Use it or lose it! (Make your body adapt to recover from injury)

-

The human body is adaptable in both a negative and positive way. In the past, rest was prescribed for injury but was it the the right thing to do?


Short answer:


Probably not.


Why? I feel better when I rest so that's good, right?


Not necessarily.

Think about it. Do your muscles get stronger with rest? Do your bones get stronger? Do your tendons?  Do you get fitter? No!

In fact the opposite occurs. So that can't be good can it?


Muller et al (1970 found that after 8 days of resting, muscle strength reduced by 2-6%.

Most injuries are caused by cumulative overload to a structure, which basically means they are loaded beyond their physical strength. So taking this on board does rest work?

No, because the tissue that is injured will actually get weaker, which of course, causes more of the same problem that actually caused the injury in the first place.



A great example is the Achilles tendon. Here you have a structure that on average takes between 6-8 times your body weight when you run (Pierre-Jerome 2010).

Research has found that although rest makes it feel better in the short term it will actually make things worse in the long term (Malliaras et al 2013). The evidence actually shows that you need to progressively load the tendon which stimulates healing and makes the structure stronger. It also makes it more able to tolerate the forces applied to it, therefore making it more resistant to injury: Loading of tendon creates an upregulation of insulin-like growth factor (IGF-I) & this stimulates healing (Khan & Scott 2009).


So what constitutes load for an injured Achilles tendon?


Bohm et al (2015) found that loads greater than 70% of a maximum voluntary contraction for isometric loading and 70% 1 repetition maximum for isotonic loading that continues for a 12 week period leads to greater tendon stiffness and therefore more tolerance to load.

Another example is bone density issues like Osteopenia and Osteoporosis. People with these conditions shy away from impact and loading activities for fear of breaking a bone but again this will just make the bone weaker. Here too, evidence shows that if you load the bone you can actually increase the bone density and reduce your risk of fracture: Resistance training & jumping exercises increased bone density in men with low bone density (Hinton et al 2015).

So the case for not resting and instead loading (carefully and progressively) your injuries is the best policy.  I would however, advise being assessed first to ensure that you are doing the correct thing for your injury before starting any loading program.


So if you want to get assessed and looked at, then you can contact me on any of the following:

Telephone: 01782 771861
Mobile: 07866195914
Email: mathewhawkesphysiotherapy@gmail.com



Comments

Post a Comment

Popular posts from this blog

Patella Tendinopathy

-
Image
I hear different terminology used all the time, so what is tendinitis, tendinosis or tendinopathy? Tendinopathy: This is a broad term encompassing painful conditions occurring in and around tendons, which includes tendinitis and tendinosis. Tendinitis: This basically means inflammation of a tendon. Tendinosis:  This means degeneration of tendon (Meaning cumulative damage). So what does this mean to me? For a long time tendinitis was the term used and it was considered that injured tendons were simply inflamed. Then the thinking shifted to the thought that there was little or no inflammation present in these conditions (Andres & Murrell 2008). However as is with research, the thinking is changing again: There may be an inflammatory response associated with chronic tendinopathy, even though recent opinions had decided it to be non-inflammatory (Rees 2013). So both types can occur! This is important as the way that you treat each one has to...
Read more

Cubital Tunnel Syndrome

-
Image
Heard of Cubital Tunnel Syndrome? Probably not but you may have heard of Carpal Tunnel Syndrome. Well they are similar but Carpal Tunnel Syndrome is in the wrist and hand whereas Cubital Tunnel Syndrome is in the Elbow. What is Cubital Tunnel Syndrome? Basically it is a compression neuropathy, which means that a nerve is "trapped”. The nerve at fault in this case is the ulna nerve and where it gets “trapped” is in the cubital tunnel of the elbow: See the below picture: How common is it? It is the second most common compression neuropathy in the upper limb (Palmer & Hughes 2009). What causes it? A common cause is frequent bending of the elbow or constant repetitive pressure on the elbow itself. This then irritates the nerve and it is irritated too much then it becomes a “neuropathy”. What are the symptoms? The patient will complain of pain and numbness in the ring and little finger and weakness is common. If left untreated then this ...
Read more

The case of the clicky hip (AKA: Snapping hip syndrome)

-
Image
Ever wondered what the click in your hip is? Firstly you need to know a little about the anatomy of the area. Bones: Ilium, Ischium, Pubis, Femur: Ilium: Acetabulum (lunate surface, margin of acetabulum) Anterior inferior iliac spine Anterior superior iliac spine Ala (wing of ilium) (gluteal surface and iliac fossa)) Iliac crest (outer lip, tuberculum, intermediate zone, inner lip) Gluteal lines (anterior, inferior and posterior) Posterior superior iliac spine Posterior inferior iliac spine Greater sciatic notch Body of Ilium Illiopubic eminence Arcuate line Auricular surface for the sacrum Iliac tuberosity Ischium: Ischial spine Lesser sciatic notch Body of Ischium Ischial tuberosity Ramus of ischium Obturator foramen Acetabulum Acetabular notch Pubis: Superior pubic ramus Pubic tubercle Obturator crest Inferior pubic ramus Acetabulum Pecten pubis (pectineal line) Symphyseal surface Obt...
Read more