One secret to safely getting back to pain-free motion after a joint injury is to get comfortable with this idea that it normally takes a lot of time to get better. Not days, not weeks, but generally it takes many months for a tendonitis, ligament or other joint-strain to not only cool down, but for normal strength to return. In fact, when considering a significant change in your present activity level, injured or not, the more time you take to ease into your new regimen or optimal activity level, the more easily your body tissues will adapt. Too often I see individuals become frustrated with their lack of ability to quickly bounce back to regular exercise after physical set-backs. For most people it is a long process where there are typically a few bumps in the road. For example, you are successful in dosing your exercise, swimming, tennis, or say your yoga workout in a way that does not cause exacerbation to that sore neck, shoulder, back, knee, hip or ankle. You become a tad too confident because things are starting to feel better and spend a bit too long in a seated twist, swimming, or perhaps swinging that racket. As a result, you experience renewed soreness or stiffness. You then feel you are back to square-one and become frustrated. This road-block can most often be avoided.
Understand that many musculoskeletal aches and pains arise due to what might be described as an inconsistent relationship to gravity. Wearing a new pair of shoes for many hours can create blisters rather than a callus. Most musculoskeletal aches, pains and or injuries are caused or perpetuated due to unaccustomed changes in activity over too short a period of time. Our body tissues not only take their own sweet time to get stronger, it takes even longer to move past a pain pattern.
The key to promote healing is to identify the amount of activity that does not cause an exacerbation but rather alleviates effects of the injury. The next step is to strategically micro progress an amount that does not elicit pain, soreness or stiffness in any way shape or form. You continue with this progressive approach until you are maintaining your desired activity level. Most joint injuries are successfully dealt with by providing a mechanically sound unaccustomed stimulus (ie the appropriate exercise and activity level) over a long period of time. This is a fundamental art and science underlying the profession of physical therapy. The more active you are, the healthier you are, however when it comes to rehabilitation, it can be like a tight-rope walk. In the very beginning acute stage, on one side of the tight-rope there is too much activity, an amount that inhibits healing. On the other side is not enough activity. Research has now shown that prolonged bed-rest for more than a few days is not a safe treatment for most musculoskeletal injuries. As rehab successfully progresses the tightrope turns into more like a side-walk and the injured part can handle more movement without exacerbation.
You don’t have to be injured for this re-entry principle to apply. If you are planning on substantially increasing your activity level, progress by small amounts. The more time it takes the safer your re-entry. Furthermore, once you achieve your goals, maintaining adequate amounts of your favorite activities lessens the likelihood that abrupt changes in normal every day tasks such as throwing some heavy luggage in the trunk of your car, will contribute or cause aches and pains.
Anna Kotula, DPT