If you’re still in pain following an injury that happened some time ago, this post will help to explain why and what to do now.
When we’re given healing times for particular injuries, what’s often not taken into consideration is the broader effect they have on the muscular system.
Sure your body can heal a torn muscle in 6 weeks and a broken bone in 8 weeks, but is that the full picture?
Perhaps not.
This review found weakness in the quadricep (thigh) muscles following anterior cruciate ligament (ACL) reconstruction surgery. Weakness that was still apparent 12-18 months post-op.
Some of these changes are not limited to muscles in the immediate area of an injury either. This study found pre-operative weakness in the hip extensors, hip adductors, and calf muscles of ACL patients.
So if studies show weakness can persist long after injury, and may be relatively divergent from the site of injury, perhaps you can see why you’re still experiencing issues.
But wait, there’s more.
Non-contact injuries don’t happen in a vacuum
Whenever you see an athlete pull up with an injury, you can bet somebody will mention bad luck.
Chance may be involved in the case of a high force tackle for example. If however an athlete is running in a straight line, by themselves, what role does luck play?
I recently read an interview with a pilot who explained that plane crashes don’t happen without warning signs.
First system A fails, or is faulty, and then B, and then C, and then D. It’s usually a series of events, rather than a one-off incident, that leads to a plane falling out the sky.
The same can be said for non-contact musculoskeletal injuries. It’s normally a series of events that ultimately leads to the overload of a specific tissue.
Look beyond the injury for better outcomes
So if a series of events can lead to injury, it stands to reason that just focusing on the site of injury may not lead to the best outcomes.
There is little point in focusing on system D without going back and also looking at the systems that led to that failure, namely A, B and C.
A hamstring pull may just as easily have its roots at the foot and ankle, the hip, the trunk, or perhaps all three.
The longer the injury, the wider the search
If you’ve been experiencing issues for some time and have made several unsuccessful attempts at rehab, this is of particular relevance.
You’re probably well aware of the saying ‘use or lose it.’ Picture a situation where your central nervous system has been expertly directing movement around a vulnerable area for months, or maybe even years.
What do you think are the consequences of this action? Further weakness? Correct.
These alterations in movement are largely imperceptible and shouldn’t necessarily be consciously overridden.
What’s required is a joint by joint appraisal of the situation and isolated strengthening where necessary.
Summary
Recovering from an injury can be a frustrating process. It often extends well beyond the typical healing time of the injured tissue.
Optimising the function and tolerance of every joint motion, not just those in the injured area, may prove useful.
This is particularly relevant in cases of long term or chronic issues.
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