Understanding Injury and Empowering Recovery

Let’s address the topic that everyone wants to avoid: Injuries. As a fitness forward population we take precautions to stay healthy, but sometimes we have an accident, fatigue impacts our form on the last set, or we simply push too hard for too long and cause an overuse injury. The fact is…injuries happen no matter how hard you try to avoid them.

As a physical therapist, obviously my job is to help clients regain mobility and strength after injuries. However, my mission is to give people the tools to continue to progress in their fitness journey and view injuries as a momentary “pause and reset” - not a crisis. I want you to stay in the gym if that’s what’s important to you.  Now, I am not saying to “push through the pain,” there is a reason the fire alarms are going off in your body. Your workout may need modifications, or it may look completely different, but movement is still important and SO beneficial.

The Musculoskeletal System

Most people think about the musculoskeletal system and immediately think of muscles, and those are obviously major players. However, your musculoskeletal system also includes your tendons, ligaments, cartilage, and bones. All of these tissues work together in order for your body to move. Let’s go over each a little more in depth:

Muscles

While your body is made up of multiple types of muscle, let’s just focus on skeletal muscles. These are responsible for voluntary movements. A way of thinking about the muscles in your body is that your big guys make big movements, and your little guys provide stability to allow for the movements.

Muscle Strains are the most common soft tissue injury and they result from the muscle fibers being overstretched or torn. Ex. You feel a sudden pain in the back of your thigh when you are sprinting to first base during a rec league kickball game. The next day it is very tender and you’ve developed a bruise on your thigh.

Tendons

Since we have muscles, we need a way to attach them to our bones, insert these guys. Tendons are the dense connective tissue that connects muscle to bone. These guys are put under tension when you contract your muscles. 

Talking about tendon injuries is where it can get a little tricky. You can have a rupture; we’ve all heard about the middle aged guy “popping his Achilles” while playing church league softball. But most commonly, people will experience a form of tendinopathy. These will manifest as either Tendinitis or Tendinosis.

• Tendinitis: Arises from acute micro-tears that occur when you overload the tendon. Ex. You decided to play a round of golf with your friends over the weekend, but you haven’t played in over a year. Monday morning you wake up to sharp pain on the inside of your elbow.

• Tendinosis: A degeneration of the collagen fibers that make up the tendon from chronic overuse. Ex. A working mom who can’t shake some lateral elbow pain, she spends her day as an accountant with lots of time spent typing on the computer. She then goes home to her one year old child, who loves to be picked up and carried while Mom does her evening chores. 

Ligaments

These are the bands that connect bone to bone at your joints. These guys are tough and work hard to provide stability in your joints.

Injuries to your ligaments are called sprains. Sprains vary in severity or “grades” and typically happen when there is a force that over stretches or tears the ligaments. Ex. Stepping off a curb and rolling your ankle awkwardly. 

Cartilage

There are different types of cartilage in our bodies, but overall its purpose is to provide a smooth articulating surface and reduce friction in joints. This guy is also found in other areas such as our intervertebral discs to provide shock absorption. 

Cartilage injuries can occur due to trauma or degenerative conditions like Osteoarthritis. Ex. The Granny that is always talking about her knees hurting and says they are “bone on bone.” 

Bones

Bones are our framework. They are what give us structure and protect our organs. 

I’m sure we are all familiar with fractures. Fractures are bone injuries that can obviously be caused by falls, accidents, or trauma. But they can also be caused by repetitive stress over time.

Acute vs Chronic Injuries in the Musculoskeletal System

Injuries to the musculoskeletal system can be loosely categorized into two categories: acute or chronic injuries. Determining which category an injury falls into can help guide your treatment plan in physical therapy. 

Acute Injuries occur suddenly and are often the result of a specific incident or trauma. Basically, something  went wrong and now there is damage. Common acute injuries include fractures, sprains, and strains. 

Chronic Injuries are the nagging things that develop and persist over time due to repetitive stress or overuse. You’ve probably tried to rest it or you think it will go away eventually, but the reality is it’s still bothering you. Conditions such as tendinosis, bursitis, and stress fractures fall into this category. 

What To Expect if You’re Injured

Recovery from musculoskeletal injuries vary widely based on the type and severity of the injury, along with numerous personal factors. However, here are some general timelines:

Muscle Strains: Mild strains may heal in 2-3 weeks, while severe strains can take 6-12 weeks or longer (Bahr et al., 2017).

Tendinopathies: Recovery from tendinopathies can take several weeks to months, depending on the severity. Complete tears may require surgical intervention, followed by a rehabilitation period of 6-12 months (Maffulli et al., 2015).

Ligament Sprains: 

• Grade I sprain may heal in 1-2 weeks

• Grade II sprains can take 3-6 weeks

• Grade III sprains, which involve complete tears, may require surgery and several months of rehabilitation (Hughston et al., 1976).

Cartilage Injuries: Cartilage healing is slow due to its limited blood supply. Minor injuries may take weeks to months, while significant damage may require surgical intervention and a lengthy recovery process (Smith et al., 2016).

Fractures: Most fractures heal within 6-8 weeks, but complex fractures may take longer, especially if surgery is required. The recovery timeline can also depend on age and overall health (Giannoudis et al., 2007).

Conclusion

The most important factor to remember when injured, is that each of the tissues require different types of exercises or modalities to heal. That is where Physical Therapy comes into play, we can evaluate your symptoms and develop treatments to support your specific needs. 

Recovery is a process that requires patience, but with the right knowledge and tools, it can also be a time for growth and reflection. Remember, movement is essential, and even when faced with challenges, there are always ways to modify workouts and stay active. Embrace the journey, prioritize your wellbeing, and keep striving towards your fitness goals, knowing that every pause can lead to a stronger comeback.

And as always feel free to reach out to one of our professionals at BUILD POWER GRIND if you have any questions regarding Strength Training, Physical Therapy, Personal Training or Group Classes!

CITATIONS

Bass E. Tendinopathy: why the difference between tendinitis and tendinosis matters. Int J Ther Massage Bodywork. 2012;5(1):14-7. doi: 10.3822/ijtmb.v5i1.153. Epub 2012 Mar 31. PMID: 22553479; PMCID: PMC3312643.

Bahr, R., & Krosshaug, T. (2017). Understanding injury mechanisms: a key component of injury prevention. British Journal of Sports Medicine, 51(12), 967-968.

Giannoudis, P. V., et al. (2007). The management of fractures. Injury, 38(6), 1-2.

Hughston, J. C., et al. (1976). Classification of ankle ligament sprains. Journal of Bone and Joint Surgery, 58(3), 376-380.

Maffulli, N., et al. (2015). Overuse tendon conditions: time to change a confusing terminology. British Journal of Sports Medicine, 49(7), 1-7.

Smith, M. M., et al. (2016). The role of cartilage in the healing process and the implications for treatment. Journal of Orthopaedic Research, 34(1), 1-11.