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Health & Fitness: Returning to Exercise after Injury

In my last article, I explained how exercise is an essential part of helping you to stay injury free. But, what if you are an experienced athlete or someone who exercises regularly to stay in shape and you find yourself with an injury that interrupts your routine at some point in your life?

Your injury can be the loss of function of a body part due to a muscle strain, ligament sprain or a more serious issue like a fracture or ligament tear.

Whatever the injury, there are three basic phases to getting yourself back to where you were prior to the injury: the immediate post-injury phase, the recovery period, and the functional phase. You may move through these phases quickly for minor problems or it may take months for severe injury.

During the first 24 hours to 48 hours, or the acute phase, following a minor injury, think R-I-C-E – rest, ice, compression, and elevation.

Rest: Minimize movement of the injured body part to prevent further harm to the tissues.

Ice: Apply as soon as possible following the injury or onset of inflammation. Ice the area for 15 to no more than 20 minutes. Experts differ on how frequently to apply ice to decrease pain and swelling. You should wait 30 minutes before applying ice again, and there may not be any advantage to repeating ice treatment more frequently than every two hours.

Compression: Wrap injured area immediately with an elastic bandage to help reduce swelling. Do not wrap it so tightly that the area beyond the bandage throbs. Redo the wrap as it loosens.

Elevation: Elevate the injured part of the body above the level of the heart, allowing gravity to drain fluid from the injury. Elevation is best started immediately, but it is still effective even after significant swelling has occurred.

Please check with your doctor before beginning physical activity during the acute phase.

If the injury is to any part of the leg, aerobics may not be possible during the early post-injury phase unless you have access to an arm cycle. However, you can still do upper body and arm strength training. In addition, you will want to start very gentle stretching of the muscles in the affected limb and you can perform regular stretching of the rest of your body. Stop stretching if it causes pain. To maintain muscle tone around the injury, do sets of repetitive isometric contractions (no active joint movement).

The Recovery Period

Once swelling is subsiding and pain diminishes, you move into the recovery phase, during which you regain range of motion, strength and endurance. At the same time you are working on the affected area, continue exercising your other body parts.

Go slow – stretching intensity can increase gradually, but most important is improving range of motion. Warm your muscles with heat or by aerobics before stretching and joint movement. Use ice following the routine if you have pain or swelling afterward. Stretch two to three times a day; do range of motion more frequently.

Keeping up your endurance after an injury is often the most challenging task, especially for runners. Swimming and water aerobics will usually put the least amount of stress on an injury to the leg.

The Post-Injury Functional Phase

This last phase is the time to build toward regaining your full exercise capacity. You will be testing the injured area as you work your way up to your previous fitness level. For example, if you have sprained an ankle, start with quick-paced walking and light jogging for 10–15 minutes. Use pain and swelling to guide you on how quickly you can increase the time and intensity of exercise that puts pressure on the ankle. If you can, ice the injured area after exercise for at least the first week or two, especially if there is any discomfort or swelling.

Preventing repeat injury is an important component of the functional phase. Consider using a simple elastic brace or consult with your doctor about other devices and orthotics to provide a little extra support. Even without the injured area causing symptoms, the tissues may not have healed completely.

The fastest way to return to normal activity after an injury is to give your body the time it needs to rebuild its strength and conditioning. Many people are unaware that fitness training and injury recovery go hand in hand. After any injury you should discuss any treatments with your doctor.

Gradually return to your previous fitness level without overdoing it. Too rapid a return can lead to other problems like stress fractures and tendonitis.

Preventing repeat injury is an important component of your recovery. If your injury forced you from your activities for more than a couple weeks, expect an equal amount of time to return to your previous level. Always, listen to your body and let it guide you on your return.

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