Post injury rehabilitation; To move or not to move?

To move or not to move is not the really the question. We should be asking how much movement, what type of movement and at what stage in the recovery process.

It can be tempting when recovering from injury or surgery to want to rest and protect the body part in question. Whilst rest certainly plays its part, immobility can delay the recovery process.

Injury repair follows 3 main phases.

1.       Inflammation.  A normal process in which blood clots form to prevent further leakage, specialised ‘scavenger’ cells flood into the injury site and remove damaged cells and potential infections, followed by newly synthesized sticky collagen laid down over the injury site in an unorganised mesh to essentially glue the area.

2.       Proliferation. (2-3 days post injury). The ‘glue’ is replaced by scar tissue and newly formed vascular and lymphatic vessels allow essential nutrients into and through the site.

3.       Remodelling. The scar tissue, blood and lymphatic vessels are remodelled and become more robust to meet the demands of the recovering wound.

People will often mistakenly try and stop the inflammatory process, but this is a natural part of repair and should be controlled rather than stopped (e.g., excessive inflammation acting on pain receptors can increase the perception of pain).

Once the ‘glue’ has been laid the effect of movement either passive i.e., manual therapy, or active (self-movements) aids the formation of the ‘mesh; into the correct alignment, increasing tensile strength and function. The ‘pumping’ action of movement around the site orientates blood and lymph vessels increasing their capacity to ‘feed and clear’. Movement also helps prevent the appearance of adhesions (‘cross-links); within the muscle fibres which restrict the capacity of the soft tissue re-align correctly. Movement aids in the circulation of synovial fluid contained within joints which nourishes and lubricates.

More recent research shows that movement preformed early in the recovery process leads to optimal regeneration, shorter recovery period, greater range of movement and increased duration of repair.

Which movements? How to move? When to move?  I can help with functional rehabilitation movement patterns for you to achieve the best outcome.