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Matt Buckley, South Notts Physio

Pulled a muscle? Your body is busy doing what it needs to... are you?

Muscular injuries are pretty common. You can never fully prevent them although there are things you can do to reduce the risk (essentially get strong and stay strong!)

If you are unfortunate enough to suffer from a muscular injury the body immediately gets to work to help you recover. This process is pretty predictable, and also pretty impressive. Knowing what your body does at different stages of recovery is essential. Depending on what your body is doing, what you need to be doing changes. We can split our recovery from a muscle injury into 3 phases; there are subtle fluctuations in the timings depending on type of injury of course but you'll get the idea.

As always get yourself checked if you're unsure, this is not designed to substitute for a full assessment but merely to discuss our natural recovery process. I have changed the names of the phases to make it easier to understand, and I have simplified it somewhat. No need to over-complicate things!

Phase one - Cleaning

Immediately after suffering an injury your body will work hard to provide the injury site with recovery 'staff'. The first job is to clean the area. Cells are sent to the site to clear any debris - you will potentially see swelling or bruising (but not always) and you will undoubtedly feel some pain. These cells do not get involved with the re-building process and typically take up to 72 hours to do their job. You will not start to re-build the tissue for the first few days - you haven't even started producing the cells responsible for this task yet! Within this time I would recommend you reduce you activity levels (don't completely rest) and lay off anything strenuous. Use pain-killers if you need to, apply ice to the area for additional pain-relief (not to reduce your swelling - we need the swelling!) and basically take it easy.

Phase two - Building

Once you get to between day 3-5 after your injury your body will start sending builders to the site. Imagine these arrive by bus load. Each day your body sends another bus-load of builders to the injury site to help repair your muscle. Buses will arrive each day & typically we reach our optimum number of builders by week 3. Following a muscular injury it is not advised to go back to full sport within this time, allow the builders to do their work.

However, here's the issue... Your builders can often be accused of being somewhat lazy. They need motivating, they need pushing, the need a project manager. THIS IS YOU. You can't motivate these builders by shouting at them though - you have to challenge them.

If you do nothing, your builders will slow down. But if you start getting the muscle to work a little bit you will motivate them. Whilst your builders are doing their thing, you need to be doing some form of daily exercise - simple, tolerable, gentle initially - basic movements without aggravation. As time goes on you can gradually do more and more. Don't ever push through pain, but embrace the need for gradually increasing your exercise levels. For specific exercises that are appropriate for you, ideally you would need an assessment with a Physio, however knowing your phases of recovery can help you understand and rationalise your symptoms, management and planned return to sport.

Typically your builders have done their work by about week 4.

Phase three - Plastering

The numbers of building cells will gradually reduce from week 3-4 as they finish up their work. After that a team of plasterers will arrive on-site to help get the muscle as strong as possible & ready for action. Your plasterers may be doing their job for 2-3 months after the injury however you are safe to return to sport within this time-frame as long as you have been gradually building up your exercise levels, you ease yourself back in & you don't push through pain.

Risk of re-injury can closely be linked to residual weakness so make sure you're nice and strong! Use exercise to challenge your cells and ensure your re-building process is nice and smooth and efficient.

If in doubt, ask someone in the know!

As always, any questions feel free to drop me an e-mail!

southnottsphysio@gmail.com

Cheers!

Matt

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