This idea of resting if an ache or a pain occurs is outdated, dogmatic and essentially not helpful. Return to play/activity determination is multifactorial. In most cases, returning to full activity is not achievable right away, but can be sped up with the proper guidance. The first 3-5 days following the injury will be the most acute phase. In this phase, inflammation control is the goal. Complete reduction of inflammation is not necessary or helpful. Inflammation is necessary to bring in the proper substances for healing but needs to be controlled as to not run rampant and cause further damage. During the initial healing process, you can start with slow loading if weight bearing is tolerated. If you rest a soft tissue injury too much in the beginning phases, then the fibrotic tissue that is being laid down will become disorganized and lead to tissue that does not efficiently absorb and release forces. This in turn leads to more inflexibility and tightness. This in the long run leads to an increased likelihood that the person will injure the same area again. The sooner you load the tissue, the less strength you lose as well. Also, let’s face it, no one wants to be benched and miss out on their seasons.
Beyond the initial phase, improving proprioception in the area before return to play needs to be achieved. When joints are injured, there is damage that occurs to mechanoreceptors and nociceptors that interrupts the brain’s communication to that area. This leads to a decrease in motor activation and reaction time, which again can put you at a risk of re-injury. Performance enhancement can also be discussed post injury and exercises given to not only reduce the risk of re-injury but make the area stronger.
So please, next time you or an athlete you know is injured consider giving us a call. The difference in approach is the difference in my background and education. I have been a Certified Chiropractic Sports Physician for the past 7 years. I have worked with athletes of all levels and varying sports. Also remember, a minor injury can turn into a serious injury later if it is not addressed properly and efficiently. My goal is not only to get you back to your activities as soon as possible, but also as safely as possible.
Have a safe and joyful week,
Cindy VanSickler, DC, CCSP, Cert. MDT