初級 腹部捻挫・肉離れリハビリテーション

Pain at rest less than 2/10 on visual analog scale,Ability to activate transversus abdominis without compensatory breathing patterns,Tolerance of gentle pelvic floor contractions without pain or bulging,No increase in symptoms with static supine positioning,Ability to perform diaphragmatic breathing without abdominal guarding,Pain with resisted trunk flexion less than 4/10

→ 次の段階へ： Week 2: Controlled Mobilization

Pain-free range of motion in pelvic tilts within tolerance,Ability to maintain neutral spine during log-roll movements,Less than 50% pain increase with gentle curl-up progression,Tolerance of static hollowing exercise in hook-lying position,No pain reproduction with light functional activities (sitting to standing),Improved ability to coordinate diaphragm with pelvic floor activation

→ 次の段階へ： Week 3: Early Strengthening

Complete 10 repetitions of modified curl-up with proper rectus abdominis activation,Hold abdominal drawing-in for 10 seconds without loss of neutral spine,Able to perform side-lying oblique activations without pain referral,Tolerance of 5 repetitions of short-lever hip extension in prone without compensatory lumbar extension,No provocation of symptoms with coughing or sneezing (diaphragm and pelvic floor coordination),Ability to maintain abdominal engagement during upper extremity functional movements

→ 次の段階へ： Week 4: Progressive Strengthening

Complete 3 sets of 12 repetitions of modified plank hold (knees on floor) without loss of neutral spine,Able to perform dead bug progression without lumbar compensation,Tolerance of functional load progression (light carrying) without symptom exacerbation,Maintain transversus abdominis activation during respiratory challenges,Complete 10 repetitions each side of side-bridge without pelvic drop,No recurrence of symptoms 24 hours post-exercise

→ 次の段階へ： Week 5: Functional Training

Able to perform 15 repetitions of full curl-up with controlled eccentric phase,Complete 3 sets of bird-dog exercise (alternating arm and leg) without lumbar hyperextension,Tolerance of 30-minute moderate activity without symptom flare,Able to generate intra-abdominal pressure appropriately during functional tasks,No pain with sudden unexpected movements or perturbations,Able to maintain core stability during lower extremity exercises

→ 次の段階へ： Week 6: Advanced Conditioning

Complete 3 sets of 15 repetitions of resisted trunk rotation without pain,Able to perform plank progression (forearm to full plank) with maintained linea alba integrity,Tolerance of high-repetition core endurance exercises (60 seconds total holds),No provocation of symptoms with Valsalva maneuver during exertional activities,Able to transition from quadruped to standing without loss of core control,Complete 20 minutes of continuous aerobic activity at moderate intensity

→ 次の段階へ： Week 7: Return to Activity Preparation

Full return to pre-injury activity level without compensation,Complete 3 sets of 10 repetitions of advanced rotational exercises symmetrically,Ability to maintain pelvic floor function under fatigue conditions,No abdominal wall herniation or bulge with exertional activities,Pass sport-specific or functional movement screening,Patient-reported return to pre-injury confidence level