In the last blog post [linked here], I detailed a bit about the pain process in terms of perception, stages, and how to manage them generally. In the next series of posts, I'll discuss more specifically about strategies and examples to use. The acute/inflammation stage lasts about one week, and typically comes with pain, decreased range of motion, impaired strength, and difficulty performing your day to day tasks or exercises. Simple strategies that take this into consideration can be very useful in not only shortening the time of injury, but also reducing the risk for muscle loss from lack of use.
The strategies should be adjusted based on how severe or intense your symptoms are. DISCLAIMER: Always consult your medical professional in order to provide more tailored treatment that is specific to your injury/condition. This guide in not meant to treat, but serve as a teaching tool to inform the lay person regarding the frameworks around injury management. As a word of caution, should your pain worsen or peripheralize (travel away from the original injury site toward your hands or feet), then either stop or reduce the intensity/motion of the activity. It is likely that you are aggravating the injury site and worsening the symptoms.
Feel free to reference this table to make sense of the examples that I will give you.
Active Range of Motion (AROM): Here you want to think about maintaining activity within the muscles, tendons, and joints without stressing them. It helps to mitigate pain, reduce swelling, and keep your muscle performance intact. I advocate for 50-80% because you will likely be having trouble completing full ROM due to pain or other factors.
Active-Assisted Range of Motion (AAROM): This method utilizes a tool to help complete the full motion such as dowel rod, rope, belt, or band. Notice the motion has increased from 50-80% to 80-100%. The reason being is that you want to ensure that you are maintaining not just the activity within the contracting units (muscles and tendons), but also preserving the joint capacity for motion. This is a great way of reducing the risk for a joint contracture (a REALLY stiff joint).
Isometrics: This type of training is very similar to resistance training, however has a slight twist in that it can be performed with or without resistance. The main point about this is to generate and maintain muscle tension for a specific period of time. This can help preserve the strength and integrity of the muscles, tendons, and ligaments so that they don't experience the negative effects of being sedentary. The emphasis of this switches to percentage of effort, as opposed to percentage of complete motion.
Resistance: Most are familiar with the concept of resistance training incorporating bars, bands, bells, balls, and other equipment in order to maintain strength. The key difference lies in the intensity of the movement. Typically you want to scale back with whatever movement you're performing in order to reduce further injury to the body part and also to focus on other things aside from pure performance. This is a great opportunity to develop your body sense and awareness (proprioception) which can help you feel where your body is in space without looking in a mirror; think eyes closed. It also presents a good chance to work on technique, especially if your injury was a direct result of lifting too much, improperly.
These are just a few examples of ways that you could help to manage your initial symptoms after an injury using MOVEMENT. Remember, there is always nuance to these conversations, and you should consider utilizing your physician for medical management if your injury is significant. Other initial management strategies that were not mentioned include compression, elevation, medication (NSAID/Acetaminophen/Opioids), electric stimulation, massage and body work, and many...many more.
If you have specific questions regarding a new or recent injury and would like an evaluation, consider filling out an injury screen request below and I will reach out to you. As always, thanks for reading and I hope that you will share this with anyone and everyone you know!
In good health,
Dr. James Babana PT, DPT, LMT