How can an athlete maintain fitness when injured?

Depending on the nature of the injury, there are a number of activities that can help the athlete maintain fitness levels. When there is a lower-extremity injury, non-weight bearing activities should be incorporated. Pool activities provide an excellent means for injury rehabilitation. Cycling also can positively stress the cardiorespiratory system.

Besides maintaining cardiovascular fitness, one should not forget about strength, balance, and hand-eye coordination when sidelined with rehabilitation. Creativity and cross-training are keys to success. Swimmers with upper extremity injuries can use a stationary bike, Stairmaster, or similar equipment. They can work on trunk balance using a large medicine ball in addition to performing their daily upper extremity rehabilitative exercises. Runners with a lower extremity injury can utilize a UBE (upper body ergometer that resembles a bicycle for your arms). If the lower extremity injuries are not severe, an elliptical transporter or stationary bike can be utilized in addition to performing the appropriate lower extremity rehabilitative exercises. These devices also provide cardiovascular conditioning for athletes with upper body injuries. For hand-eye coordination, anything from putting in golf to throwing darts or shooting pool can be useful in the continuous stimulation of these neuromuscular pathways. In general, guidelines for the return of sport can be outlined by a physician, physical therapist, and athletic trainer working in conjunct. Guidelines should be sports-specific, i.e., runners should be on a walk/run program, baseball players should be on a light toss, short-distance, limited-number-of-throws program and advance as tolerated and as indicated by performance and any symptoms. It is important when an athlete has advanced to a pre-competition phase of rehabilitation, that he or she not forget to perform their basic rehabilitation program on a maintenance basis as well.

Koto: My advice is to rest the injured body part and work the rest of the body. Many times athletes use injuries to take a "time out." Our policy is to work the athlete during the recovery stage, especially if it is during the season, but protect the injured body. This includes hydro-therapies, such as swimming, water aerobics, non-impact (gliding) exercises for lower extremity injuries (e.g. stationary bikes, nordic track, elliptical trainers upper body ergometers, etc.).

As far as return to activities, it depends on the phase of the season and the type of sport (anaerobic vs. aerobic). If an athlete is in-season, the injury is of short duration, and the athlete is training daily, there usually is little training loss, and the athlete may return with very little loss of conditioning. However, if the injury or surgery is in the off-season, the athlete may be significantly deconditioned, and may require gradual return to activity.