Imported from FerroxLabs/wayland (src/process/resources/skills-library/bodies/skills/health-wellness/injury-rehab/SKILL.md). Install upstream with npx skills add FerroxLabs/wayland --skill injury-rehab. Copyright stays with the author (Apache-2.0).

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)

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

Weightlifting Injuries

Team Sports Injuries

Racquet/Throwing Sports

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

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.