Training coming of an injury

Beginning activity once you are ready after an injury is always exciting as the process of not being able to exercise when you are injured can be depressing and aggravating. There is, however, a process that is important to adhere to when you are able to get back into activity to ensure you do not set your rehab back, and make your injury worse.

There are very few injuries that you can sustain that necessitate doing no activity. Some might include a back injury, severe leg injury, or broken bone. However, most, like a sprained ankle or wrist, broken finger, strained calf muscle, shoulder injury, allow you to exercise the rest of your body. During the time that you are first injured, usually the first week or two, when you are unable to exercise the injured body part, you can perform cardio training and stretches for the rest of the body. If you have an ankle injury, you can stretch the upper body, the legs (other than the calf of the injured leg), and the back and neck. You can also, after the first few days, swim with just the arms, maybe ride a stationary bike, or use an arm bike. When you have an upper body injury, you can stretch the lower body and the other arm and ride a bike, deep water run sometimes or walk for cardio. It is important to continue to do these activities both to keep the body active and to maintain your mental health as an active person.

For the injured area, it is important to have the opinion of a medical person as to when you can start exercising the area and what exercises to do. For the first few days to few weeks, depending on the severity of the injury, you will have to avoid most if not all exercises with the injured body part. This is to allow for the initiation of healing in the area. Any exercise to the area will disrupt this healing and possibly create more damage or another injury.

Once you have entered the second stage of rehab, called the repair phase, there is a balance that occurs between the activities you do with the injured area. You want to create some stress to that area so that the healing that occurs is strong and helps stabilize the area. However, you do not want to do so much that it aggravates the injury, disrupts the healing that is occurring or causes further injury. This makes it important to consult with a medical person as to what you should be doing and avoiding. In general, isometric exercises and range of motion exercises are a good minimum to do at this point. Range of motion exercises are those that increase the movement of the injured area - tracing alphabet letters with an injured foot or ankle, swinging an arm in a pendulum action, opening and closing the fingers and thumb of the hand. Isometric exercises are resistance exercises that create force across an area without having it move - pushing your foot into the floor without pushing up onto the toes, pushing your arm into the wall or arm of a chair without having it move out to the side, a plank abdominal exercise, squeezing a fist. These exercises serve to promote strength in the injured area without compromising it with too much movement or pushing the force through a movement when the healing tissues might not be ready. Balance exercises and easy cardio activities can also be added at this time as long as they do not aggravate the injured area. Exercises beyond this should be advised by a medical person who is familiar with the injury.

Once the majority of healing has occurred in the injured area, then the maturation phase begins. This is the time when more and more activities are added to create the strength in the injured area to ensure it can withstand what you want it to be able to do when completely healed. It is important to ramp up exercises slowly to see the result on the injured tissues. Usually if it is a little uncomfortable after the exercise, but not painful, and there is no increase in the swelling of the injured area, then the added activity is fine. You should do an added activity for at least a few days before adding another or increasing the intensity or duration. This will ensure that the body and injured area is not being overstressed during this last phase of healing.

As always, healing injuries are individual, both to the person and the injury sustained. It is always best to work with your own body and the symptoms it is experiencing to make the best decisions around adding exercises back following injury. Medical advice from someone familiar with the injury, your sport and you specifically, can be helpful.

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THP The Healing Path