Timing criteria for sports injury recovery training

There is no resting pain, weight-bearing pain or delayed pain after exercise at the injured site, and basic functions have been restored to more than 90% of the healthy side. Professional imaging/physical examination confirms that there is no unhealed structural damage. If you move rashly earlier than this point, the probability of secondary injury will increase by more than three times. If you delay it too late, disuse problems such as muscle atrophy and joint adhesion will easily occur, which will prolong the recovery period.

The easiest pitfall for many people is to take "swelling down" and "no pain when sitting" as a signal that they can resume training. I just picked up a girl who ran a marathon last month. The fifth metatarsal fracture in her left foot was only 4 weeks old. The clear fracture line could be seen on the X-ray. She felt that there was no pain when walking, so she secretly went for a 10-kilometer brushing, which directly caused a displaced fracture. In the end, she had an operation and a steel nail. It was supposed to be cured in 3 months, but it was delayed for less than half a year.

Oh, by the way, there are actually two seemingly opposing voices in the sports rehabilitation circle. One group advocates "early intervention" and says that functional training can be started after 72 hours of the acute phase of injury. The other group insists on waiting for imaging to show complete healing before moving. Many people are confused after reading some fragmented popular science and don't know who to listen to. In fact, both opinions are correct. Basically, everyone confuses the concepts of "rehabilitation intervention" and "recovery-specific training". The training mentioned in the former refers to low-intensity movements such as isometric contractions and joint range of motion exercises that hardly add extra burden to the injured area. The purpose is to avoid adhesions and maintain muscle activity. The latter is the specialized sports that everyone often talks about such as running, playing ball, and lifting irons. They are completely different.

Let’s talk about the pain indicator that is the easiest to self-monitor. It does not mean that it doesn’t hurt when you sit or lie down. You need to do a few stress tests: For example, if you have a sprained ankle, stand on one foot for 30 seconds without shaking or pain. Then try two small jumps. If there is no pain, or even faint soreness when you wake up the next day, you have passed the pain level. Don’t underestimate this kind of delayed pain. It is like the body’s delayed alarm. Many people are fine after moving one day, but wake up in pain the next day and cannot get out of bed. This is because the internal damage has not healed, and the inflammation has worsened after the force is applied. At this time, the dosage must not be increased.

It's not enough to judge by physical sense alone. After all, there are many deep strength differences that you can't feel when you walk normally. The easiest thing for ordinary enthusiasts to do is functional benchmarking. No professional equipment is needed, just compare it with your uninjured side. For example, if you have a rotator cuff injury and your healthy side can hold your arm flat for 1 minute without getting sore, but if your injured side shakes like a sieve if you lift it for 30 seconds, it's definitely not time. ； If a person with a sprained knee can do 20 consecutive squats without weight on the healthy side, but the injured side becomes weak and painful after doing 10 squats, then he will have to wait. Generally speaking, only when the basic strength and range of motion of the healthy side can reach more than 90% of the healthy side can you have the foundation for recovery training. Otherwise, if you rely on other muscles to compensate for the force, you will destroy the east wall to make up for the west wall, and other joints will also develop problems after long-term training.

The last thing you need to know is a specialist examination. This money really cannot be saved, especially when it comes to structural injuries such as ligament tears, fractures, and cartilage damage. I met a young man who played CUBA before. Three months after the fork reconstruction surgery, he felt that he had no problem walking and squatting, and the functional test was almost 85% of the normal side. He was anxious to go back to play games. An MRI showed that the graft was still in the edema stage and had not been fixed at all. Fortunately, it was stopped. If he really went on the field, it would break twice as soon as he hit it, and the previous sin would have been in vain. Oh, by the way, don’t benchmark yourself against the recovery speed of professional athletes. There is a whole rehabilitation team behind them, who do various physical therapies and precise nutritional supplements every day. The recovery conditions of ordinary people are completely different from others. Don’t blindly imitate others who come back after a few weeks after injury.

When I usually evaluate patients, I also add a soft indicator of "psychological concerns". If you stand on the court or on the track and still subconsciously dare not exert force because you are always afraid of pain, then don't rush to recover. Psychological fear often means that your body is not actually ready, and you may easily get injured due to deformation of your movements.

After all, there is no standard answer to the matter of injury recovery. Some people can return to the track in two weeks with a sprained ankle, while some people still dare not jump after a torn ligament for half a year. Don't compare your recovery speed with others, listen more to your own body's signals, and if you are not sure, ask a professional rehabilitation practitioner for an evaluation. It is much more reliable than trying to figure it out on your own and trying to make do.