How to recover smartly from muscle injuries

2189924965_d6d4d780d1_mSo you hurt yourself. Maybe it happened working out, maybe you were just trying to carry something heavy in an awkward way. Maybe you lunged to get that ball. But you pretty much know you hurt yourself, even if later you think “ah, it’s going to be fine, I’ll be ok, it’s just a strained muscle.”

You’re right, it is a strained muscle. Strained means torn. Not the whole thing, usually.. you’d know something BAD has happened if it was that. But a strain is always a tear of some kind, and it means it has affected muscle. When it’s a ligament that’s torn, we call it a sprain.

Strains of a big part of a muscle can take months to heal, smaller ones, microtears, are ok within a few days and can even make the whole muscle stronger (and bigger, which is why bodybuilders like to say “tear it down to build it up!”).

Every body is different, sure, and different people heal different ways. But there are enough common elements for me to put a protocol together. Let’s say you have a small tear, a medium-grade strain. Not just a microtear… a real injury.

You know it’s an injury because there was an “oh, shit!” moment. That’s pretty much the cardinal symptom. You think “oh shit” because you felt something suddenly snap, or a very sharp pull, and you knew this wasn’t good.

Without an “oh, shit” moment you probably don’t have a tear. And yes, of course you might have something completely different, so when in doubt, go see a doctor. That was my disclaimer. No, not enough, my lawyer says.

All right, litigation freaks. So: I’m not a medical doctor, and I’m just a physician in Germany, probably not where you’re reading this. And even if I was, I can’t make a medical diagnosis based on the profanities that went through your head when you hurt yourself. This text contains some ideas of what can be done to assist muscular injuries in healing, not medical advice. If you don’t get better day by day, please see a doctor to get some medical advice.

I can only speak from experience here, and from what I read and have seen in clients.

So here goes:

Put some ice on, elevate, compress, REST! Rest is the most important here. You can wrap an elastic bandage around, but in a lot of cases that’s just not practical. Icing is only useful the very first day, to prevent swelling and numb the pain. Later, please don’t ice any more, whatever people say. You have an injury, it needs to heal, and ice constricts the blood vessels. You need functioning circulation to heal.

You do need REST. Sure, don’t just lie on the couch for the next six weeks. But if you injured a foot, maybe lie down a lot, for a few days. Still move the leg, rotate the ankle; rest doesn’t mean being motionless.

Imagine your torn muscle like torn skin. If you have a cut in your skin, you wouldn’t start pulling on it, would you? You’d leave it alone and make sure it doesn’t break open again. Imagine the same thing with your muscle tear. It’s under the skin, so you don’t see the injury–but just imagine it.

So you don’t want to use the muscle for anything that requires strength, AND DON’T STRETCH it, either. Would you stretch a cut in your skin? No, the thing would start bleeding again, right? Leave it alone.

You can, and should, however, move things around carefully. Let the pain be your guide. Do what doesn’t hurt. Light mobilizations are good if you either had a very small injury, or after you’ve rested a couple of days.

Don’t hurt yourself again! Work around the pain, not through the pain. Don’t stretch! Just go through the range of motion carefully, VERY SLOWLY.
Stay in the area where it feels easy. You’re just keeping circulation going, and you want to make sure the muscles can move and that the injured area doesn’t start sticking to neighboring layers of fascia. Imagine the healing as if there is some sticky goo being put in the areas that are ripped open. That’s fibrin, which is always in the blood in an inactive form. It gets activated at the site of injury, and then it’s really sticky.

It doesn’t only stick the ripped tissue together, it can also stick other tissues to the injured tissue. That’s why you want to get mobile quickly–that way you keep moving those neighboring tissues, and they don’t stick to the injury. Makes sense?

  1. After days of mobilizing gently, and if nothing hurts, you can very carefully start stretching. Just a tiny bit. SLOWLY. Just extend the range of motion a little. If it hurts, BACK OFF!

  2. Now you can add strength training. VERY little. Just do a few exercises that are usually supereasy, and stop yourself before you feel challenged at all. Then wait until the next day. If you’re hurting, you did too much. Wait another day, then start again, more carefully this time.

  3. You don’t need to stretch much. I know, people talk about stretching a lot. But just do little bits here and there, maybe after working out. Just to prevent the injured tissue getting shorter.

  4. Once your normal strength exercises are challenging, but don’t hurt you the next day, ADD COORDINATION. You want the nervous system to be aware of the injured area and to make it functional. Nerves get injured, too, there are nerves in every bit of muscle. You need to make sure they’re sending the right signals to the brain, and the brain can give the right commands.

So do silly things. If you injured a leg, try some dance steps. If it’s a shoulder, try juggling. Something you haven’t done much, and something that really forces you to pay attention.

After that you can get back to normal workouts, but be still careful. If this whole process took longer than two weeks, and you had to back off a few times, you will still need a few more months until you can really treat the injured part as if it’s normal.

That’s where a lot of people get injured over and over again. LET IT HEAL properly the first time.

If it’s a very minor tear, this whole protocol might only take you a week.

If it’s a bigger one, it might take months.

Feel better soon!

(and if you don’t, see a doctor)

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