Last week, I went into detail about how to manage your initial injury. You can find the link for the blog post here. This week is more focused on the repair, or subacute, phase of healing and how to promote it while reducing the risk for re-injury. By now, the pain and swelling should be subsiding, you might have more strength and range of motion, and you can tolerate either more volume or intensity of exercise without increased or slightly additional discomfort.
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.
Active Range of Motion (AROM): With the mid-stage of an injury healing, you want to restore the motion back to full as quickly as possible. Consider that if you're not able to achieve full motion against gravity, the transition to resistance training will be that much more difficult.
Active-Assisted Range of Motion (AAROM): Continue using your devices to help manage your full joint capacity, and by this point you would have ideally been able to achieve 100% joint motion. If not, don't worry just keep working at it. I would say that discomfort or mild pain that goes away after the exercise is an appropriate range to work through.
Isometrics: The build up here is ideally easier than in the first week of injury. Now, you can start thinking about ramping up your intensity a little sooner (assuming that you're warmed up and prepared for it). Remember, this can be completed with either multi- or single joint focus which can set up you for a big lift or challenge a smaller movement.
Resistance: You need to continue exercising caution here (pun intended). Just because you're starting to feel better than the week prior, you likely still have strength differences which can not only put additional strain on the area still healing, but also the uninjured side. For example, if performing bench press, you may see differences in force output meaning the bar is lowered or pressed unevenly. Make sure to stack your weights appropriately and carefully!
If you notice, the reps and sets did not change, however the load/effort and intention of the exercise is slightly intensified. The key when recovering from an injury is to respect the process, learn the form, and to develop the strength, endurance, and balance in order to perform the movement safely.
Make sure that you are listening into your body and what it is telling you. If you don't speak that language, then find a trusted healthcare provider that is versed in movement therapy. Like me! I know, I'm shameless.
These images were taken at Steel Fitness Club in Morton Grove, Illinois where I am currently practicing. If you are interested in a tour, lets get you in!
In good health,
Dr. James Babana PT, DPT, LMT