Speed Recovery of Ligaments and Tendons
For years we've been taught that to help our bodies heal from injuries, we should use a system known as P.R.I.C.E. That stands for Protect, Rest, Ice, Compression and Elevation.
You're supposed to PROTECT the injured body spart from further harm. REST, stop or take a break from the activity that caused the pain or injury. ICE the affected area for 10 to 20 minutes at a time, three or more times a day. Apply COMPRESSION to the injury by wrapping it with some sort of elastic bandage. Then ELEVATE the sore area above the level of your heart, to minimize swelling.
Each step seemed to be common sense, until it wasn't. The first major change appeared in 2013, when researchers discovered muscles probably shouldn't be iced. Icing was effective at reducing short-term pain, but over time it actually slowed down how quickly muscles healed. Researchers concluded that, "icing...might be closely related to a delay in muscle regeneration [and] impairment of muscle regeneration..."
So P.R.I.C.E. became simply P.R.C.E. But now another part of that is under attack. It seems we may be taking the Rest part too far. One of the most fundamental rules of working out is this: To develop larger muscles and grow stronger, we have to stress those muscles through training. That means lifting weights or engaging in cardio programs.
Yet many doctors seem to take the opposite approach to repair and rebuild injured tendons and ligaments. Extended periods of rest are prescribed to “let our bodies heal.” Can you imagine a coach telling his students that the best way to grow strong is by sitting around and resting?
Ligament injuries are one of the most common causes of musculoskeletal joint pain and disability that physicians encounter in primary practice. They also don't recover as well as other connective tissues like bones, muscles or skin. So researchers decided to look into different recovery methods to see what works best.
In a paper published in The Open Rehabilitation Journal in 2013, 6, 1-20 researchers said:
“One of the most important advances in the treatment of ligament injuries has come from the realization that controlled and early resumption of activity can stimulate repair and restoration of function, and that treatment of ligament injuries with prolonged rest may actually delay recovery and adversely affect the tissue’s ability to repair itself.”
Researchers found that it was better to put stress on the ligament and start physical therapy to move and load it with weight, as soon as six days after the initial injury. The key is waiting until swelling or inflammation has subsided. Once that happens, mobilization should begin.
Just to be clear, when the researchers talked about activity, they weren't suggesting resuming a full workout routine. Recovery was seen with as little as 5 minutes of exercise therapy a day. You can have better effects by increasing that all the way up to 15 minutes daily, but going beyond that didn't show any significant additional benefit.
Pain was one of the primary problems researchers encountered with early recovery programs. Participants had to be taught the differences between good and bad pain. Discomfort is normal, sharp or shooting pain is not. A physical therapist can design programs that stress your body without causing further damage.
Be cautious in your use of anti-inflammatories like ibuprofen or a cortisone injection. They can be very beneficial for things like a knee injury. The anti-inflammatory can reduce the pain in the knee, allowing you to move easier and with less pain. That in turn allows you to perform therapeutic movements to help the knee heal.
However, for soft tissue injuries, anti-inflammatories haven't been shown to help with the healing. In fact, in several studies, they slowed down the overall recovery process. Suppressing inflammation can suppress healing.
Not all injuries benefit from this approach. If you've got something like a stress fracture, an injury that's caused by exercising too frequently or too strenuously, you shouldn't expect even more exercise to cure the problem. In cases like that, you have to stop hurting your body and PROTECT the injured part. Once the inflammation has subsided, adopt a more realistic fitness program that doesn't overstress you.
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