#injury#reinjury#healing#rehab
Why re-injuries occur? My hypothesis:
Case Study: By chance, I recently had two tennis elbow clients in fast succession. The first had been dealing with the condition for more than two years, while the second had been dealing with intermittent pain for several months before it suddenly became worse from overusing his forearm. I only take on cases for those who have visited the doctor the required number of times but have not recovered. I consider it a research project.
Current status: Both returned to optimal functionality without pain whilst their tissue is still healing ( at lateral epincondyle).
Let’s delve into the subject of injuries and examine it from a cellular perspective. In the case of a injury tissue damage
– Platelets and clotting factors gather at the site of injury.
– Neutrophils accumulate at the damaged area to prevent pathogens from entering and form a protective clot.
– Fibroblasts deposit proteins beneath the wound, followed by the growth of new skin cells to cover the wound.
Healing: The best and most fundamental way to heal any part of the human body is to provide it with rest. In musculoskeletal injuries, healing essentially involves reducing movement in the affected area to allow platelets and clotting factors to gather at the wound site.
Rehab: The fundamental principle of rehabilitation is to avoid aggravating the injury.
Imp note: The duration of healing depends on the severity of the injury, age, and overall health. Overall health here includes the entire musculoskeletal system.
Now let us look at the application of science in our day today life and how we inadvertently disturb the process of healing. In our daily lives, we move every joint – knees, elbows, shoulders, ankles, and so on – even when we are not actively training. Although the best recommendation would be to avoid using or disturbing the injured part and allow it to heal, however ife cannot come to a standstill. We continue to move, which puts stress on the affected area. This is where a good rehabilitation expert can help to reduce the stress and facilitate tissue healing by teaching you a few postural nuances to put less stress on the injured area.
But then why do re-injuries occur?
One of the main risks of future injury factually lies in the fact that how the soft tissue was rehabilitated or recovered, from previous injury/ surgery. Was it rushed?
Let me clarify this for you: When an injury occurs, the functioning of the surrounding muscles is inevitably disrupted. Some muscles become overactive, some become inhibited, and others become isometrically or eccentrically compromised.
Here’s an analogy: Imagine a brand new racing car with a powerful engine, with one old, worn-out tire and three brand new tires.
– Now, think about your elbow, which is worked upon by triceps, biceps, forearm flexors and extensors, and ligaments that join the humerus, radius, and ulna bones.
Return to analogy: Despite having a strong engine and brand new radial tires, the car cant reach its max speed without risking an accident. Even if it does, it cannot sustain that speed without breaking apart.
Similarly, any injury or tissue damage in the arm/hamstrings (or elsewhere) will alter the functioning of the entire musculature. While one may heal the injury over time, what happens to the imbalance caused by the initial injury? Or, more likely, was the imbalance (btw overactive and underactive musculature in a circuit) the reason for the injury in the first place?
FACT: unless we address the root cause of the injury, we cannot prevent its recurrence.
The sports world faces a significant gap when it comes to identifying the root cause of injuries. Doctors may not comprehend the intricacies of a particular sport or the athlete’s role in it, making it difficult for them to pinpoint the cause of the injury accurately. The roots for pain could be at this feet whereas the pain area could be at shoulder! So its fair that they can’t because its not their area of speciality. Additionally, they have little control over how an athlete trains, which can further complicate the healing process.
Ironically, while trainers can help athletes improve their performance, they may not have a comprehensive understanding of the rehabilitation process. On the other hand, rehab experts may not be able to intervene in an athlete’s training routine, leaving a gap in identifying and correcting the root cause of the injury.
So, who can bridge this gap?
In short: a trainer doesn’t understand the rehab and a rehab expert can’t intervene with training. Then who figures out the root cause?
Umesh Chhikara 