Recovery: Is Professional Guidance Needed?

Returning from an injury might require more than a self-diagnosis and self-treatment, writes Adam Kelinson.

Returning from an injury might require more than a self-diagnosis and self-treatment, writes Adam Kelinson.

Two of the most talked about topics in sports are prevention and recovery. A successful training program integrates both of these into the plan on a daily basis, and at that level, recovery becomes part of prevention as a post-workout element in preparation for the next session.

For those with undeniable injuries, however, recovery takes on a different meaning, as it becomes the sole focus in an attempt to regain participation. There are scores of articles about how to recover from an injury, but all too often the anxiety of getting back in the game leads to premature reentry, lack of a full recovery, and eventually a component of the repetitive and nagging injury formula.

Often, injuries may also seem minor enough that professional help is ignored. If so, how does one know when an injury is actually “recovered?”

The American Association of Orthopedic Surgeons refers to being recovered as “Return to Play,” the point in recovery from an injury where a person is able to go back to playing sports or participate in an activity at a pre-injury level. Conceptually, that seems easy enough, but for Dr. A.J. Gregg, the owner of sports chiropractic and physiotherapy office HYPO2 in Flagstaff, Ariz., almost all of the injuries he sees are an escalation of minor ones now requiring professional help.

Athletes often use indicators to return as soon as the most obvious symptoms (limp, swelling, pain) subside. Although they may feel better, this generally accounts for only 70-75 percent of the healing process. That remaining 25-30 percent can be difficult to understand because “pain is usually where the injury ends up, but often not where the injury started,” Gregg said.

In addition, while injured, the body’s mechanisms for adapting to and shifting tissue loads are incredible. This is both a blessing and a curse: It allows an athlete to actively recover under proper supervision, but it creates the perception that he or she is healed and an opportunity for a compensatory injury.

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“Even if the tissue has completely healed, the compensatory biomechanics developed during the injury and healing process need to be addressed,” said Sinead Fitzgibbon, a sports physiotherapist in Sag Harbor, NY. Subsequently, even the most minor injuries can be deceptively incomplete in their healing and rear themselves again sooner then later.

Recovery is clearly a process to being recovered and even minor injuries are not always what they seem, making the argument for working with a professional very persuading. Along with the other components (nutrition, body work, strength) a professional can use sport-specific tests to determine readiness, chart your progress, and provide expert opinion.

“I rarely allow an athlete to return to race if they are not close to 100 percent,” Fitzgibbon said.

“Running is a symmetrical sport — this gives the do-it-yourselfers an advantage,” Gregg said.

Your injured side of the body, according to Gregg, “should be as strong, mobile, stable, and quick as the other side.”

If someone has an injury that is causing pain or gait adjustments such as a strained calf and an MRI, ultrasound, or professional palpitation cannot detect anything wrong, one can compare one side of the body to the other. Does each side stretch as far? Can each heel raise to the same height? Can each leg bear the same load when jumped on? Is balance the same?

Fitzgibbon suggests “keeping a log that records athletic performance, effort, time and notes about how you feel.”

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“If the runner can run a week of pain-free easy runs without altering their gait, we’ll begin to slowly increase volume and intensity again,” said ultrarunning legend Ian Torrence, who works as an online coach for McMillan Running.

Using discomfort during movement and muscle strength gives you some base to work with. Add in a full range of motion, regaining 90 percent of original strength, and the other guidelines above, and an athlete should be able to return to play as soon as possible.

Ultimately, says Fitzgibbon, “be honest” about where you’re body is at, and don’t fall into the Einstein definition of insanity by trying the same thing over and over again expecting a different result. “That’s incomplete healing.”