How Do I Return After an Injury?
The question is always "when can I run or excercise again" not "when will I be healed".
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Understand the Mechanism of Injury
The patient needs to understand the cause of injury. Is the cause from repetition, acute injury or fall, or poor technique or mechanics of exercise.
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Understand the time frame it takes to return safely:
- A break from activity causes disorganization of the strength and flexibility of muscles
- 2-3 weeks off leads to significant losses of fitness especially the endurance components
- Return takes twice as long as the down time
Once the patient understands what has caused the injury and that it will take a period of time to get better we can provide adequate treatment.
PHASE I - Acute Injury or New Inflammation and Pain
(3-6 weeks)
Goal: to eliminate the pain or stimulus for pain
- NSAIDS (monitor for stomach burning, Gastrointestinal distress, or kidney problems
- Ice
- ***Stopping the activity
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Active or inactive rest
Active Rest:- Cross training, walking, swimming that does not cause pain
- If cross training causes pain, need complete rest
- Gentle stretching or Range of motion
- Deep tissue message
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Core Strengthening
- Yoga, pilates are great for flexibility and strengthening
Phase II - Resolution of Pain and Return of Base-line Training
(3-4 weeks)
Assume pain is absent
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We are beginning our sports specific motion (trains coordination of joint and muscle)
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First progress mileage and not intensity (low heart rate or power)
- Running on flat predictable ground
- Cycling on flat or gentle rollers
- After the mileage has increased, the intensity can increase
- Still on a relatively flat surface
- Specific Strengthening
- Leg press, mini-squats, leg curls, leg extensions, etc
- Continue Core Work (Pilates, Yoga)
- May still require NSAIDS
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First progress mileage and not intensity (low heart rate or power)
**** Be Aware of the Pain ******
Phase III - Return To Sport Specific Activity Return to training
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Still focused on the specific strengthening
- *eccentric or plyometric training
- Stretch
- Avoid injury by understanding cause or mechanism

