Every injury is unique. What structure is injured? Soft tissues such as muscles, ligaments or tendons? Bone? Is there something underlying that may need further investigation or intervention? How and when did it happen? Has there been any treatment administered so far?
Given there are so many factors that need to be considered there isn’t really a ‘recovery recipe’ that can be applied to everyone. Instead what we do have are some guidelines that help us to manage different injuries.
In an attempt to try and keep it simple let’s consider two scenarios. An ACUTE soft tissue injury such as an ankle sprain vs your dad’s CHRONIC bad back that he's been complaining about for a few years.
Sprained ankle
A sprained ankle: You stumbled off the curb on the way to work and rolled your ankle. There was immediate pain, by the time you got to work obvious swelling had appeared and it’s not comfortable to put all your weight on that foot. What do you do?
RICER Protocol
Your recovery starts immediately with what’s called the RICER protocol:
- R: REST
- I: ICE
- C: COMPRESSION
- E: ELEVATION
- R: REFERRAL
These principles should be applied for the first 72 hours following any acute injury. I would always encourage one to seek advice from a physio as soon as possible. Ultimately they will guide you through the often painful initial stages as well as the later stages of recovery which will involve gradual loading, strengthening and eventually sports specific exercises. The recovery period for soft tissue injuries is usually 4-6 weeks, but this is a very general time frame with some more severe injuries taking 12 weeks or longer.
Back injury
What about your dad’s bad back that he’s complained about for years? The recovery of a chronic injury such as this starts with the decision to actually do something about it. That sounds silly, but there are far too many people who think its normal to experience pain everyday; I’m telling you it’s absolutely not normal!
When you have persistent pain for an extended period your body adjusts by developing compensatory movement patterns. It might have started as localised lower back pain but what you find when you assess these clients many years down the track is a whole bunch of imbalances ranging from stiffness in the hip joints to poor gluteal strength, poor pelvic stability, mid thoracic stiffness and reduced lumbar mobility.
For these patients the ‘recovery’ involves gradual re-training of efficient movement which I like to break down into a few components:
- Strengthen areas that are weak
- Mobilise areas that are stiff
- Address fear avoidance behaviours (Its not uncommon have avoided certain movements that people associate with pain such as bending over or twisting)
- Educate and build confidence
This can be a timely process, and it requires much diligence on the clients behalf. I will also discuss other lifestyle factors with all of my clients because I strongly believe that sleep, nutrition, stress, hydration and mindset can play a huge role in the recovery of an injury.
Recovering from an injury is a gradual process. Some recovery journeys are relatively straight forward: relative rest, gradual loading, progressive strengthening and return to sport. Other are not so linear and require one to unpack years of compensatory behaviours, slowly re-build strength, restore mobility and eventually improve overall function. One thing I do know is that your recovery will be made much easier by having the right person to support and guide you through it all.