How to continue rehabbing an injury after initial treatment
I wrote an article recently on the treatment of injuries and focused on the different ways of applying ice and heat for recovery. The use of ice and heat is usually intended for treatment to an injury in the first stages of the injury. The part of the treatment missing was the length of time for the initial application of ice or heat. The most common answer seems to continue treatment until there is no inflammation or warm skin temperature to the wound area. Most use the back of hands to touch the injured area and see if it still feels warm to the touch. And if there is still swelling to the area, this is another indication that more treatment is necessary. This is difficult to determine for a runner with a sprained ankle. Standing on the feet will cause the blood to ‘pool’ in the ankle and may seem like there is still swelling. Massage and compression on a regular basis will help relieve that swelling considerably.
The next part of recovery comes from moving the injured area as soon as you can. If the injured area is rested too long then the muscles surrounding the injury get weaker and atrophy (get smaller) and that causes a longer recovery time. When an injured area of the body is first moved after an injury there is often pain. The key is to be able to distinguish between pain from hurting and being harmed. Working with physical therapists show that the sooner they can get the patient to move and start using the muscles and joints again, the quicker the recovery will be. The key is knowing the difference between a hurt of muscle tightness to actual harm being done to the muscle when it is moved. One method of determining the difference is if the area still intensely hurts after stopping for 20 minutes. If the pain is lessening and the pain is not intense, chances are it is muscle soreness from the first time moving. I like to massage the area after an initial exercise bout after an injury and it seems to help.
There is a body adaptation called “Wolff’s Law” that states the body will adapt to the stress placed on it. Even bone strength will increase if resistance is applied to it. Muscles will get stronger and increase the blood flow to the area to flush out swelling (edema). The tendons will be tighter in the beginning but will stretch out when exercise is applied. Ligaments also get stronger with movement and resistance. As the muscles get stronger, the tendons lengthen, the ligaments get stronger, the swelling decrease the movement becomes easier and healing time will shorten. The intensity of the workout is determined by pain level and whether the pain increases, stays at the same level or lessens when you move it for several minutes. The old adage of runners of “Listen to your body” applies here. And knowing the difference between pain that “hurts” (discomfort may be a better word) versus pain that caused “harm” is good to know.
As movement increases the intensity of the exercise can be gradually lengthened and more resistance added. Allan Besslink, author of “RunSmart” and a physiotherapist, says, “Go ahead and run as fast as you can, as slow as it might be, for a faster recovery from an injury.” Just remember the difference between discomforting pain and harmful pain.
This type of treatment goes back many years. Back before baseball had the position of “relief pitchers,” a pitcher that started the game was supposed to finish the game. If the game went 14 innings, he pitched 14 innings. If his arm was sore the next day, the treatment was to keep throwing a ball against a wall until it got better and stopped hurting. It seemed to work from reading reports of pitchers recovering after a long ball game.
Exercise and movement are great treatments for injury recovery once initial treatment is completed. There are examples of an athlete getting injured and instruction is “to walk it off.” For minor twists and bruises, this has been a staple in athletic circles. For many minor injuries, this seems to work well. And a tape job around the sprain gives extra support and prevents excessive movement to the injured joint. There is an elastic tape called “KT” tape that athletes use to give a little extra support when the muscle is used for the first time. It helps to evaluate the length of time it takes for the discomfort to diminish. If it still is sore the next day you need to back off on today’s workout or rest.
Run, run healthy and move that body to feel refreshed and energetic.
