When faced with a niggle or injury do you pop painkillers or anti-inflammatories and rest it? Has this strategy become less effective? Or have you found you’re injuring yourself more frequently?
Have you ever considered what could be happening?
It may seem sensible to rest when you have niggle or injury, (and this is good to do in some cases), but it won’t fix your injury. It may help your inflammation to settle and enable you to resume exercising again but this doesn’t mean the injury has healed.
The symptoms may have settled but has the root cause been addressed?
I’ve seen many people who have said that their back (or neck, knee, ankle etc.) flares up every 6 months (for example) but it settles again after a few weeks rest and they are able to continue as normal. However the underlying issue has not been identified or addressed. And each time a flare up occurs, it can cause just that bit more trauma, which, in the long run can lead to significant injury or longer recovery.
It is vital to identify the root cause of the injury and to rehab this cause thoroughly to minimise the chance of it reoccurring.
Two people can present with the same injury but the cause could be very different. Back pain for one could be the result of an old ankle injury while for the other, the result of a neck injury. Once the cause has been identified and your goals established, your rehab plan can be developed, giving you the best possible chance of recovery.
Your goals are important as these will establish just how far the rehab process has to be taken before you are fit to return to what it is you would like to do. For example, someone who wants to be able to walk their dog daily will not necessarily have to undergo as vigorous a rehab as somebody who would like to run daily.
Keeping your rehab programme going
Once the rehab process begins, after a few sessions you may feel a lot better, but not necessarily pain free. This does not mean that you are now fully rehabilitated and able to return to your activity. It is so important to follow each step of the rehab process as once you are pain free, there is still work to be done to restore the use of muscles that may not have been working properly before. It is important to ensure that all muscles are working coordinatively not just during slow controlled movements (such as exercises done lying down) but that you are able to carry out multidirectional movements at a higher speed.
On the other hand, you may continue to experience pain or discomfort during the initial stages of rehab. This is not uncommon as when you carry out daily activities, you may still be relying on dominant muscles, or the muscles that have contributed to the injury in the first place. However, as the rehab progresses and becomes more functional where it begins to mimic movements that you do during the day, discomfort levels should start to decrease.
Step by step
I compare the rehab process to someone wanting to learn to play an instrument. At Grade 1 chords are learnt slowly and it may take some time to figure out just how to move their fingers in a certain way. With lots of practice, this becomes more and more natural and the person can speed up the movement.
As they move from grade to grade, the speed at which they pick up the chords and music tends to quicken and they don’t have to necessarily think as hard before playing each note. And at each stage they are required to pass the exam before they move on to the next level until they ultimately achieve the end goal, Grade 8.
The more gifted musicians may find the early stages easy and may skip from say Grade 1 to Grade 3 or 4 with few issues. However, they could get to Grade 5 or above and suddenly discover a symbol which they may have missed in the skipped grade. This sets them back to a degree.
The same can happen during rehab. Some individuals may be more coordinated or stronger and feel it's ok to jump ahead and ignore certain seemingly basic movements. But down the line they will be presented with more challenging movements and they would have missed a few steps in reaching this point.
The rehab process is important - each step builds on from the last, and the level required to be reached will depend on your goals. The more thoroughly each stage is completed, the more chance you have of being able to return to your activity of choice.
It’s important to partner with someone who will help you achieve this step by step rehabilitation process through identifying the root cause and establishing the best rehabilitation exercises and methods to be free of injury long term.