Prehabilitation

For those of you who do not know what “prehabilitation” means, it is doing preemptive work to decrease the risk of incurring an injury. Thus, the list of risk factors we went over should be your guide to how to properly assess if you need prehabilitative work.

If you are weak you need to get stronger. If you have very tight muscles it is imperative to increase mobility in those muscles through static stretching and/or proprioceptive neuromuscular facilitative stretching after your workouts. If you’re getting up in age, you definitely need proper warmups before workouts. Save your static stretching for after workouts except for where you need it to maintain proper technique.

And, most importantly, ALWAYS maintain proper technique. If you are doing timed workouts it is important to always emphasize technique over getting a faster time. Constantly drilling technique is the key to success in every sport and athletic endeavor. You are not doing yourself any favors by short cutting yourself to look or feel better, and you increase your injury risk. It is a lose-lose situation.

Rehabilitation – Acute/inflammatory phase

The acute phase in all injuries is characterized by tissue damage that elicits an inflammatory response in the muscle. Swelling and bruising may or may not be present. If they are it is all the more necessary to take the proper steps to encourage healing of the tissues.

1. RICE
In general, RICE – rest, ice, compression, and elevation – is prescribed. The latter three will be critical to reduction of swelling and inflammation within the first 0-48 hours. Afterwards, compression will be the biggest factor in reduction of inflammation so it would be wise to invest in some compressive material to limit swelling if necessary.

Also, within this first period reduction in inflammation is critical to speed the body’s recovery processes. Inflammation is a natural process which helps stimulate healing through increase of blood flow to the area but blocking the blood flow out of the area as well as increasing the amount of immune response to the area. This is great when we are sick to promote recovery; however, in injuries to our bodies the inflammation is overkill and actually prolongs it. Thus, we want to reduce it a fair amount.

2. Keep moving without pain and self massage
It is important to keep the body part moving as much as possible without causing pain. This is because of the inflammation and the scar tissue that is about to be formed. In addition, in any traumatic injury the muscles tend to tighten up and lock down to prevent further damage. These factor will impede the healing processes.

If there is excessive swelling use your hands to push the swelling up towards the heart. This will help clear it out and speed up healing.

Massage in this phase should focus on light/superficial massage to the surface of the skin moving swelling and inflammation out towards the heart. Do not push into the tissue hard or do anything that causes significant pain as you will be interrupting the healing process, but light work is good to stimulate the blood flow and help organize regrowth.

3. Anti-inflammatories
Most docs nowadays for grade I or II strains will slap you with a prescription of NSAIDs and possibly a couple other drugs (to counteract the affects of strong NSAIDs) and tell you to RICE or rest.

This is not bad because it works, but my preference is with the strong anti-inflammatory effects of fish oil. Fish oil not only had GREAT side effects such as better overall health through improvement of cardiovascular risk factors and improvement of depression, schizophrenia, etc. Since most of us have problems with inflammation in the modern age (from eating too many carbs, and grain fed meat), reduction in inflammation is extremely positive on healing rates.