Running Injuries, Sports Injuries
and Treatment for Pulled Muscles
What happens after the first 48 to 72 hours?
Part 2
In last months issue we talked about the initial treatment for sports injuries, like running injuries and other common pulled muscle complaints. Soft tissue injuries to be specific. If you missed last months issue, or would like to refresh your memory, click here to view part 1 of this article.
Last month, we discussed how critical the first 48 to 72 hours are to a full, and complete recovery. If you followed the advice from part 1, the R.I.C.E.R. regime will have kept any bleeding and swelling to a minimum, and the injury will have already started the repair process. Lets move on.
After the first 48 to 72 hours
What happens after the first 48 to 72 hours? Lets take a quick look at how your soft tissue (muscle, tendon, ligament, etc.) repairs itself.
When any sort of damage occurs to the soft tissues, like a strain or sprain, the body immediately goes into a process of repair. Where the individual fibres have been ruptures, or torn, the body begins to bind the damaged fibres together using a fibrous protein called collagen. Or, as it's more commonly known, scar tissue!
You see, when a muscle is torn, you would expect that the body would repair that tear with new muscle. In reality, this doesn't happen. The tear, or rupture, is repaired with scar tissue.
Now this might not sound like a big deal, but if you have ever suffered a soft tissue injury, you'll know how annoying it is to keep re-injuring that same old injury, over and over again. Untreated scar tissue is the major cause to re-injury, usually months after you thought that injury had fully healed.
Scar tissue is made from a very brittle, inflexible fibrous material. This fibrous material binds itself to the damaged soft tissue fibres in an effort to draw the damaged fibres back together. What results is a bulky mass of fibrous scar tissue completely surrounding the injury site. In some cases it's even possible to see and feel this bulky mass under the skin.
What is scar tissue?
When scar tissue forms around an injury site, it is never as strong as the tissue it replaces. It also has a tendency to contract and deform the surrounding tissues, so not only is the strength of the tissue diminished, but flexibility of the tissue is also compromised.
So what does this mean for the athlete? Firstly, it means a shortening of the soft tissues which results in a loss of flexibility. Secondly, it means a weak spot has formed within the soft tissues, which could easily result in further damage.
Lastly, the formation of scar tissue will result in a loss of strength and power. For a muscle to attain full power it must be fully stretched before contraction. Both the shortening effect and weakening of the tissues means that a full stretch and optimum contraction is not possible.
Now, if you've taken the advice from part 1, and used the R.I.C.E.R. regime to treat the initial reaction to a soft tissue injury, you're well on your way to a complete recovery. If however, you didn't use the R.I.C.E.R. regime, you're behind the eight-ball, so to speak. Let me explain.
From last months issue we learnt that when an injury occurs the body responds by sending large amounts of blood to the injury site. If this isn't controlled, with the R.I.C.E.R. regime, it will result in massive bleeding, swelling and pain. More importantly, it will also result in a large formation of bulky, painful scar tissue.
As we know from last month, the R.I.C.E.R. regime will help to control the bleeding, swelling and pain, but more importantly, it will also control the formation of scar tissue. When the R.I.C.E.R. regime is used correctly, there will only be a minimal formation of scar tissue, which allows for optimal return of flexibility and strength.
How to get rid of scar tissue
So, how do we put the finishing touches on your recovery? How do we get rid of that annoying formation of scar tissue?
Firstly, you must keep active! Don't listen to anyone who tells you to do nothing. Now is the time to start active rehabilitation. Most of the swelling will have subsided after the first 48 to 72 hours and you are now ready to start light activity.
Light activity will not only promotes blood circulation, but it will also activates the lymphatic system. The lymphatic system is vital in clearing the body of toxins and waste products, which can accumulate in the body following a sports injury. Activity is the only way to activate the lymphatic system.
Before we move on, a quick word of warning. Never, Never, Never do any activity that hurts the injured area. Of course you may feel some discomfort, but NEVER, NEVER push yourself to the point where you're feeling pain. Listen to your body. Don't over do it at this stage of the recovery, you've come too far to blow it now.
To complete your recovery and remove most of the unwanted scar tissue, you now need to start two vital treatments. The first is commonly used by physical therapists (or physiotherapists), and it primarily involves increasing the blood supply to the injured area. The aim is to increase the amount of oxygen and nutrients to the damaged tissues.
Physical Therapists accomplish this aim by using a number of activities to stimulate the injured area. The most common methods used are ultrasound and heat.
Ultrasound, or TENS (Transcutaneous Electrical Nerve Stimulation) simply uses a light electrical pulse to stimulate the affected area. While heat, in the form of a ray lamp or hot water bottle, is very effective in stimulating blood flow to the damaged tissues.
Secondly, to remove the unwanted scar tissue it is vital that you start a course of deep tissue sports massage. While ultrasound and heat will help the injured area, they will not remove the scar tissue. Only massage will be able to do that.
Either find someone who can massage the effected area for you, or if the injury is accessible, massage the damaged tissues yourself. Doing this yourself has the advantage of knowing just how hard and deep you need to massage.
To start with, the area will be quite tender. Start with a light stroke and gradually increase the pressure until you're able to use deep, firm strokes. The more you massage the effected area the harder and deeper you will be able to push.
Use deep, firm strokes, moving in the direction of the muscle fibres. Concentrate your effort at the direct point of injury, and use your thumbs to get in as deep as possible to break down the scar tissue.
A few final points
Just a few final points before we finish up. Be sure to drink plenty of fluid during your injury rehabilitation. The extra fluid will help to flush a lot of the waste products from your body.
Also, I recommend you purchase a special ointment to use for your massage called "Arnica". This special ointment is extremely effective in treating soft tissue injuries, like sprains, strains and tears. You can purchase this ointment at most health food shops and pharmacies.
Now, if you've come this far, you've done well. If you've applied the information in this article and part 1 you should be well on your way to a complete recovery. However, there is one final stage of treatment before you're back to 100%.
In next months issue we'll take a look at the last stage of your rehabilitation. This phase of your rehabilitation will look at regaining the fitness components that may have been lost during your recovery. Click here to view part 3.
If you enjoyed this issue of The Stretching & Sports Injury Report, please feel free to forward it to others, make it available for download from your site or post it on forums for others to read. Please make sure the following paragraph and URL are included.
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Article by Brad Walker. Brad is a leading stretching and
sports injury consultant with nearly 20 years experience
in the health and fitness industry. For more articles on
stretching, flexibility and sports injury, please visit
The Stretching Institute.
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