Injury Rehab

---
name: injury-rehab
description: |
  Comprehensive injury prevention and recovery resource covering RICE protocol, common sports injuries by activity, rehabilitation exercises, stretching programs, foam rolling techniques, recovery nutrition, and return-to-activity criteria.
  Use when the user asks about injury rehab, or needs help with comprehensive injury prevention and recovery resource covering rice protocol, common sports injuries by activity, rehabilitation exercises, stretching programs, foam rolling techniques, recovery nutrition, and return-to-activity criteria.
  Do NOT use when the request requires professional medical advice or falls outside the scope of injury rehab.
license: Apache-2.0
metadata:
  author: foundry-skills
  version: "1.0.0"
  tags: "health-wellness step-by-step guide"
  category: "health-wellness"
  subcategory: "fitness-exercise"
  depends: ""
  disclaimer: "not-medical-advice"
  difficulty: "intermediate"
---

# Injury Prevention & Recovery Guide

> **Disclaimer:** This skill provides general wellness and health information for educational purposes only. It does NOT constitute medical advice, diagnosis, or treatment recommendations. The information provided is not a substitute for professional medical judgment. Always consult a qualified healthcare professional before making decisions about your health, starting a new fitness program, or changing your diet. If you are experiencing a medical emergency, contact emergency services immediately.
## When to Use

**Use this skill when:**
- User asks about injury rehab
- User needs guidance on injury rehab topics
- User wants a structured approach to injury rehab

**Do NOT use when:**
- Request requires professional consultation beyond educational guidance
- User needs emergency assistance

## Questions to Ask the User First

1. **What is the nature of your concern?** (Active injury / Injury prevention / Recovery from past injury / General soreness)
2. **Where is the pain or concern located?** (Specific body area)
3. **How did the injury occur?** (Acute trauma / Gradual onset / Overuse / Unknown)
4. **When did symptoms begin?** (Today / This week / Weeks ago / Months ago)
5. **Rate your pain on a 1-10 scale.** (At rest / During activity / At worst)
6. **What activities do you participate in?** (Running / Weightlifting / Team sports / etc.)
7. **Have you seen a medical professional for this issue?** (Yes / No / Planned)
8. **What is your recovery goal?** (Return to sport / Pain-free daily living / Prevent recurrence)
---
## When to See a Doctor Immediately

### Red Flags - Seek Emergency/Urgent Care
```
SEEK IMMEDIATE MEDICAL ATTENTION IF:
- Visible bone deformity or bone protruding through skin
- Inability to bear any weight on the affected limb
- Joint appears dislocated or "out of place"
- Severe swelling that develops rapidly (within minutes)
- Numbness or tingling below the injury site
- Loss of pulse below the injury
- Severe pain that does not decrease with rest and ice
- Locking of a joint (unable to bend or straighten)
- Popping sound at time of injury followed by immediate swelling
- Head injury with confusion, vision changes, or vomiting
- Signs of infection: increasing redness, warmth, fever, red streaks
```

### When to Schedule a Medical Appointment
```
SEE A DOCTOR WITHIN 1-3 DAYS IF:
- Pain persists beyond 72 hours despite self-care
- Swelling does not decrease after 48 hours of RICE
- Pain prevents normal daily activities
- Pain disrupts sleep
- Recurring injury in the same area
- Bruising is extensive or spreading
- Limited range of motion that does not improve
- Clicking, catching, or grinding sensations in a joint
```
---
## RICE Protocol (Acute Injury First Aid)

### Phase 1: Immediate Response (0-72 Hours)

| Component | Protocol | Details |
|-----------|----------|---------|
| **R**est | Protect the injured area | Stop activity, avoid using the injured area, use crutches/sling if needed |
| **I**ce | Apply cold therapy | 15-20 min on, 40-60 min off, repeat throughout the day. Use barrier (towel) between ice and skin |
| **C**ompression | Apply gentle pressure | Use elastic bandage (ACE wrap), snug but not tight. Check circulation (skin color, sensation) |
| **E**levation | Raise above heart level | Prop up on pillows, especially while sleeping and resting |

