Which Comes First, Cardio or Weights_ - Alex Hutchinson [56]
Not surprisingly, contact sports like hockey and rugby cause the most injuries among adolescent boys (soccer and basketball lead the way for adolescent girls). But non-contact sports are capable of producing overuse conditions like tennis elbow and runner’s knee. By some estimates, in fact, a staggering 70 percent of recreational runners get an injury in any given year. With that in mind, it’s important to understand that occasional injuries are an inescapable part of exercise—but with the right care, you can make a rapid return to full strength.
Ouch, I think I sprained something. How long should I stay off it?
When figure skater Anabelle Langlois fractured her fibula in a training accident just over a year before the 2010 Olympics, doctors pursued every possible avenue for her rehabilitation, including two surgeries. One thing they didn’t recommend, though, was a long period of complete rest for the injured leg.
In the past few decades, doctors have changed their thinking about the best treatment for sports injuries, ranging from sprained ankles and pulled muscles to, in some cases, broken bones. After the acute pain and swelling has passed—sometimes in as little as a few days—movement and gentle loading of the injured area seems to help muscles heal better, hasten return to full strength, and reduce the risk of recurrence. That advice remains little heeded, in part because of the very real risks of pushing too soon, and in part because of our natural caution. “In your head, you want to protect an injury,” says Langlois. But at the urging of her doctor, she was putting weight on her injured leg within two weeks of being operated on, with a still-broken bone and an open surgical scar. “That really surprised me,” she says.
The goal of early mobilization isn’t just to return an injured athlete to competition as quickly as possible. Favoring an injury for too long causes muscles to atrophy from disuse and affects the healing process. “If an injured muscle heals without any stress being put on it, it will generally heal in a shortened position, and the affected area will be a bit weaker and more fibrotic than the surrounding tissue,” says Shawn Thistle, a lecturer in the orthopedics department of the Canadian Memorial Chiropractic College. “It ends up being the weak link when you return to activity.”
A study published last year in Histology and Histopathology illustrates the process. Brazilian researchers compared the recovery of rats that rested against those that began moving their legs either an hour or three days after a muscle injury. Both mobilized groups were able to regenerate more muscle fibers than the rested controls, but only the early mobilization group also had a decrease in fibrotic scar tissue. Humans and rats recover at different rates, so it’s impossible to apply these findings directly to humans (and it’s equally difficult to find a group of human subjects with identical injuries to conduct a similar experiment), but the general principle of early mobilization is the same.
There are limits, though: before you start mobilizing the injured muscle, you have to give it a chance to form scar tissue strong enough to prevent re-tearing. During this period, which for mild injuries may last three to seven days, the “RICE” protocol of rest, ice, compression, and elevation helps speed recovery. Once the acute phase has passed, activity can progress in a sequence beginning with simply moving the affected muscle through its range of motion, then load-bearing exercises, and eventually functional activities, says Thistle. You can think of it as “MICE” rather than “RICE,” where movement replaces rest. Pain can serve as a useful guide to tell you when you’re pushing farther than you should.
Of course, elite athletes aside, most people won’t have a team of physicians carefully monitoring their progress, which makes it risky to push the pace of rehab too much. Any injury in which the initial pain and swelling persist for more than a day or two should be evaluated