Here is my own personal experience with a sports
injury I recently suffered, and the process I used to get myself
back to 110%. I say 110% because it's always my goal to rehabilitate
the injured area to the point where it's stronger after the
injury, than it was before the injury.
Let me paint you a picture. It's Sunday afternoon
in late September (spring time in the southern hemisphere).
It's a perfect 26 degrees C, clear sky, light breeze and I'm
enjoying the day with family and friends at a local park by
the beach.
After feasting on a barbeque lunch a few us
decide to kick the soccer ball around to work off all that food.
So here I am; no warm-up, no stretching, and running around
in bare feet on very un-even ground. I should have known better,
and I bet you can guess what happened next.
So the inevitable happens. I step into a hole
and I go over on my left ankle. Nothing too severe. Most likely
just some minor stretching of the ligaments. So minor in fact,
that I keep playing for another 15 or 20 minutes.
By the time I got home that evening I knew I
needed to do something about the ankle. I'd never injured it
before and I didn't want it to turn into one of those nagging,
re-occurring injuries, so I thought I would take some of my
own advice.
The treatment begins
Sunday evening
I start by getting an ice pack out of the fridge,
sticking my ankle up on the coffee table and applying the ice
pack directly to the injured area. I keep the ice on for about
15 minutes and then give it a rest for a while. Over the course
of the evening I applied the ice another 2 or 3 times for about
15 minutes at a time.
Monday morning
The first thing I notice is that my ankle is
very stiff and a little sore. It feels tight and difficult to
move. I'm not too concerned about it at this point in time,
I've had my fair share of sprains and strains, and I know this
is all part of the healing process. I keep up with the ice,
applying it 5 to 6 times throughout the day. I also try to keep
off it as much as I can, not wanting to put too much weight
on it.
Tuesday morning
My ankle is still a bit stiff, but most of
the soreness has gone. I do my best to stay off it as much as
possible and apply ice a couple of times throughout the course
of the day.
Wednesday morning
My ankle feels good; still a little stiff but
no swelling or pain. It's time to move onto a few easy range-of-movement
exercises and apply some light weight to the ankle. I start
with a few gentle movements; pushing my foot forward and stretching
out the ankle; then pulling my toes back towards my shin; and
then move onto some gentle circling motion.
Later in the day I start to apply normal pressure
to my ankle by standing with equal weight on both feet, and
by the end of the day I'm walking without favouring my good
ankle.
A quick word of warning! Never, Never, Never
do any activity that hurts the injured area. Of course you may
feel some discomfort, but NEVER, NEVER push yourself to the
point where you're feeling pain. Listen to your body and don't
over do it at this early stage of the recovery.
Thursday morning
My ankle feels fine, ...but it's at this point
that most people will make the mistake of thinking that everything
is okay and discontinue any further treatment. Just because
the injury feels better doesn't mean it has fully recovered
and if you stop treatment now, you're at risk of continual re-injury
until the complete rehabilitation has been successful.
To see what's been going on under the surface,
let's take a quick look at how damaged ligaments repair.
When any sort of damage occurs to the ligaments,
the body immediately goes into a process of repair. Where the
individual fibres have been ruptured, or torn, the body begins
to bind the damaged fibres together using a fibrous protein
called collagen. Or, as it's more commonly known, scar tissue.
You see, when a ligament is torn, you would
expect that the body would repair that tear with new ligament.
In reality, this doesn't happen. The tear, or rupture, is repaired
with scar tissue.
This might not sound like a big deal, but if
you have ever suffered an ankle injury, (or any soft tissue
injury) you'll know how annoying it is to keep re-injuring that
same old injury, over and over again.
Scar tissue is made from a very brittle, inflexible
fibrous material. This fibrous material binds itself to the
damaged ligaments in an effort to draw the damaged fibres back
together. What results is a bulky mass of fibrous scar tissue
completely surrounding the injury site. In some cases it's even
possible to see and feel this bulky mass under the skin.
When scar tissue forms around an injury site,
it is never as strong as the ligaments it replaces. It also
has a tendency to contract and deform the surrounding tissues,
so not only is the strength of the tissue diminished, but flexibility
of the tissue is also compromised.
So, how do you go about getting rid of that
annoying scar tissue?
Heat and Massage
Throughout the day I used a hot water bottle
to apply heat to the injured area, which helps by stimulating
blood flow. I also started to use light massage on the ankle
and specifically at the injury site. Massage is a very important
process that helps to breakdown, remove and align the scar tissue.
Without massage very few sports injuries will heal completely.
Friday morning
My ankle feels great, so it's time to get into
some serious rehabilitation. I start off with some easy mobility
exercises and then follow them up with a good massage. I start
with light strokes and gradually increase the pressure until
I'm using firm, deep strokes. I concentrate all the pressure
at the direct point of injury, and use my thumbs to get in as
deep as possible to break down the scar tissue.
After a 10 minute massage, I continue with a
few more mobility exercises, but this time I push them a little
bit further and a little bit harder. I then finish off with
some very gentle stretching exercises.
Later that evening I give my ankle another massage
while sitting in front of the TV, and finish with some more
stretches.
Saturday to Monday
Over the course of the next few days I massage
my ankle another 2 or 3 times and keep some heat on it whenever
I'm at home. I constantly stretch my ankle and do my range-of-movement
exercises, and I gradually incorporate some weight bearing exercises
like balancing on one leg, half squats and half lunges.
The following week
My ankle feels great. I went for an easy walk
on Monday morning and included a few stretches for my ankle
and lower legs. Throughout the week I continued with my range-of-movement
and balancing exercises, and towards the end of the week I started
on some very easy plyometric exercises. These are explosive
type exercises and include things like jumping, hoping, skipping
and bounding.
Over the next month
I continued with all the exercises I've listed
above, gave my ankle the occasional massage and kept up with
the stretching. I also included a series of more intense exercises
to help really strengthen my ankles and lower legs. Exercises
like single leg plyometric drills, weight training exercises
like squats, lunges, leg press and various forms of calf raises,
plus started to run again.
Today, my ankle feels strong and stable, and
I know it's in better shape now, than it was before the injury.
Check
the Sports Injury Index for more articles on ankle injury prevention
and treatment