### RICE Protocol Details
```
ICE APPLICATION GUIDE:
- Ice bag or frozen peas wrapped in thin towel
- Apply for 15-20 minutes maximum
- Wait 45-60 minutes between applications
- Repeat 4-8 times per day for first 48-72 hours
- NEVER apply ice directly to skin (risk of ice burn)
- STOP if skin becomes white or numb

COMPRESSION WRAPPING:
- Start wrapping below the injury (distal to proximal)
- Overlap each layer by 50%
- Snug but not tight - you should be able to slide a finger under
- Loosen if: numbness, tingling, increased pain, color change, swelling beyond wrap
- Remove to sleep if concerned about circulation

ELEVATION:
- Above the level of the heart when possible
- Use 2-3 pillows for leg injuries
- For arm injuries, use a sling or prop arm on pillows
- Maintain elevation as much as possible in first 48 hours
```

### Updated PEACE & LOVE Framework

The modern approach to acute injury management:
```
PEACE (Immediately after injury):
P - Protect: Avoid activities that increase pain
E - Elevate: Higher than the heart
A - Avoid anti-inflammatories: Let natural healing begin
C - Compress: External pressure with bandage
E - Educate: Understand your injury, avoid over-treatment

LOVE (After the first few days):
L - Load: Resume normal activities as tolerated
O - Optimism: Positive mindset aids recovery
V - Vascularization: Pain-free cardiovascular activity
E - Exercise: Active approach to restore mobility/strength
```
---
## Common Sports Injuries by Activity

### Running Injuries

| Injury | Location | Cause | Recovery Time |
|--------|----------|-------|---------------|
| Runner's Knee (PFPS) | Front of knee | Overuse, weak quads/glutes | 4-8 weeks |
| IT Band Syndrome | Outside of knee | Tight IT band, weak hips | 4-8 weeks |
| Shin Splints (MTSS) | Front of shin | Too much too soon | 2-6 weeks |
| Plantar Fasciitis | Bottom of foot/heel | Tight calves, overuse | 6-18 months |
| Achilles Tendinitis | Back of ankle | Overuse, tight calves | 6-12 weeks |
| Stress Fracture | Shin, foot, hip | Overtraining | 6-12 weeks |

### Weightlifting Injuries

| Injury | Location | Cause | Recovery Time |
|--------|----------|-------|---------------|
| Rotator Cuff Strain | Shoulder | Poor form, overload | 4-12 weeks |
| Low Back Strain | Lumbar spine | Rounding during lifts | 2-8 weeks |
| Bicep Tendinitis | Front of shoulder/arm | Overuse, heavy arm exercises | 4-8 weeks |
| Patellar Tendinitis | Below kneecap | Heavy squats, jumping | 6-12 weeks |
| Wrist Strain | Wrist | Poor grip, heavy pressing | 2-6 weeks |
| Elbow Tendinitis | Elbow (medial/lateral) | Gripping, pressing | 6-12 weeks |

### Team Sports Injuries

| Injury | Location | Cause | Recovery Time |
|--------|----------|-------|---------------|
| Ankle Sprain | Ankle (lateral) | Rolling ankle | 2-8 weeks |
| ACL Tear | Knee | Cutting, pivoting | 6-12 months (surgical) |
| Hamstring Strain | Back of thigh | Sprinting, kicking | 2-8 weeks |
| Groin Pull | Inner thigh | Lateral movement | 2-6 weeks |
| Concussion | Head | Impact | 1-4 weeks (medical clearance required) |
| Shoulder Separation | AC joint | Fall on shoulder | 4-12 weeks |

### Racquet/Throwing Sports

| Injury | Location | Cause | Recovery Time |
|--------|----------|-------|---------------|
| Tennis Elbow | Outer elbow | Repetitive extension | 6-12 months |
| Golfer's Elbow | Inner elbow | Repetitive flexion | 6-12 months |
| Rotator Cuff Tear | Shoulder | Overhead repetition | 3-6 months |
| Wrist Tendinitis | Wrist | Repetitive motion | 4-8 weeks |
---
## Basic Rehabilitation Exercises

### Ankle Rehabilitation Protocol
```
PHASE 1 - ACUTE (Days 1-7): Pain and swelling management
- RICE protocol
- Ankle alphabet (trace letters with toes): 2x daily
- Towel scrunches: 3x20 reps
- Gentle ankle pumps (up and down): 3x20

PHASE 2 - EARLY REHAB (Weeks 1-3): Restore range of motion
- Seated ankle circles: 10 each direction, 3 sets
- Resistance band dorsiflexion: 3x15
- Resistance band plantarflexion: 3x15
- Resistance band inversion/eversion: 3x15
- Calf raises (bilateral, flat ground): 3x15

PHASE 3 - STRENGTHENING (Weeks 3-6): Build strength
- Single-leg calf raises: 3x12
- Single-leg balance: 3x30 sec
- BOSU ball balance: 3x30 sec
- Lateral band walks: 3x15 each direction
- Single-leg deadlift: 3x10

PHASE 4 - RETURN TO ACTIVITY (Weeks 6+): Sport-specific
- Jogging in straight lines
- Figure-8 running
- Lateral shuffles
- Cutting and pivoting drills
- Sport-specific movements
```

