When dealing with acute injury and resulting inflammation, it is important to utilize a progressive set of tools which begin to immediately move fluid and down regulate the CNS. This is why CARS (Controlled Articular Rotations) from the FRC system offer so much value. Immediately after injury occurs or surgery, assisted CARS can be utilized to maintain range of motion and avoid muscular atrophy while sending a signal of safety to the nervous system. Far more than making a joint circle, the goal is to increase the ability to generate internal tension in the area in question as a form of progressive resistance.
Here is a progression example for the Hip CAR:
1. Assisted supine hip CARS- We can also stop throughout the ROM and perform isometric contractions every 15-20 degrees to re-educate the client to ramp up tension in affected areas.
2. Side lying hip CARS- The goal here is to move the top hip while keeping the bottom hip stationary
3. Standing blocked hip CARs- The wall creates a constraint to eliminate torso movement forcing the hip to work throughout its true ROM.
The ultimate progression criteria for each position would be to perform reps with full internal tension and little to no pain.
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