Patience is a virtue
Our bodies are incredibly complex things that are working even while we are fast asleep. If we hurt ourselves our body begins an incredible process of recovery. Pain, is our early warning system that we often choose to ignore, but if we listen very closely and understand what that signal is telling us then we can quickly do something about it. This may be resting completely or adapting the movements we do. Many of the injuries I see in clinic are related to over load. This is when a task has been performed too many times or at too high a level for the body’s soft tissue to be able to cope with. A large majority of my patients are runners and for many their symptoms occur through over training and poor running style. One area I always try to cover is the recovery time. Runners are notoriously impatient, without fully understanding the complex process that is required for the body to heal itself. In new runners there is a suggestion that recovery times are around 10 weeks but there is very little research in this area. One small study in 2018 (Mulved et al 2018) looked into the average recovery time for the most common of running injuries. Medial Tibial Stress Syndrome and Achilles Tendinopathy where the most common injury. The following are the average recovery times in days, for these conditions:
Medial meniscus injury 89
Hamstring injury 74
Medial tibial stress syndrome (MTSS) 70
Gluteus medius tendinopathy 56
Iliotibial band syndrome (ITB) 56
Achilles tendinopathy (AT)56
Patellofemoral pain (PFP) 49
Soleus injury 49
Gastrocnemius injury 49
Plantar faschiopthay (PF) 35
89 days is around 3 months which most runners would be horrified at. For most, the thought of not running for that length of time just isn’t an option. What seems to happen is runners have a week off then return to running at somewhere around where they left off when they got injured. I often hear the words ‘I went out for a 4 miler to test it out’. The usual result is a return of pain and often this sets off a roller coaster of training. So what can we do as runners if we get injured?
First of all get to know your body. Listen to what it is telling you. If you are thirsty drink some water, if you are tired have an early night. Rest when you feel weary, rub your legs if they feel achy. When you have a niggle try to pin point where it is and when you feel it. Having an understanding of where the pain may be coming from is a good start to understanding what may be causing it.
Get a niggle checked out early. I don’t just fix people. Part of my role is to educate and advise. If you seek advice early on, often a change in tact can mean you can still train whilst allowing the injured tissue to recover.
Know what’s causing your pain. Muscles tend to be a sudden pain in a muscle belly, it might feel hot and look red. With rest and gentle movement the muscle tissue; that is rich in blood supply, heals over 3-7 days. You may have to ease back into training gradually whilst the healing proves continues but you can work around it.
Bones are usually broken by trauma so you would have a pretty good idea of what the cause is but bone injuries such as stress fractures can come on over time. Stress fractures tend to be isolated pain and it will hurt on weight bearing or impact and if left will cause pain continuously even when not weight baring. If left or ignored you will have to stop training and may even end up in a cast.
Bones take 6-12 weeks to heal and then beyond that to fully start to strengthen. It may start as a little niggle along a bone and is usually sore to press. Don’t ignore bone pain and come and get it assessed.
Ligaments are usually over stretched and injured by a trauma when a joint moves beyond its normal range. You are looking at 6-12 weeks recovery but even from day 1 you can start gentle exercises to assist the healing process.
Tendons are the gremlins of injuries. They tend to start feeling sore at a very low level and often the pain eases with activity so its quite easy to continue training. As the tendon becomes more irritated the pain may be more acute after periods of inactivity but still continue to ease with activity. This is usually a process that occurs over a few months so, often I see tendon injuries as acute injuries. You are looking at 3- 6 months and beyond to recover from a tendon injury. However with the right advice you can continue to train around a tendon injury.
The key to any MSK injury is finding the source of the pain and then adapting your movements and load to reduce the strain on the injured soft tissue. Those who recover well are generally those who show patience and commitment. The commitment to change and to persevere with that change. Recovery isnt a linear path it has ups and downs
If you are experiencing pain come and get it checked out so you can understand what is causing your pain and start to make changes to assist your body’s remarkably adept healing process. GPs will often tell you to rest and take pain medication. For most MSK conditions this doesn’t need to be the way forward. Physiotherapists are ideally placed to diagnose and treat MSK conditions. You should be able to work together with your physio to allow you to continue doing what you love and here at KHPhysiotherapy I pride myself in providing a service that really encompasses both your physical and mental health during the recovery period. Please don’t ignore pain and remember………patience is a virtue.