Every month, it seems like there is a new fad for injuries. One month inflammation is the devil, then its icing. This year, cupping is all they hype, but what happened to K-tape? And whats up with blood-restriction training?! In order to be an educated consumer, you must arm yourself with the facts behind what happens when you get hurt. Understanding the healing cycle will help you know what you can do to help your body rebound. Here are some answers to some common questions people have about getting hurt.
How do Injuries happen?
Most of the time, we can point our fingers at stress and a bit of bad luck. Stress is directly proportionate to strain. The more strain we put on our body, the higher the chance we have for injury. Stress on the body comes in all different forms. Some examples of stress includes: physical, postural, emotional and breathing patterns. Stress puts strain on the body and strain increases stress. Its a vicious cycle, but it can be broken. Posture can be fixed, emotions can be lifted, and breathing patterns can be changed. Although bad luck happens, your tissues can recover and heal in a way that can minimize future strain.
What happens when an injury occurs?
Depending on what source you use, there are 3-4 stages in healing. For our purposes today, I am going to use the 3 stage model.
Inflammation Stage (Acute):
This stage is the shortest of the three, typically lasting just a few days up to a couple of weeks. This is the time that your body attempts to clean up the mess. Your injury might get red or black & blue, swell up and be painful. The mechanism behind this stage is an influx of blood to the area. This is because more white blood cells (Neutrophils & Macrophages) need to enter the area to clean up damaged tissue.
Inflammation gets a bad rep. Thats too bad because it is necessary for healing. Inflammation becomes a problem when it lasts longer than it should.
When does inflammation become a problem? As a rule of thumb, its more than two weeks.
This is when the good stuff starts to happen. Your pain begins to decrease, while your body begins to rebuild the damaged tissues. Your body replaces the injured tissues with scar tissue made up of collagen. This tissue is not as strong as the original tissue and is prone to re-injury if too much stress is applied too early. This stage may lasts up to six to eight weeks.
This final stage is the longest, which can last anywhere from 3 weeks to 12 months following the injury. Tissues that have a good blood supply (i.e. bones & muscles) will heal the fastest. Tissues with poor blood supply (tendons, ligaments, joint capsules), will take the longest. This stage is when the new tissue is “remodeled” by good physiological stresses. This helps to align the collagen fibers in a way that maximizes their strength. The damaged tissues may never be as strong as it once were, but if it heals correctly- it can be pretty darn close.
How do I know what stage my injury is in?
Understanding what stage of healing your body is in will be the best guide for determining what to do. We use pain to determine what stage we’re in.
- Inflammation: it hurts before resistance is applied to the tissue.
- Repair: it hurts when resistance is applied to the tissue
- Remodeling: it hurts after resistance is applied to the tissue.
So what does that mean? Lets use an ankle sprain as an example. When you first twist an ankle, it hurts just putting your toe on the ground. That’s pain before resistance, therefore you are in the Inflammation/Acute Stage. A few days later, you are able to walk on it but it hurts when you do so. Thats the Repair/Sub-acute Stage. Eventually, you are able to walk longer distances, but hurts at night. Thats the Remodeling/Chronic Stage.
Why do injuries re-occur?
Injuries re-occur because the healing tissues aren’t as strong as they were pre-injury. The tissues are most vulnerable in the remodeling period. Since we use pain as our indicator for determining what healing stage we are in, pain killers may inhibits our ability to tell where we are at. I am not advocating that we stop taking pain killers. I just want to highlight the fact that we are not able to listen to our body if we are blocking what it is trying to tell us. Athletes have a tendency to go too hard too fast. We block the pain and then go back out there in hopes of performing at the same level that we were at before. If we do this during the Repair Stage, we are likely to re-injure the tissue. This is how injuries become chronic.
How do injuries become chronic?
Injuries may become chronic at any of the healing stages and are also be prone to going hay-wire. For example, chronic inflammation. This becomes an issue because it interferes with the Repair and Remodeling stage, preventing healing and may actually further damage healthy tissues. This is due to the non-discriminate action of Neutrophils. Injuries may also cause trouble in other areas of the body. One of the underlying reasons for this is because other areas of the body now have to “compensate” for the weakened tissues or for a lack motion available. Scar tissue may also cause issues. Scar tissue can proliferate beyond the boundaries of the injury. This causes tissues that once slid past each other to get stuck.
You will be able to find more information on this blog site which will help you to address the injuries in your body and the deficits that may follow. Stay tuned.