“How long will it take for this injury to heal”? This is a common question I hear frequently from athletes with sports injuries. They don’t like slowing down or stopping their routine, injuries are inconvenient disruptions to their busy training schedule. Answering this questions isn’t easy or straight forward. There are many factors involved in the injury process some physical, some psychological, always a combination of both. Alleviation of pain is often the primary goal of therapy/rehab – nobody likes to be in pain.
Managing pain can actually be the easiest part of the rehab process particularly in the initial/acute phase. Rest is always good, massage helps as does heat, ice, proper nutrition/hydration etc. The RICE protocol (Rest/Ice/Compression/Elevation) is the standard go-to formula for acute sprain/strain injuries. In another post I’ll delve deeper into the management of injuries. It is when the initial pain has subsided where things get complicated.
While I do work with acute sports injuries my biggest client population have long standing symptoms that span months to years. These are the chronic/intermittent symptoms (hard to pin down diagnostically since the symptoms vary with activity/intensity/time), x-ray/MRI are often inconclusive so they are not candidates for surgery, many receive cortisone injections. They’ve typically seen other therapists with mixed therapeutic results.
The truth is the longer an injury or pain has been present the more complicated the rehab process is. Even a moderate ankle sprain, if not rehabbed appropriately, can lead to knee and hip symptoms on the same or opposite side – it’s like a domino effect since all joints in the body are linked in a dynamic movement sequence. All injuries and pain disrupt the smooth, natural movement sequence. The sports medicine field calls this disruption “movement compensation”. So whatever the initial injury, could be an ankle sprain, muscle strain etc. the athlete adapts by altering how they move in an attempt to lessen some symptom or experience like weakness, pain or poor joint control. Often they aren’t even aware of what they are doing or why.
With long standing sports injuries with movement compensation my main focus is to develop movement awareness first. Without a sense of how their body feels, moves and performs they will be unable to change the dysfunctional movement patterns into optimal movement patterns. Sometimes it requires breaking down a movement sequence like running into one slow step, feeling how muscles work (or not) and how joints balance and articulate (or not). The movement sequence of running for example begins with one small step which can be traced up through the whole body revealing poor pelvic alignment, poor arm swing/shoulder function and poor neck/head balance.
As the rehab process progresses movement awareness is reinforced by specific (corrective) exercises and alterations in the athlete’s training program. Manual therapy is utilized to target specific compromised soft tissue structures. The overall goal is always to bring the body back into a balanced state of alignment, function and control.
The first step is often the most important one.