Hey guys, so for this post I have done some in depth research into the stages of injury and the best ways to try speed up your recovery. Hope you find this interesting and don't forget to comment and share!
Injury can range from a tear or
pain in a joint, muscle, tendons and ligaments to breaks or
dislocations. The most common injury seen in elite athletes is an ACL (Anterior
Cruciate Ligament) tear. This is most commonly seen in footballers and happens
mainly when a player is jumping to head the ball and as they come down to land
their knee twists rupturing the ACL. Injury prevention is important in the life
of an athlete as it is necessary for them to keep strength across all their
body muscles. Strength and conditioning is the most utilised method of injury
prevention and it is applicable across all sports.
When an injury occurs, it follows three stages: Inflammation,
Proliferation and Remodelling. The Inflammation stage is the first stage of
injury and may last between 4-6 days. Inflammation starts as soon as an injury
occurs. The injured area appears red with swelling and is often hot and quite
painful. This leads to a loss of function to the injured area. Redness occurs
because small blood vessels are ruptured when tissues tear, which releases
blood into the surrounding areas. Chemicals
are released when the injured tissue cells die which irritates the tissues
causing local blood flow to increase and in turn leads to the red appearance. During this stage, the injured tissues depends
on clotted blood and tissue fluids, meaning the injured area is quite weak.
Until blood and swelling clears and new collagen tissues form, the strength of
the area remains poor. Tissues are in their 'lag' phase which means healing is
progressing although tissue strength remains unaltered. Stretching at this
stage can disrupt the healing process and prolong inflammation. The swelling occurs
because of the change in concentration of the fluids around the blood vessels and
this causes watery fluid to leak out and into the surrounding areas which allow
for swelling. Swelling is clear in injuries that are close to the body surface
e.g. Ligament tear (foot). Deeper injuries often don't show signs of swelling
for a couple of days after initial injury. Heat is felt over the skin surface because
of increased metabolic activity from the inflammation and this can often feel
uncomfortable and cause irritation. Pain occurs because of the pressure that
stems from the swelling as well as chemical irritation from metabolic changes.
Proliferation occurs
following inflammation and has the main objective of removing all damaged
tissues and cells to allow healing to be effective. Special blood cells engulf
the dead material and digest it, thus removing the dead cells. Delicate
granulation tissues form once the dead tissues have been removed as new
capillaries start to grow into the damaged area. Collagen tissue starts to form
between the third and fifth day of injury. A bridge is then formed as the
collagen tissues join the damaged tissues. "These collagen fibres are laid
down haphazardly and, if this orientation remains, the scar formed will be very
weak" (Norris, C.M. , 2007). Gentle
movement in the form of a rehabilitation programme should be started at this
point as it will improve the overall strength of the scar tissue. This gentle
exercise allows larger and stronger fibres to form and bond to each other,
further increasing the tissue strength of the injured area. Correctly
prescribed exercise at this stage of an injury allows for a more suitable healing
pattern. "Most of the collagen will have been laid down by 16 to 21 days
after injury, so this is the time when stiffness is greatest and stretching
will be most effective" (Norris, C.M., 2007). Movement at this stage should be prescribed from a professional as doing wrong movements at this early stage can result in a lengthened recovery.
The final stage of injury, Remodelling,
occurs 21 days after the original injury. The amount of collagen produced and
broken down in this stage is the same as the fibres overlap and form map
adhesions which, if movement is not performed, will stick to the surrounding
tissues. It is important that stretching is continued in this stage of injury
or else the collagen will begin to shrink. This phase is trying to create a
bridge that is as similar as possible to the original tissues before the injury
occurred. The function of the bridge is the same as the original tissues
function, although they may not look the same. Exercise is vital at this stage
as without exercise the bridge tightens up, thus restricting normal movements
and can in some cases cause changes in alignment. When an injury occurs, it is
important to follow the RICE (rest, ice, compression and elevation) strategy. If
these four steps are followed the injured area is likely to improve it’s
physical appearance quicker than if it is not followed. This is the basis for all injuries no matter how severe.
The stages of injury
prevention differ between severity of different injuries but in general follow
the same process of inflammation, proliferation and remodelling. Time frames
may change if an injury is more severe. For example, an anterior cruciate
ligament tear has a much longer healing process than an ankle sprain. With ACL
injuries however, it is important to follow the time frame given by the
specialist, as a return to any activity before the knee is ready will severely
inhibit any process you had been making. Warm ups and stretching, mainly
dynamic are extremely important before training or competition. A warm up and
stretch on its own is a good injury prevention method. However self-myofascial
release is also important for elite athletes as it releases any built-up
pressure in the muscle and increases their range of movement, thus enhancing
performance.
I will do a full post on warm-ups before training and stretching in the coming week. Feel free to leave a comment and don't forget to share my blog! Thanks guys!
1.
Behm et
al (2011). A review of the acute effects
of static and dynamic stretching on performance. European Journal of
Applied Physiology, 111(11):2633-51.
2.
Fradkin,
A.J et al (2006). Does warming up prevent
injury in sport? Journal of Science and Medicine in Sport. Volume 9, Issue
3, Pages 214-220.
3.
MacDonald, GZ. et al
(2013). An acute bout of
self-myofascial release increases range of motion without a subsequent decrease
in muscle activation or force. Journal of strength and conditioning research, 27
(3):812-21.
4.
Norris, C.M (2007). The Complete
Guide to Stretching. A&C Black Publishers Ltd. London
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