Pain and injury are an inevitable part of life for most of us at some point. Seeing patients on a daily basis, I can say that the psychological distress of not being able to do what you want to do is usually the most difficult piece of recovery to manage. However, if we can break down in simple terms what it means to be in pain and/or injured (note that they are not the same thing) and then unravel some principle-based strategies to rehabilitate the problem, then some of the psychological hardship can probably be mitigated.
So, what does it mean to be injured?
In simple terms, if a tissue is injured, it means it did not at some point tolerate the loads being demanded of it to the degree that the tissue has been damaged (this applies both to discrete traumatic events and to repetitive stress injuries in which adaptive potential is exhausted). Pain is simply the alarm alerting you to the damage. You can think of pain like a fire alarm. The sound of the alarm can be quite annoying (like pain), but it is not the root of the problem. The problem is the fire. On a side note, neurophysiological changes often occur if you’ve been in pain for a long time to the point that you can be in real pain without actual tissue damage (i.e. the tissue has healed). This would be analogous to someone pulling the fire alarm as a prank without an actual fire. These cases are not overly common thankfully, and some of the same strategies discussed to recover from an acute injury can work to mitigate chronic pain as well. However, it usually takes longer because it requires a little slower progression.
So, if you have suffered an injury, there are two likely scenarios:
- You move very well and efficiently with adequate variability, but the loads have just accumulated faster or to a greater extent than your inherent ability to adapt.
- Your movement patterns are compromised by mobility and/or stability deficits, and thus, you likely have to move with limited variability leaving some tissue to be stressed the same way all the time causing it to be loaded beyond its ability to adapt.
No matter which of these two scenarios applies to you, there are some simple strategies to facilitate healing. You and no one else (i.e. physician, surgeon, chiropractor, physical therapist, massage therapist) can directly “fix” the injured tissue. What you can do, and they can help you do, is create a good environment for your miraculous body to heal.
So, here is a recipe:
Stop overloading the injured tissue for a while. Very simple and extremely important, but very difficult psychologically. The tissue needs a chance to repair in the acute phases without continuously stressing it. It’s amazing how many minor aches and pains feel better after 7-10 days if we simply don’t make them worse in that time.
If there is a movement dysfunction, address it. Restore missing mobility and stability prerequisites. This sort of training is often found to be quite boring and challenging. The fruits of your labor in these areas take a long time to realize, but if you can stay patient and diligent, you will never stop reaping the benefits. If you are missing a prerequisite your body will have to compensate in some way, and you leave yourself open to delayed healing and/or repeated injuries.
Gradually and progressively build the tissue back up and be patient. The body has an amazing ability to adapt, but it takes time and the appropriate stimulus. A good strategy here is graded exposure. Think of someone trying to conquer a phobia. One mode of therapy is graded exposure, in which the person is slowly and progressively presented with more and more threatening stimuli as they tolerate the stages before. Recovering from an injury is similar in that you slowly expose the tissue to threatening stresses, and once it tolerates a certain stress, you gradually give it a little more.
Dr. Andreo Spina has a nice and succinct formula that I think applies here:
Load > Capacity = Injury
Capacity > Load = Rehab
Capacity >> Load = Prevention
Is there anything else you can do when you suffer an injury?
Make sure your sleep is in check. Everything works better, including your body’s ability to heal, when you’re sleeping well.
Work on your weaknesses. What better time to address areas of weakness. For example, if your knee is injured, get really good at pull-ups. Or, if you hurt your shoulder, get really good at pistols.
Ask for help. Sometimes an outside objective view can be very helpful.
Don’t panic. There are more important things in life. And it happened, it’s in the past, what are you going to do about it now.
- Coach Mike