Tissue Failure: The Perfect Antidote for Sprains and Strains

by Angelo dela Cruz

Sprains and strains would most likely be the most common injury that we have all faced. They can dampen our fitness goals and affect our work productivity and the way we live our everyday lives. A sprained ankle can cause a serious limp, slow down our mobility and if not taken care of properly, lead to lasting negative consequences.

The good news is that by gaining some basic knowledge, we can better equip ourselves to deal with sprains and strains more easily, minimize their effect on our lives and prevent possible future frustrations.

What Is a Sprain or Strain?

A sprain involves overstretching or tearing of the ligaments or joint capsule that connect a bone to another bone. When tearing happens to muscle or tendons, it’s called a strain. Often times, sprains and strains occur together. Just like rubber bands, ligament, muscle and tendon fibers can stretch to a certain point and then return to normal resting length.

Sprains and strains occur when these fibers stretch excessively exceeding their maximum elastic capability. The tissue fibers then tear or remain incapable of returning to their normal resting length. The speed and force of overstretching will determine the level of damage. Ligaments and tendons may also be injured gradually over time due to repetitive and overuse stresses leading to tendonitis, such as golfer’s or tennis elbow.

Common Sprains:
- ankle
- knee
- wrist

Common Strains
-hamstring
-low back
-shoulder rotator cuff

What to Look For:

It is important to seek medical attention immediately if a loud, painful “pop” was heard during injury, if severe swelling is present, or if there is severe loss of function or muscle weakness (the joint feels as if it’s going to “give out”).

Minor sprains and strains typically involve slight pain, sometimes reported as a “twinge” with slight muscle or joint tightness and a feeling that you can continue with activity (although not necessarily the best thing to do). More moderate and severe cases involve a higher level of pain, tightness/ stiffness, swelling and discoloration, tenderness to touch around the injury site, and inability to continue with activity.


Phases of Inflammation and Repair

Inflammation follows shortly after injury and is your body’s way of beginning the healing process. The inflammatory response involves pain, swelling, redness, heat, and decreased function of the affected muscle or joint. Although necessary for healing, inflammation can be “overactive.” Prolonged or severe swelling is detrimental because it can "choke off" oxygen and nutrients to the injured area and surrounding healthy cells.

Acute inflammation lasts approximately 1 to 6 days after injury. This is the most delicate phase of the process and the level of care taken at this phase will determine the speed and effectiveness of recovery. As the inflammation settles, the injury site will undergo regeneration and repair lasting from 3 to 8 weeks. The end of the repair phase is when moderate to almost full activity might be resumed. (You might notice that 3 to 8 weeks is a lot longer than most of us would like to wait.) After the repair phase, the body will work to remodel or reshape the area for 2 months to 2 years afterwards.

Basically, the injured area is like a construction site and during these stages of inflammation and repair it becomes imperative to provide elimination of waste products and increase the flow of repair materials (i.e. specialized cells, oxygen, nutrients) into the injury site.

If not taken care of properly, we unnecessarily risk
• Increased inflammation
• Further injury
• More pain
• Excessive atrophy and deconditioning
• Excessive adhesions and decreased range of motion
• Chronic injury and secondary compensations affecting other parts of the body

All of these would lead to a much longer and more difficult recovery time and more time away from doing the things we like to do.

What to Do for Fast Recovery

1) Discontinue the activity that caused the injury and limit movements that cause pain, especially during the acute phase of injury. With minor strains and sprains that don’t seem like “a big deal” at that moment, continuing activity increases the risk of causing a more severe injury.

2) Determine if you need medical attention. If any severe symptoms are present such as those mentioned in the “What to Look For” section, get professional help.

3) Protect the injured area and prevent further damage. These are the primary goals during the acute phase of injury. The earlier these steps are taken, the better the outcome. Remember the acronym R-I-C-E + Move:

• Rest – This means to avoid painful movements as much as possible. The use of crutches or other or a sling may be helpful.

• Ice – Apply ice as soon as you can to reduce inflammation. Do not apply ice directly to the skin. A thin towel may be used or Ziploc bag with a bit of water. A bag of frozen corn or peas may be used if you’ve used all of the ice for margaritas. It’s best to ice the injured area for 15-20 minutes and then wait at least an hour to repeat as necessary.

• Compression – A pressure bandage may be used to also reduce inflammation. It is important not to wrap the area too tightly that blood flow is cut off. There should be no increased pain or throbbing or tingly sensations. Remove the bandage every 2-4 hours to allow proper circulation and reapply if necessary.

• Elevation – This will also aid in decreasing inflammation and increase venous blood flow away from the affected area. If possible, it is recommended that the injury site be elevated to about 12 inches above the heart.

• Movement – Begin moving in slow, pain-free ranges of motion as soon as possible. By doing this, you will be flushing the injured area of waste products and speed healing and repair.

* If there is no sign of improvement in a day or two following this protocol, seek help from a health care provider.


How Massage Can Turbo Boost Your Progress

Orthopedic massage and bodywork is specifically designed to treat the common pain and dysfunctions that people experience, including sprains and strains. In conjunction to the above protocol, the recovery process will be dramatically improved for new injuries and the negative consequences greatly minimized. Orthopedic massage can also be used to clean up and "erase" old injuries to maximize function and performance of the entire body.

Specially applied massage techniques will stimulate healthy cell production, encourage proper alignment of healing tissues, and aid in faster remodeling of the injured site. You will also be guided in isometric contractions and gentle movements that you can do anywhere at any time to build more momentum towards quicker healing.

You may also use orthopedic bodywork to help you prevent injury and promote your body's structural balance and integrity. By identifying possible problem areas and keeping those tissues more pliable and youthful, your body will be more resilient to damage. In addition, the treatment session will help counter the stressful effects of pain by inducing a healing physiologic environment for the body and mind.


Angelo dela Cruz
Orthopedic Bodywork Specialist
http://www.kineticbodywork.com