### Knee Rehabilitation Protocol (Patellofemoral Pain)
```
PHASE 1 - PAIN REDUCTION (Weeks 1-2)
- Quad sets (isometric): 3x10 (hold 10 sec each)
- Straight leg raises: 3x10
- Clamshells: 3x15
- Hamstring flexion (prone): 3x12
- Stationary bike (low resistance): 10-15 min

PHASE 2 - STRENGTHENING (Weeks 2-6)
- Wall sits: 3x30 sec
- Step-ups (low step): 3x10 each leg
- Mini squats (pain-free range): 3x15
- Side-lying hip abduction: 3x15
- Single-leg balance: 3x30 sec
- Glute bridge: 3x15

PHASE 3 - FUNCTIONAL (Weeks 6-12)
- Bulgarian split squats: 3x10 each
- Single-leg squat to chair: 3x8 each
- Lateral band walks: 3x15 each
- Step-downs (controlled): 3x10 each
- Leg press (moderate weight): 3x12
```

### Shoulder Rehabilitation Protocol
```
PHASE 1 - PAIN MANAGEMENT (Weeks 1-2)
- Pendulum swings: 2 min each arm
- Isometric internal rotation: 3x10 (hold 5 sec)
- Isometric external rotation: 3x10 (hold 5 sec)
- Scapular squeezes: 3x15
- Ice after exercises
PHASE 2 - RANGE OF MOTION (Weeks 2-4)
- Wall slides: 3x10
- Passive range of motion (using other arm to assist)
- Doorway pec stretch: 3x30 sec hold
- Cross-body shoulder stretch: 3x30 sec hold
- Sleeper stretch: 3x30 sec hold
PHASE 3 - STRENGTHENING (Weeks 4-8)
- Band external rotation: 3x15
- Band internal rotation: 3x15
- Band pull-aparts: 3x15
- Face pulls (light band): 3x15
- Prone Y-T-W raises: 3x8 each
- Side-lying external rotation: 3x12
PHASE 4 - RETURN TO ACTIVITY (Weeks 8-12)
- Overhead pressing (light): 3x10
- Push-ups (modified to full): 3x10-15
- Rowing movements: 3x12
- Sport-specific movements
```

### Low Back Pain Protocol
```
PHASE 1 - ACUTE PAIN RELIEF (Days 1-7)
- Gentle walking (10-15 min, several times daily)
- Pelvic tilts (supine): 3x10
- Knees-to-chest stretch: 3x30 sec
- Cat/Cow: 2x10
- Child's pose: Hold 1 min
PHASE 2 - MOBILITY RESTORATION (Weeks 1-3)
- Bird dog: 3x10 each side
- Dead bug: 3x10 each side
- Glute bridge: 3x15
- Side plank (modified): 3x15 sec each side
- Seated spinal rotation: 3x10 each side
- Hip flexor stretch (kneeling): 3x30 sec each
PHASE 3 - CORE STABILIZATION (Weeks 3-8)
- Plank: 3x20-60 sec
- Side plank (full): 3x20-30 sec each
- Pallof press: 3x10 each side
- Bird dog with holds: 3x10 (5 sec hold)
- McGill modified crunch: 3x10
- Hip hinge pattern (bodyweight): 3x10
PHASE 4 - RETURN TO LOADING (Weeks 8+)
- Goblet squat: 3x10
- Romanian deadlift (light): 3x10
- Farmer's carry: 3x30 sec
- Gradual return to loaded movements
```
---
## Stretching Programs

### Full-Body Flexibility Routine (15 minutes)
```
Hold each stretch for 30 seconds, 2 rounds:

UPPER BODY:
1. Neck tilts (each side)
2. Cross-body shoulder stretch (each arm)
3. Doorway pec stretch
4. Tricep overhead stretch (each arm)
5. Wrist flexor and extensor stretches

LOWER BODY:
6. Standing quad stretch (each leg)
7. Standing hamstring stretch (each leg)
8. Kneeling hip flexor stretch (each side)
9. Seated figure-4 (glute stretch, each side)
10. Standing calf stretch (straight leg and bent leg, each side)
11. Seated inner thigh stretch (butterfly)

SPINE:
12. Cat/Cow (10 slow repetitions)
13. Seated spinal twist (each side)
14. Child's pose
```

