46 | Akwa | March / April / May 2023 STRATEGY: ONE ON ONE Not all injuries are created equal. Poor posture, prolonged sitting, strenuous work, and repetitive action can stress soft tissues and fascia. Overstretched or injured muscles, ten- dons, or ligaments can result in strains, sprains, or spasms. Lifting, pulling, bending, or twisting puts pressure on the spine’s disks, which can cause them to bulge or slip. Growing research shows that a combination of hands-on therapies and other non-drug measures can be just as effec- tive as more traditional forms of orthopedic care, includ- ing drugs and surgery. The American College of Physicians (ACP) issued guidelines for back-pain treatment, saying that the first line of defense should be non-drug measures. (Con- sumer Reports, June 2017). Degenerative joint changes or spinal instability may resolve over time with less aggressive therapies, and taking that approach is safer than surgery. Orthopedic surgery should be considered only if an imaging test confirms an abnormality; those operations could include neck, shoulder, hand, wrist, hip, knee, spine, ankle, and foot surgeries. Rehabilitation is the art of healing an injury, normalizing a debilitating condition, or improving a chronic condition. One-on-one rehabilitation care always starts with an assess- ment, which determines the nature of the injury care. It may start as pre-surgery conditioning (prehab), whose purpose is to work with the whole body and find pain-free guided movement to prevent the individual from resorting to phys- ical inactivity. Preserving physical activity is the key to preventing muscular weakness and stiffness of ligaments and tendons, which can influence post-surgical recovery. Psychologically, it is reas- surance, indicating to the person that they have a capacity to heal and actively participate in the healing process. This can be beneficial for a wide range of surgical procedures. After the surgery, post-surgical rehabilitation (post rehab) continues the good work started in prehab. It’s important to get moving again, to whatever degree is considered safe and beneficial, as soon as possible after the procedure. The goal is to restore the functional ability of the body. For an injury, this is a return to pre-injury ability. For those with chronic conditions, we are looking for improved functioning and an increased sense of independence. In many situations, the most efficient pre- and post- rehab methods take place in the water with a transition to exercise on land as the client progresses in recovery and gains move- ment confidence. The Burdenko Method embodies a proven protocol supported by positive results. This progression starts in deep water, progresses to shallow water, and continues to land exercises (see table below). For more information on the Burdenko Method, see the article on page 9 by Beth Scalone. Typical Movement Progression in the Burdenko Method Pre- and Post-Surgery Rehabilitation By Maria Pritz, EdD Deep-Water Exercise Shallow-Water Exercise Land Exercises: On Mat (Lying Down) Land Exercise: On Bench (Sitting) Land Exercises: Standing (Stationary) Land Exercises- Standing (Mobile) Promotes non-weight-bearing, pain- free movement. Progress to more complicated movement patterns and more strenuous conditioning with minimal stress on the joints, mus- cles, tendons, and ligaments. Move to exercise patterns with par- tial weight-bearing while remaining pain free. Promotes a supine position where the torso is supported; only extremi- ties need to move against gravity. Activate the postural components of movement. The vertical position is emphasized. Focus on pelvic stability. Vertical position in full gravity envi- ronment. Pelvic stability, pain-free movement, breath work, and basic exercises for balance, coordination, flexibility, endurance, speed/quick- ness, and strength are emphasized. Fully dynamic land exercises, movement sequences embodying balance, coordination, flexibility, and endurance using various speeds and dimensions (forward, backward, side to side, vertical).
