I think I have an injury. Now what do I do?

I listened to a good podcast on this subject over the weekend.  The guys over at Cycling 360 Media did a show in August about common cycling injuries and did a great job covering this topic.  Go here to listen or download the show.  I’m not going to repeat what they talked about but expand on the topic a bit.

Injury prevention

Sharp pain can often indicate an injury. Achiness that goes away after warming up might indicate muscle tightness.

What Darryl and Victor discuss is primarily about overuse injuries.  Overuse injuries can occur for a number of reasons, the biggest being that a constant repetitive action creates an imbalance on connective tissue or musculature and therefore can create undue stress around a joint.  This is usually seen around two scenarios.  The first is that someone begins training too hard, too soon without giving the body time to adjust to the workload.  What I see more commonly in my practice is an overuse injury that comes about after a long period of training or preparation for an event.  Victor is right on when he mentions that for cyclists, quite often, it can be a position issue.  For runners, it often comes down to high mileage and muscle imbalance.

But what I want to talk about is how someone determines the severity of injury and what to do about it.  The first question is whether rest helps the injury.  I don’t mean a few easy days, but absolute rest.  This is so hard for athletes to do.  But the fact of the matter is that even up to a week away from training is not going to impair performance.  More often, it will bring an athlete to the next level with additional recovery, because they may be overtrained.

Sometimes rest does not help.  There may be a muscle strain or ligament sprain that needs specific attention.  At this point it may be wise to seek the assistance of a  professional.  I would suggest contacting someone that has experience in working with sports injuries.  This can be a physical therapist, massage therapist, doctor, chiropractor, etc.  The important thing is that the person has the knowledge and experience to assess the problem.  I say assess because it is not within the scope of practice for a massage therapist, for example, to diagnose a condition. However, a qualified massage therapist will be able to appropriately assess what structure is affected.

Let’s use an injury with knee pain for example.  A lot can be determined by active range of motion (where a client flexes or extends the knee without assistance), passive range of motion (where the therapist extends or flexes the knee and the client does not assist) manual resistive tests (where the knee is held in place by the therapist and the client performs an isometric contraction) and special orthopedic tests.  From using these different tests it is quite possible to determine whether the pain is being caused by a tight muscle, a trigger point in the muscle or maybe a muscle strain. Or perhaps a problem is a torn meniscus, sprained ligament or a more complex problem within the knee joint.  If the problem is within the joint capsule then it might be necessary for a more sophisticated diagnostic process such as a CT scan or MRI.  Frequently, there needs to be pain for an extended period of time before a doctor will order this.  Palpation of the affected areas gives even more information to the therapist assessing the problem.

The one thing I always stress to clients is to make sure that a provider is actually putting their hands on them.  I’m always a bit baffled when a client comes to me with a diagnosis but their primary care provider has not even laid a hand on them.  Advocate for yourself and inquire about how your doctor or therapist comes to their conclusion.  These people work for you and you are paying them good money to do so.  Make sure you get value for your dollar!

Now let’s say that you’ve got a good treatment plan going, and in partnership with a healthcare provider you are making progress.  Don’t assume that you can’t do any exercise during this period.  Inquire about what you can do or what is a good alternative workout.  Over the past year and a half my teenage son has been working with a disc herniation.  He is seeing one of the best pediatric sports medicine physical therapists in the area.  He has some restrictions; he should not bend at the waist and lift heavy weight and he really should not sit for extended periods of time.  He is encouraged to participate at the highest level he can in soccer, which is his sport of passion.  More movement is better for him as he works with this.  Being sedentary always brings his pain to a higher level.  The lesson here is don’t assume that you should be completely inactive.

Victor talked about an old injury that he had.  When an injury occurs the body responds by laying down scar tissue as quickly and rapidly as possible.  While it is amazing that the body can heal itself in this fashion the scar tissue is laid down randomly, much like a spider web.  But it effectively is just a patch, so to speak, for the damaged tissue, whether it be a muscle, tendon, ligament, etc.   In my experience, the sooner I can get to work on scar tissue after a sub-acute injury the better.  But even years after an injury, progress can be made to restore tissue to normality and then improve flexibility.

There should be a natural progression for treating and rehabilitating a soft tissue injury.  A few weekends ago I participated in a continuing education class taught by Whitney Lowe.  Whitney breaks down rehabilitation protocol into four progressive steps.

  1. Normalize Soft Tissue Dysfunction – This involves resolving trigger points, reducing tight musculature, breaking up scar tissue, etc.
  2. Improved Flexibility – Gaining full normal range of motion.
  3. Restore Proper Movement Patterns –  Neuromuscular Facilitation/Facilitated Stretching
  4. Strengthening and Conditioning

Clients need to be cautious about listening to their bodies and not moving through these four steps too quickly.  Strengthening and conditioning too soon can exacerbate conditions and cause regression.  If an activity is painful, it likely will not get better by continuing to exercise.  You’ll just create a chronic injury out of an acute injury.

Above all, it is vitally important to listen to your body when it begins to voice its displeasure.  Don’t ignore the pain but listen and nip it in the bud.  Remember that time helps a lot with healing and quite often injuries get better on their own without a good explanation.  And finally I would caution against self-diagnosing online.  There is a lot of misinformation on the internet.  Even going out of network for an assessment can be affordable and get you back on the road to recovery much sooner.



The post I think I have an injury. Now what do I do? appeared first on Raining Faith Massage.

The post I think I have an injury. Now what do I do? appeared first on Raining Faith Massage.

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