HEAD AND CERVICAL SPINE

Rehabilitation of head or cervical spine injuries is highly variable and is based on the type of injury, the severity of the injury, reoccuring symptoms post-injury and the patient's recovery. Because of the involvement of the brain and spinal cord, rehabilitation may involve rest and limited activity in order for recovery to take place. It is important to follow the physician's guidelines for proper rehabilitation of any head or cervical spine injuries.

 

The main goals of rehabilitation are:

• Structural Integrity

• Pain-free Range of Motion and Joint Mobility

• Flexibility

• Muscular Strength

• Muscular Endurance

• Muscular Speed

• Muscular Power

• Intergrated and Coordinated Movements

• Agility

• Cardiovascular Endurance

 

Inflammatory Response Phase

 

During the early stage of rehabilitation, the injury site is going through the inflammatory response stage, where the body is starting to slowly heal. It is important to manage swelling and pain symptoms, as well as protect the injured body part from further damage. Often during this phase, it is important to include rest, immobilization, ice, compression, anti-inflammatory medications, and light range of motion exercises into the rehab plan. 

 

Fibroblastic Repair Phase

 

During this middle stage of rehabilitation, the body is going through the fibroblastic repair stage. The body is slowly repairing itself. This phase can start anywhere between three and fourteen days post-injury and can last for two to three weeks. During this phase, the clinician should be focusing on strengthening musculature and its surrounding structures. Modalities should be continued to manage pain and swelling, if applicable. 

 

Maturation/Remodeling Phase

 

The maturation/remodeling phase is the third phase in the healing process. This is the longest phase of the healing process and can last anywhere from three weeks to several months to several years, depending on the patient's compliance and injury severity. During this phase, collagen fibers continue to synthesis and the increase stresses and strains of physical activity allows for an increase in the realignment of the collagen fibers. The implications of this is described in Wolff’s law, which states that bone and soft tissue will respond to the physical demands placed on them, causing them to remodel or realign along the lines of the tensile force. Therefore, the collagen fibers will align with the line of tension for maximum efficiency. Heating is beneficially in this phase to loosen the collagen fibers, reduce pain, and increase blood flow.