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Post-injury prescription: caring for and recovering from musculoskeletal injuries

American Fitness, July-August, 1998 by Patricia L. Skergan

Injuries like tendinitis and bursitis may be avoided with proper stretching and warm-up before activity.

Who hasn't pulled or strained a muscle at some time in their life? Whether you injure yourself working out or during leisure athletics, you want the most appropriate remedy.

An accurate diagnosis of your injury is necessary to decide the best course of treatment. Ask your doctor if it is a muscle strain or tear, tendon pull, ligament strain or an irritated bursa. Don't settle for a general diagnosis, such as "you've irritated something in your shoulder." Get the name of the specific muscle, bursa or ligament involved. Muscle names can be long and difficult to pronounce. If you aren't familiar with a certain name, have your doctor write it down and explain its exact location and action.

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Two common types of skeletal injuries are bursitis and tendinitis. Bursitis is an inflammation of a bursa, which is a fluid-filled sac surrounding a joint or muscle tendon. Bursae function to guide and lubricate the muscles and joints. Symptoms of bursitis include constant pain, especially upon touch, and limited range of motion.

Tendinitis is an acute or chronic inflammation of a muscle tendon. The tendon is the end portion of the muscle where it anchors to the bone. Although it is part of the muscle, it has a different composition. It is painful to move a muscle or joint if a tendon is inflamed.

Both tendinitis and bursitis may heal without any long-lasting effects, although many of these injuries can be avoided with proper stretching and warm-up. Pay attention to what your body is telling you. If you begin to feel pain while exercising, stop.

The goal of any treatment plan for either bursitis or tendinitis is restoring proper joint motion. Rehabilitative stretches, physical therapy and nutritional supplementation are effective in controlling pain and preventing damaged tissue from scarring. If you don't receive appropriate care for an injury, it is less likely to heal properly.

HEAT AND ICE

Ice packs constrict the blood vessels, causing less blood to stay in an area. This action decreases swelling, numbs the area and reduces pain. Ice also tightens ligaments and decreases muscle spasms. It should be applied if an area is painful to move or swells after exercise.

The best way to use ice is to directly apply an ice pack or bag of crushed ice wrapped in a thin wet towel to the painful area for 15 to 20 minutes every two hours following an injury. For general irritation or overuse, an ice pack two or three times a day is recommended. Don't forget to use a towel or several tissues between the ice pack and your skin. If you don't have an ice pack handy, try a bag of frozen vegetables.

Ice is not recommended for previously frostbitten areas or areas with poor circulation. If ice is best for a given situation, but you can't stand the cold, try applying the ice pack to the affected area and then draping a hot pack over the ice pack. This allows the sensation of heat around the injury while icing it.

If an injury is in an advanced healing stage, which is usually after four to five days, heat is recommended. Heat relaxes the local blood vessels, causing more blood to flow to the area. This increased blood supply brings healing cells to the area and takes away cellular waste products. Heat also relaxes areas such as the lower back and shoulders.

Use moist hot towels or microwavable heat packs for 10 to 15 minutes at a time, several times a day. If the heat is too intense, put a layer between the heat source and your skin. The area will become reddened during use, but should return to normal shortly after the heat is removed. Don't ever sleep on a heating pack.

If an area swells after it's been used, it usually means it just wasn't ready to be worked. After the initial healing, start a series of slow and gentle range of motion exercises to maintain mobility and decrease the formation of scar tissue.

RESUMING ACTIVITY

How do you know how much activity to undertake after an injury and how soon to do it? Consult a reputable health practitioner who specializes in musculoskeletal health and injuries. Also, use your own common sense and listen to your body. Many re-injuries are incurred by intentions to "work it out." On the other hand, people who are afraid to move an injured area are sometimes left with arthritic and locked joints, shortened muscles and weakened ligaments.

THE HEALING PROCESS

There are many factors involved in the healing process. The severity of the injury and adherence to a good treatment plan play major roles in how quickly you heal and whether you will suffer from residual dysfunction. Complete healing time can range from two to six weeks. If there are major tears in the soft tissue or other conditions involved, such as fibromyalgia, healing can take longer.

Eventually, injured tissues are absorbed into the body and new tissue is produced. You want this new tissue to be healthy with no adhesions or scars. Re-education of the soft tissue is important. Rehabilitative exercises designed to help stretch and strengthen the injured area will help new tissue to be healthy and flexible with no adhesions or scarring.

Post-injury prescription: caring for and recovering from musculoskeletal injuries

American Fitness, July-August, 1998 by Patricia L. Skergan

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