Let’s take a moment to discuss consistency with exercises in the treatment of musculoskeletal conditions, and why your physio keeps nagging you to exercise even when you feel you’re back to how you were before, or almost there.
One thing we need to think about, is WHY the issue happened in the first place. Whether that’s a muscle strain, a tweaked back, a rolled ankle, a rotator cuff tear, a flare up of your arthritis pain, or just general muscle soreness (hello again DOMS, you sly devil you!), there’s generally always a reason things happen.
Obviously if you fall off a roof while fixing your satellite dish in a hurricane (which, incidentally, we do not advise), that’s probably the main reason for your multiple fractures, so there are always exceptions. But for your general day to day aches, pains, injuries and the majority of sports/exercise related soft tissue injuries (muscles, ligaments, tendons etc), there are usually precipitating factors that will predispose you to an injury like this.
What can predispose me to an injury??
Soft tissue injuries – such as a muscle strain, a strained ligament, a tendinopathy etc – generally happen when the structure is not capable of bearing the load that has been put through it. These structures have to work so hard to do what your brain and body is asking it to do, that it can end up having too much tension being put through it, which can result in an injury.
This can manifest as an “over-stretching” type strain, an overuse injury (progressive inflammation or mini tears), a small tear, a large tear, or a tension type inflammation at the tendon. Basically this is your tissue feeding back to your brain that it is not happy with the amount of load that has been put through it.
So for this reason, we find underlying weakness to be a main predisposing factor to soft tissue injury. Underlying weakness can happen for a variety of reasons; a previous injury that has not been properly rehabilitated will generally result in weakness of that area. For example – think back to the last time you rolled your ankle (come on, we’ve all done it…) – were you a bit wobbly standing on that foot afterwards? Did that leg feel like it got tired more quickly than the other leg if you then tried to walk up a hill or a set of stairs?
Our body will get used to this weakness over time and will adapt to it, but it doesn’t automatically get stronger or less wobbly as time goes on, we actually have to specifically train it to get back to where it was. Therefore, if you don’t train it, BOOM there is your underlying weakness, ready to give you a nice little calf strain the next time you decide to sprint up a hill.
Another aspect that can result in injury is when you try to do something completely new that your body isn’t used to doing (see our DOMS blog post for more info on how our body tends to respond to new and difficult things).
If your muscles aren’t used to climbing a ridiculously high and steep mountain, they’re probably going to suffer a bit afterwards. In some cases, it will result in DOMS (see our previous post), but in some cases you may end up with something a bit more severe, such as a tendon inflammation (tendinopathy) or some joint irritation, not to mention strains etc.
What do I do when I actually have an injury?
The best thing you can do if you end up with an injury is to consult your physiotherapist, so we can conduct a full in-depth assessment and give you the best advice for your specific injury. We can most likely delve into your lifestyle, history etc, and suggest possible reasons that this injury happened in the first place.
Generally, we will then provide you with a home exercise program, comprising strengthening exercises and maybe some other things such as stretching, foam rolling etc. These exercises are specifically prescribed to you as an individual to focus on your exact issues. They will focus on easing pain and improving function, and will always also focus on addressing the cause of the issue in the first place.
So why do I need to keep doing them once my pain has subsided?
A lot of the time, your pain will subside once you have started doing your exercises, as you are activating muscles in the right way, which causes increased blood flow to the area, as well as reinforcing to your brain that you can move those joints in a safe and pain-free way, which generally calms down the pain pathways from your brain to your sore area, making your general perceived pain better.
This does not, however, mean that because your pain has gone away, your muscle is miraculously super strong and rehabilitated. It just means your wonderful, super smart body has adapted to the pain and has gotten used to it. Going back to earlier where we discussed the “why” behind your injury, we still need to make sure we are addressing, and hopefully correcting, the underlying cause of your issue.
If it was weakness causing overload and pain – we need to correct that weakness with a progressive strengthening program to ensure we have adequately strengthened the area so your injury is less likely to reoccur.
Strengthening your muscles is not a quick or easy process. The research tells us that in a “normal” population; that is to say, you do not have any underlying health issues, connective tissue disorders etc; strengthening needs to be done in a progressive manner to ensure the load is always challenging for your muscles, and can take a minimum of 6-8 weeks before you really notice a functional difference in your strength.
For this reason, it is SO important that you are consistent with your exercises, but also that you keep in regular consultation with your physiotherapist, exercise physiologist, strength and conditioning coach etc, as your program will need regular updating to ensure your exercises are always challenging and you are progressing.
Take home message
Consistency is key in helping to ease your pain and symptoms of your injury, avoiding further injury, or future re-injury! So, we mean this with love…. Please do your exercises!!! There is method behind the madness we promise, and if you are ever wondering “why are they harping on about this so much” – please just ask!!
We love to educate and explain things to people. Knowledge is power, and you will be much more likely to throw 110% into your exercises if you understand why you are actually doing them in the first place!!!
Up next?
We are going to stay on the topic of consistency with exercises in our next post, but the next one will be VERY different. We will be discussing why consistency is key when recovering from a stroke or traumatic brain injury, and when undergoing physiotherapy for other neurological conditions such as Parkinson’s Disease. Stay tuned!