Following our current topic of exercise and muscle soreness, let me discuss a very common injury occurrence and then show you a decision making process to deal with an injury. Ultimately, our goal is for you to have a better understanding of when you might need to go see someone for a muscular-skeletal injury.
Example: You wake up one morning after jogging the night before with a stiff and painful knee (insert any type of exercise and insert any painful joint). What should you do? We already discussed decreasing our activity level if we get sore so before we've even limped out of bed we have decided not to exercise today, or exercise at a very low level. Most of us also know that we should put ice on a newly discovered injury.
So here we are eating our morning breakfast, slurping down our cereal with an ice pack on our knee. Missing work is out of the question, so even if you have to roll yourself to your car and have a co-worker carry you to your desk, you are going in.
You make it through the day because luckily you didn't have to do that much walking at work, but every time you do you still feel that same pain and stiffness. As you struggle to your car, thoughts are now not on what's for dinner, but rather, "Do I need to go see someone about this knee".
This can be a difficult decision. It takes precious resources, namely time and money, to go see a professional. Let's start eliminating the easy scenarios and work our way to our current situation.
If you woke up in the morning and noticed that your knee was the size of a grapefruit and you couldn't stand, you would need to go see someone - that's obvious based on the severity. If you woke up and the pain was so intense that you couldn't tolerate it, that too, is a definite reason to call your local physical therapist or physician not only to be seen but to get some immediate relief.
The majority of injuries however are usually somewhere in between. Your knee hurts and there may be some swelling but it may not be altering much of your day to day life. What do you do now?
Here are my suggestions: Time can be on your side, but it can also be against you.
1) Remember that your body is a healing machine. Given enough time, the body does an adequate job of healing most injuries.
2) Remember that with most injuries there is inflammation, which is how your body reacts to an injury in an attempt to heal itself. Inflammation can be damaging to a joint and surrounding tissues if it is prolonged, causing more damage than the original injury did.
These two statements seem at odds with themselves. One says to wait while the other says to act now. If you put them together in our example this is what you come up with:
On our way home from work we realize that we have to take it easy tonight. No exercise and continue to ice. When we wake up in the morning we will see how we feel. Based on our new information, we should expect for our symptoms to be less or (at worst) the same as they were yesterday. If our symptoms have gotten worse then it is a good idea to go see a physical therapist or physician.
If every day your symptoms gradually improve then you should just continue to monitor them and rest, unless the process is too slow to your liking (then go see someone). This scenario is the body naturally healing from the injury. Generally speaking, after three to four days if you aren't feeling a significant improvement (about 50% better) then it is time to make an appointment. Your body should recover quickly from mild injuries and if there isn't a day by day improvement that you can predict that within a few more days you will be one hundred percent, then you should book an appointment to be checked out. When things aren't healing smoothly, that is the way your body tells you it needs help. So get some!
We always try to leave an appointment open each day for exactly this reason. We realize that if you've made the decisiosn to get help you don't want to have to wait a week to get some.
As always comments and questions are encouraged
Yours in Health,
Chris Ostling PT, DPT
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