Ouch! That hurt…now what?
Recovering from Muscle, Tendon or Ligament Injury

By Dr. Barry Wahner

We All Get Injuries

Living an active life means you will experience injuries along the way. There are steps to take to prevent injury but even the most diligent person can’t remove all the risks. So at some point you will thus be recovering from an injury. The question at that time is: “How can I get better faster?”

The Most Common Type of Injury

Most commonly the injury will be a “soft tissue” injury which is damage to a muscle, tendon or ligament. These types of injuries fall into 4 Grades:

• Grade I: Tearing or damage of less than 50% of the tissue fibers.
• Grade II: Tearing or damage of more than 50% of the tissue fibers.
• Grade III: Complete tear of the tissue fibers separating the tissue into two sections.
• Grade IV: Complete tear of the tissue at the attachment to bone pulling off a chip of bone.

Grades three and four require professional care and possibly surgery, thus the best treatment advice is to get an appointment with your Doctor ASAP. In the interim, you can follow advice for Phase One of Recovery designed to control inflammation.

THE GOAL: RECOVERING FROM INJURIES!

Recovery from soft tissue injuries follows 3 phases. Understanding the phases will help you to make the choices and do things to help you heal faster and better.

Phase One
The Inflammatory Phase

Obviously inflammation is the primary component of this phase. Phase one lasts 48 – 72 hours (as long as further stress or trauma is not placed on the injured tissue as this could lengthen the inflammatory phase). In this phase the damaged tissues leak blood and cellular products into the area. This causes swelling, irritation and pain.

To improve recovery, inflammation must be controlled. The standard methods work well here - Remember PRICE:

• Protect the tissue from further stress
• Rest the injured area
• Ice the area
• Compression
• Elevation

Most of this is simple to do but a bit of advice will help:

ICE

• Ice cubes work great. Just put them in a big plastic bag placed directly over the injured tissue.

• Use a thin material between the ice bag and skin (paper towel or a t-shirt) to prevent the ice from sticking to the skin. Very often people place a thick towel under the ice, but this prevents the tissue from getting cold enough and thus limits the benefit.

• Ice for up to 20 minutes for “thicker tissues” like the thigh or back and as little as 5 minutes for “thin tissues” like the elbow or hand. When the tissue returns to normal temperature, apply the ice again.

COMPRESSION

• Wrap the area firmly but not so tightly that blood flow is restricted beyond the injured tissue.

• Monitor the area over time because if inflammation increases, the pressure could increase and restrict blood flow. Obviously if you see this occurring, loosen up the compression.
  

Phase Two
The Repair Phase

After the initial inflammation ends, the repair phase begins and lasts for six or more weeks. During this time, the swelling and inflammatory products are removed from the injured area and the damaged tissue begins to be repaired. Pain will reduce and function will improve, but if you put too much stress on the injured area, you will see the pain return and lose function and mobility again.

The key in this phase is to gradually increase activity of the injured area. Increase stretching, exercise and resistance activity slowly. Let the pain guide you. When you are working the area, if it is painful, you reached the limit. Do NOT push into pain (“No Pain – No Gain is NOT your friend here). Pain means you are past the tissue’s strength limits and are thus re-injuring the area. This obviously slows the healing process in this phase.

As the tissue heals it will become stronger and allow you to move further, push harder and work more. As this phase progresses you will regain function. The key here is patience and persistence.

Phase Three:
The Remodeling Phase

This is the longest phase of healing as it can continue for up to two years! During this phase your body transforms the scar tissue built up in the first two phases into more functional tissue. The initial scar tissue fibers are laid down in a random fashion; during this phase the body re-orients those fibers along the lines of stress and increases the strength of the fibers.

The key in this phase is to return to full activity and function. Your best rehabilitation at this point is to perform your normal daily activities, or your sport. Let pain guide you, but as time progresses you can push more into the pain threshold without fear of re-injury. It is important to understand that full recovery does take a long time. Don’t be discouraged by soreness or stiffness even months after the injury.

Nutritional Approaches

There are nutritional approaches that assist in injury recovery. I recommend Omega-3, Magnesium, Zinc and Vitamin C as the basic supplemental support. More advanced support involves Co-Enzyme Q10, and a product blend that contains herbs such as Ginger, Turmeric, Rosemary and the nutrient Bromelain.

Addressing the Cause

Finally, if you suffer an injury, try to determine why it happened and address that cause if possible. If you have structural imbalances, muscle weakness, tightness or strength imbalances that caused the injury, you need to address that problem. If you don’t, there is nothing to stop you from simply re-injuring the tissue again. Take the time to learn from your mistakes.

by
Dr. Barry Wahner

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