### Runner's Stretching Routine (10 minutes)
```
1. Standing quad stretch: 30 sec each leg
2. Standing calf stretch (wall): 30 sec each leg
3. Soleus stretch (bent knee calf): 30 sec each leg
4. Kneeling hip flexor stretch: 30 sec each side
5. Pigeon stretch (or figure-4): 30 sec each side
6. Hamstring stretch (doorway or supine): 30 sec each leg
7. IT band stretch (standing cross-leg): 30 sec each side
8. Seated ankle circles: 10 each direction each foot
```
---
## Foam Rolling Techniques

### Foam Rolling Guidelines
```
GENERAL RULES:
- Roll slowly (1 inch per second)
- Spend 30-60 seconds per muscle group
- Pause on tender spots (trigger points) for 20-30 seconds
- Breathe deeply and try to relax the muscle
- Never roll directly on bones or joints
- Avoid rolling the low back (use a lacrosse ball instead)
- Roll BEFORE stretching for best results
- Can be done pre-workout (brief, lighter pressure) or post-workout (thorough)
```

### Foam Rolling Protocol by Body Area
```
CALVES (30-60 sec each)
- Sit with roller under calf
- Cross opposite ankle on top for more pressure
- Roll from Achilles to below the knee
- Rotate foot in/out to hit different angles
QUADRICEPS (30-60 sec each)
- Lie face down, roller under thighs
- Roll from hip to just above kneecap
- Turn to each side for inner and outer quad
HAMSTRINGS (30-60 sec each)
- Sit on roller under back of thigh
- Roll from glute to just above back of knee
- Cross one leg over the other for more pressure
IT BAND (30-60 sec each)
- Lie on your side, roller under outer thigh
- Roll from hip to just above outer knee
- Use top leg in front for support and pressure control
GLUTES (30-60 sec each)
- Sit on roller, cross ankle over opposite knee
- Lean toward crossed-leg side
- Roll in small circles on the glute
UPPER BACK (60 sec)
- Lie face up, roller under upper back
- Arms crossed over chest or behind head
- Roll from mid-back to upper shoulders
- NEVER roll the lower back on a foam roller
LATS (30-60 sec each)
- Lie on your side, roller under armpit area
- Extend arm overhead
- Roll from armpit to mid-ribs
```
---
## Recovery Nutrition

### Post-Injury Nutrition Priorities
```
PHASE 1 - ACUTE (First 1-2 weeks)
Focus: Reduce inflammation, support tissue repair
- Increase protein: 1.6-2.2 g/kg body weight
- Anti-inflammatory foods: fatty fish, berries, leafy greens, turmeric, ginger
- Vitamin C: citrus, bell peppers, kiwi (collagen synthesis)
- Zinc: meat, pumpkin seeds, lentils (immune function, healing)
- Omega-3 fatty acids: salmon, walnuts, flaxseed
- AVOID: excessive alcohol, processed foods, excess sugar

PHASE 2 - REHABILITATION (Weeks 2-8+)
Focus: Support muscle rebuilding, energy for rehab
- Maintain high protein intake
- Adequate calories (do not under-eat during recovery)
- Calcium + Vitamin D: dairy, fortified foods, sunlight (bone health)
- Collagen: bone broth, collagen supplements (tendon/ligament support)
- Creatine: 3-5g daily (may support muscle retention during immobility)
- Hydration: minimum 8 glasses water daily
```

### Anti-Inflammatory Food Guide

| Food Category | Examples | Key Compounds |
|---------------|----------|---------------|
| Fatty Fish | Salmon, mackerel, sardines | Omega-3 (EPA/DHA) |
| Berries | Blueberries, strawberries, cherries | Anthocyanins |
| Leafy Greens | Spinach, kale, arugula | Vitamins K, A, C |
| Nuts | Walnuts, almonds | Healthy fats, vitamin E |
| Spices | Turmeric, ginger | Curcumin, gingerols |
| Olive Oil | Extra virgin | Oleocanthal |
| Green Tea | Matcha, brewed | EGCG |
---
## Return-to-Activity Criteria

