Types of Injuries
First, there are two major types of injuries the body experiences, macrotraumas and microtraumas.
Macrotraumas are sudden, acute injuries; you’ll know the instant they occur. On the court it’s when a point guard comes down with a rebound and snaps his ankle.
That’s macrotrauma. Specific examples include fractures, dislocations, sprains (injuries to ligaments), strains (injuries to muscles and tendons), deep lacerations, and very serious contusions.
A microtrauma is a chronic overuse injury. Although less dramatic from an athlete’s point of view, microtraumas can be just as annoying as they’re often difficult to properly assess and manage.
Examples of microtraumas include stress fractures and tendonitis (some prefer the term tendinosis), with tennis elbow and golfer’s elbow being common afflictions.
It’s very common for these injuries to linger, sometimes for months, and rest doesn’t automatically heal them, adding to the frustration. Nothing’s worse than taking a month off from lifting to let an injury heal and upon returning realizing that, a) you’re now weak as shit and, b) you still have the injury to deal with. It’s enough to make some give up on training altogether!
How The Body Responds to Injury
The body goes through a three-phase response to any serious injury, be it a macrotrauma or a bad microtrauma. You can’t skip steps – you must complete one phase before moving on to the next, no matter how badly you want to rush it.
The first phase is the inflammation phase. This happens immediately (within minutes) of a serious injury and can last from several days to a couple of weeks for more serious injuries. During this phase the injured area swells up; it will likely be red, hot, may throb, and it will hurt even if the area isn’t moved.
You can train unaffected areas if it doesn’t bother the injured area, but the training goal for the injured area is simple: don’t make the injury worse. That means leave it the hell alone! Don’t train it lightly, don’t stretch it (unless instructed by a doctor), and don’t go for a light jog instead of a hard run. Just leave it alone.
You can also RICE the injured area. RICE stands for Rest (leave it alone), Ice (ice for 15-20 minutes an hour, as often as possible), Compression (wrap it up loosely), and Elevation (put it above the heart if possible when at rest).
To summarize, perform no training for the injured area. This sucks, but this phase only lasts about two weeks.
Once the inflammation has subsided (the swelling reduced and the pain at rest diminished), the body enters the second phase of injury, the repair phase.
As the name implies, the body is now trying to repair the injury, but now the body is in quick fix mode. It wants to repair the injury as quickly as possibly to allow basic functioning to return.
During the repair phase the body is using collagen tissue to fix the injury, which is a bit like the body’s version of duct tape. However, at this time the body is laying that collagen tissue down in a haphazard fashion.
This is extremely important for the lifter to remember. The body is attempting to return to basic functioning during this phase, nothing more. But problems occur when the lifter starts to feel better and, eager to return to their previous activities, tries to push it or “test it.” All too often the result is the area gets re-injured and the entire process must start all over again.
During this phase, the training goal is to prevent atrophy (muscle loss) of the injured area. The good news is that this is much easier to accomplish than creating hypertrophy (building muscle), as basic stimulation will prevent atrophy.
Training guidelines for this phase including focusing on a pain-free range of motion, even if it’s limited in the beginning. Isometrics are a useful tool; one can start in a pain-free ROM and then gradually increase it over time.
Slow speed, light-weight resistance training can be used as well, with 10-20 reps being the norm; be sure to err on the side of light weight and high reps in this phase. Open chained and isolation movements are preferred for introducing load to the injured area.
Typically the repair phase lasts about two months from the end of the inflammation phase for most reasonably serious injuries. The lifter can and should work on other areas of the body or components of fitness not limited by the injury.
The final phase in injury is the remodeling phase, which usually lasts 2-4 months from the end of the repair phase. But the body is also smarter than you and a heck of a lot more patient. It takes its sweet time in the healing process because it’s trying to do things right.
Collagen fibers are laid down now in an organized fashion and strength and stability should return over time to the injured area. By the beginning, or certainly the middle of this phase, most ROM should’ve returned to the injured area, which is important to monitor as continued limitations in ROM might become permanent if not addressed during this phase.
Getting injured sucks the big one, but all is not lost. Once the injury has been properly diagnosed and treated, sit down with your doctor and set a realistic time line for when you think you will be better.
You could even use this time as a gift, although it won’t feel like a gift when you’re mired in the middle of it. See it as a chance to return to the basics, like mastering your form on the big exercises you can safely perform. Read more, work on your weak points, and build all the components of fitness.
My daughter was injured this past weekend and I found myself explaining how the body repairs itself and how amazing our innate healing potential and wisdom to heal is! She on the other hand doesn’t think it is “so amazing” right now. But, this too shall pass and she will stronger for it!
Have a great week!