Despite the best equipment and shoes, and even though you have a sensible regime, injuries can happen to anyone. And there are few things that are more frustrating. Obviously, an injured body part, particularly if it is weight-bearing, will need to be rested. However, if you are a keen sportsman or woman who has worked hard to get fit, the last thing you want is to lose all that effort, and have to begin all over again.
Luckily, complete rest is not always the only answer to an injury. A doctor, physiotherapist or sports injury clinic can advise you as to how to use exercise and movement, with appropriate support and protection of the injured part, to speed healing. This is called active rehabilitation. Later, we’ll look at the kind of approach that’s best for specific injuries but let’s start with general advice that applies to all injuries.
Clearly, for the first two or three days, you need to rest the injured body part. But while you shouldn’t be looking to regain your previous fitness level until the injury has healed properly, you can start gentle exercise as soon as you feel able to.
Strains, sprains, muscle pulls
For these types of injuries, the NHS recommends the PRICE regime. This acronym stands for Protection, Rest, Ice, Compression and Elevation.
Protection involves making sure that you aren’t going to further damage the injured part. So if you’re going to exercise, or even while you’re resting the injury, make sure that you use a suitable support. You may need to keep a joint immobile to stop pain and further damage. These days, high-tech slings, braces and immobilisers are available, each specifically designed to be used for a different kind of injury. You could benefit from the advice of a specialist sports physio, or a specialist provider to ensure that the support you are using is the best possible for your specific injury.
Rest is particularly important if the injury is to the knee, ankle or foot. This doesn’t necessarily mean you can’t move - it just means that you need to take it easy and may require a crutch, stick, or special support, to give the injury time to heal. And remember that “exercise” simply means movement. In the early stages of recovery from an injury your exercise regime may simply be slow walking, using a support.
Ice - the well-known pack of frozen peas treatment will come in useful. You should use the ice pack in the initial stages of injury to control swelling. The NHS recommends 15-20 minute sessions every two or three hours. But remember to wrap the ice pack in a towel, to prevent ice burns to your skin.
Compression also helps to contain swelling and inflammation, assisting stability. Compression bandages have been around for a long time. For major instability and swelling, look at a laced or strapped brace, with the straps acting as external ligaments.
Strengthening exercises - healing and prevention
Physiotherapy can be helpful in treating an injury, not least because your physio is able to assess your individual injury and set it in the context of the type of activity you usually do. This means that they will know what type of support might be best for you as you return to exercise. But it’s also helpful long term, because the therapist can recommend exercises that will first of all promote healing, and then strengthen the affected area so that injury is less likely in future.
Taking the weight off
If you’ve injured a weight-bearing part of your body, such as your ankle or knee, you should avoid further stressing it at the beginning of the recovery period. This means non weight-bearing exercises which start by gently increasing the range of movement. Decreasing pain and easier movement will be your clues that rehabilitation of the injury is under way. Once you’ve reached this stage, you can start adding exercises that will stretch and strengthen the affected area.
Obviously, exercising in water is an ideal way in which to move limbs and joints without putting weight on them but be careful not to go out of your depth. Depending on where the injury is, sitting exercise such as using a rowing or cycling machine at the gym can help to maintain cardiovascular health without stressing the injured part. Remember to wear assistive devices such as supports or braces while you are doing this.
There is a useful rule of thumb on recovery from breaks to the arms or wrists. However long the fracture takes to heal, you’ll need that period again to regain full strength. So don’t try to get back too quickly to where you were - or you may risk a frustrating set back. It’s always best to take the advice of your own medical team; they know you and will be aware of any special circumstances that might affect your recovery time. Major breaks, such as those to ankles and legs will require a longer recovery period and you will need to attend follow-up appointments to ensure recovery is successful.
Severe cartilage injuries may need surgery. But rather more minor events can be managed, usually with assistive devices, for example sticks, and supports such as foot, ankle, leg or walking braces. There’s a fantastic choice of these now, all geared to specific injuries It is worth going to a specialist supplier who has in-depth knowledge of the field, and works with medical and physiotherapy professionals. They’ll be able to advise you as to which support is right for your particular injury. If you get the right support, then you may be able to exercise without tell-tale pain, because the cartilage is not being further stressed.
Dislocated shoulders occur most commonly in contact sports such as football and rugby. You can often avoid surgery, by following the specialist exercises prescribed by your medical team. These vary between the phases of the rehabilitation, and this NHS leaflet gives useful do’s and don’t’s.
Once the initial phase is over, you’ll be asked to do exercises prescribed by the physio in order to get your muscle strength and balance back, particularly in your rotator cuff (the group of muscles that work together to allow you to rotate your arm). In Phase 3 you’re working towards returning to your normal activities, including sport, by making the shoulder muscles work a little harder. You should take specialist advice and follow your prescribed regime because you can dislocate the shoulder again if you put it into certain positions too soon.
During this period you may well need to rest the arm in a sling for a few weeks. If so, look for one that is easy to get on and off, and have a look at the full range available for different types of shoulder problem.
These are common injuries in athletes, but actually anyone can damage their hamstring if they are engaged in an activity that involves bending the knee - you may simply be climbing a steep hill while on holiday. The hamstrings are tendons and associated muscles at the back of the thighs. Injuries occur when they are overstretched. While you're recovering, you won’t be able to take part in sports or resume training because starting intensive exercise too soon can cause further damage, even causing scar tissue to form around the tear. Follow the rest-ice-compression-elevation regime outlined at the beginning of this article.
When pain levels start to reduce you can start gentle stretching of the hamstrings and if this has no adverse results you can proceed to walking or cycling. A physiotherapist can prescribe a set of exercises that will rehabilitate the hamstring and strengthen it. They'll also advise you when your hamstring is strong enough for you to return to sports or training.
We all know that this condition is not confined to keen tennis players. It’s usually the result of over-using forearm muscles. A sudden bout of decorating can bring it on, as can manual work or even repetitive tasks such as typing. Orthoses such as braces, strapping, support bandages or splints may be useful as part of a physical treatment regime. Physiotherapy and supports may have a longer-lasting effect in terms of pain relief, than steroid injections do.
As with all injuries, any return to the activity that caused the problem must be gradual, and you must remember that pain is a signal to stop.