### General Return-to-Sport Checklist
```
Before returning to full activity, you should meet ALL of the following:

[ ] Pain-free at rest
[ ] Full range of motion compared to uninjured side
[ ] Strength at 90%+ of uninjured side
[ ] Able to perform sport-specific movements without pain
[ ] Completed a progressive return-to-activity protocol
[ ] Confidence in the injured area (no guarding or favoring)
[ ] Cleared by healthcare professional (if applicable)
[ ] Adequate sleep and nutrition supporting recovery
```

### Progressive Return-to-Running Protocol
```
Step 1: Walk 30 minutes pain-free (consecutive days)
Step 2: Walk/jog intervals - 1 min jog / 4 min walk x 6 (3 sessions)
Step 3: Walk/jog intervals - 2 min jog / 3 min walk x 6 (3 sessions)
Step 4: Walk/jog intervals - 3 min jog / 2 min walk x 6 (3 sessions)
Step 5: Walk/jog intervals - 4 min jog / 1 min walk x 6 (3 sessions)
Step 6: Continuous easy jog 20 min (3 sessions)
Step 7: Continuous easy jog 30 min (3 sessions)
Step 8: Resume normal easy running, add mileage by 10%/week

STOP AND GO BACK A STEP IF:
- Pain during or after running (above 2/10)
- Swelling returns
- Limping or compensating
- Pain the following morning
```

### Progressive Return-to-Lifting Protocol
```
Step 1: Pain-free bodyweight movements through full ROM
Step 2: Resistance bands at full ROM (2-3 sessions)
Step 3: 50% of pre-injury weight, higher reps (12-15) (1 week)
Step 4: 65% of pre-injury weight, moderate reps (10-12) (1 week)
Step 5: 75% of pre-injury weight, standard reps (8-10) (1 week)
Step 6: 85% of pre-injury weight (1 week)
Step 7: Gradual return to previous weights over 2-4 weeks
```
---
## Injury Prevention Strategies

### Pre-Workout Injury Prevention Checklist
```
[ ] Adequate sleep (7+ hours the night before)
[ ] Properly hydrated
[ ] Eaten within 2-3 hours
[ ] Dynamic warm-up completed (5-10 minutes)
[ ] Sport-specific warm-up completed
[ ] Proper footwear for the activity
[ ] Equipment in good condition
[ ] No sharp pain during warm-up
[ ] Training load appropriate (not making big jumps)
```

### The 10% Rule
```
Never increase training volume (mileage, weight, sets) by more than 10% per week.

```

### Prehabilitation (Prehab) Exercises
```
SHOULDER PREHAB (Before upper body training):
1. Band pull-aparts: 2x15
2. Band dislocates: 2x10
3. Face pulls: 2x15
4. YTW raises (light): 2x8 each

KNEE/HIP PREHAB (Before lower body training):
1. Glute bridge: 2x15
2. Clamshells: 2x15 each
3. Lateral band walks: 2x10 each
4. Bodyweight squats: 2x10

ANKLE PREHAB (Before running/sports):
1. Ankle circles: 10 each direction each foot
2. Single-leg balance: 30 sec each
3. Calf raises: 2x15
4. Toe walks and heel walks: 20 yards each
```
---
## Output Format

When providing injury guidance, present it as:
```
INJURY ASSESSMENT SUMMARY
Concern: [Description]
Body Area: [Location]
Likely Category: [Acute / Overuse / Chronic]
Severity Indicators: [Mild / Moderate / Severe]
RECOMMENDED ACTION:
[ ] Self-care appropriate
[ ] Schedule medical appointment
[ ] Seek immediate medical attention
IMMEDIATE CARE:
[Protocol details]
REHABILITATION PLAN:
Phase | Duration | Focus | Exercises
------|----------|-------|----------
      |          |       |
RETURN-TO-ACTIVITY CRITERIA:
[Checklist]
PREVENTION GOING FORWARD:
[Recommendations]
**REMINDER: This is educational information only. Consult a healthcare
professional for diagnosis and personalized treatment.**
```

## Example

**Input:** "Help me get started with injury rehab"

**Output:** A structured injury rehab plan tailored to the user's specific situation, following the process outlined above.

## Edge Cases

- **Incomplete information:** Ask clarifying questions before proceeding. Do not assume details the user has not provided.
- **Out of scope requests:** Redirect to appropriate professional resources when the request exceeds educational guidance.
- **Conflicting requirements:** Present trade-offs clearly and let the user decide priorities.