truly passionate about this goal and go find your tribe. Like our athletes at MUSC Health do every day, you too, can accomplish your goals.

Treat the Athlete, Not the Body Part

I recently attended a medical conference in New York, focusing on current sports medicine concepts in baseball.  The presenters were sports medicine providers including members of the sports medicine teams from both the New York Yankees and Chicago White Sox. The conference was outstanding, discussing some of the most current research and treatment techniques for injuries afflicting baseball players from the Major Leagues to collegiate and youth athletes.  There were over 20 different presenters from orthopaedic surgeons, physical therapists and athletic trainers; one of the biggest take home messages I learned was that there is little absolute consensus on treatments for different injuries.  There are a variety of different diagnostic and surgical approaches to a variety of shoulder and elbow injuries.  However, there was one consensus that ran through each section; the importance of core strengthening and stability as part of the athlete’s daily work-outs and rehabilitation process.

The idea of treating the entire athlete is not new; it is something that is discussed at almost every sport medicine conference and a topic that I have presented on a number of times in the past.  Unfortunately, players, coaches, and parents do not always have access to this information.  So there can be a lot of misconceptions out there amongst the non-medical population with regards to baseball players:

  • My shoulder hurts so I need to just rehab my rotator cuff
  • I want to throw harder so I need to hit the gym and get stronger
  • I lose my control the deeper into the game I throw, so I need to throw more in practice

For ideal results in performance, injury prevention and rehabilitation, the athlete’s entire body has to work in symmetry.  It is not about just one body part or one muscle group; it is about the entire body working in harmony to achieve a common goal.  So for the athletes that I work with, their programs focus on a variety of body parts from the rotator cuff to the peri-scapular musculature (latissimus dorsi, trapezius muscles, rhomboids, serratus anterior) to core and pelvic musculature, to the lower body.  The goal is to build strength, stability, and muscular endurance throughout the entire body to support the demands of their sport. 

You may now be thinking, how am I going to do this, my workout will take hours?  There is definitely a time and place for isolation, but the majority of the time, you can combine exercises to achieve the desired results.  There are still thousands of different exercises that you can do, but here are my top 6 exercises that I give to the majority of my throwing athletes to incorporate into their workouts:

  1. “Y’s” –  bilateral shoulder scaption prone on a stability ball
  2. “T’s” – bilateral shoulder horizontal abduction prone on a stability ball
  3. Bilateral scapular retraction to external rotation prone on a stability ball
  4. “I’s” – bilateral shoulder extension prone on stability ball
  5. Push-ups on stability ball or BOSU ball with holds
  6. Shoulder external rotation while in a side plank position

* Exercises should include high repetitions with little to no weight (zero to two pounds at most) focusing on slow controlled movements, body mechanics, and alignment. 

One of the athletic trainers at the conference said that “throwing programs should always be written in pencil, since they are constantly changing to meet the needs of the individual athlete.” I could not agree more, but I also take this philosophy to include all strengthening, rehabilitation, and maintenance programs. Every athlete is different and their program should be tailored to meet their specific needs, focusing on the entire athlete.
 

 

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