How does Movement help Injuries Heal? Tendons and ligaments.

If you’ve ever been to a physical therapist, you know that exercise is usually prescribed as the primary treatment for a number of injuries and conditions. Clearly exercise has numerous benefits, but it can sometimes seem counterintuitive to place resistance or load through an injured area — doesn’t it need time to rest and heal? The short answer to that question is generally yes, especially immediately following the injury; however, the right amount of movement and exercise can actually promote healing and recovery from injury. This is where PT comes in.

My goal is to help you understand just how exercise helps restore normal functioning of injured body tissues. This article is part of a series that will discuss how various types of tissue depend on movement to recover. Today’s subject is injured tendons and ligaments.

Tendon and ligament injuries range in terms of type and severity and are broadly categorized as tendinopathies or ruptures in the case of tendons and sprains in the case of ligaments. Examples of tendinopathy include tennis elbow, golfer’s elbow, and Achilles tendinopathy. You may have also heard the term “tendinitis” used with these conditions. Though complex and multifactorial in nature, tendinopathies often involve tissues that have become weakened and painful through repetitive usage. Ligament injuries are usually due to trauma — you’ve likely heard of athletes injuring their anterior cruciate ligament, or ACL.

Tendons connect muscle to bone, transferring the force produced by a muscle into a nearby bone to create movement. Tendinopathies often develop in situations where a person puts a repetitive load through a tendon over a sustained period of time. It is most likely to occur when the level of activity is increased relative to baseline (i.e., too much too soon), such as someone taking up tennis for the first time in a while or playing more matches than usual.

The sustained tendon stresses can cause areas in the tendon to become disarrayed and no longer align with the direction of applied force. In other words, the fibers aren’t able to convert muscle energy into movement as efficiently. The gold standard strategy to disrupt this process is to load the tendon through slow, heavy resistance training which stimulates the tendon to remodel itself and repair the injured areas. Eventually, the tendon becomes strong enough to handle loading without pain.

Ligaments connect one bone to another, protecting joints from moving in directions they shouldn’t. While ligaments are not exactly the same as tendons, the loading principles discussed with tendons allow them to handle higher loads through similar mechanisms — by increasing their thickness and the amount of force they can handle.

One very important thing to keep in mind is that immobilization is very detrimental to the strength and health of tendons and ligaments. Therefore, seeing a PT after injury may give you the best shot at retaining as much function as possible in the injured tissues.

Look out for the next article in the series about bones.

Written by: Dr. Scott Newberry

How does Movement Help Injuries Heal? Cushion for the Pushin’.

If you’ve ever been to a physical therapist, you know that exercise is usually prescribed as the primary treatment for a number of injuries and conditions. Clearly exercise has numerous benefits, but it can sometimes seem counterintuitive to place resistance or load through an injured area — doesn’t it need time to rest and heal? The short answer to that question is generally yes, especially immediately following the injury; however, the right amount of movement and exercise can actually promote healing and recovery from injury. This is where PT comes in.

My goal is to help you understand just how exercise helps restore normal functioning of injured body tissues. This article is part of a series that will discuss how various types of tissue depend on movement to recover. Today’s subject is cartilage, specifically the type that protects your joints from impact and is implicated in the onset of osteoarthritis. This type of cartilage is called articular cartilage. The scope of this article is how exercise helps a joint that is painful due to age- or activity-related changes, not acute articular cartilage injury due to trauma.

Articular cartilage covers the ends of bones where they connect to each other at joints. For instance, there is cartilage covering the end of your femur and the top of your tibia (shin bone) where they meet to form the knee joint. Over time, a loss of thickness in this tissue is normal and not always associated with pain. However, for many people, particularly those who aren’t very active, the loss of tissue can become painful and inflamed. This is termed osteoarthritis. It may seem counterintuitive that something often referred to as “wear and tear” is most common in people who don’t move very much and thus aren’t exerting much wear or tear on their joints. However, there is a distinct explanation for this phenomenon.

Cartilage receives most of its nourishment from nutrients being diffused or pushed into it from the fluid inside the joint. It does not have a very good blood supply like most of our other tissues. Therefore, it is reliant on movement to provide it with a fresh supply of nutrients; if you don’t move often, it doesn’t have a chance to receive adequate nutrition and degenerative changes can take place. The cushioning ability of the cartilage in terms of thickness and strength depends on frequent movement! Therefore, your PT will often address pain related to osteoarthritis using a graded exercise program.

Look out for the next article in the series about tendons and ligaments.

Written by: Dr. Scott Newberry

How Does Exercise Help Injuries Heal? Put some muscle into it.

If you’ve ever been to a physical therapist, you know that exercise is usually prescribed as the primary treatment for a number of injuries and conditions. Clearly exercise has numerous benefits, but it can sometimes seem counterintuitive to place resistance or load through an injured area — doesn’t it need time to rest and heal? The short answer to that question is generally yes, especially immediately following the injury; however, the appropriate amount of movement and exercise can actually promote healing and recovery.

My goal is to help you understand just how exercise helps restore normal functioning of injured body tissues. This article is part of a series that will discuss how various types of tissue depend on movement to recover. Today’s subject is muscle.

Muscle injuries are quite common. A “pulled” muscle occurs when a force strains the muscle fibers beyond their limits, resulting in tears that can range in size from very small to large. A common example of this in the sports world is a strain of the large muscles on the back of the thigh: the hamstrings. Muscle strains usually recover in a matter of weeks, though can take longer depending on severity.

So how does movement help? After the acute stage of the injury passes, generally within 5-7 days, a return to minimally painful movement helps stimulate the building of new proteins which repair the damaged areas. Movement also helps push inflammatory enzymes, many of which can cause our nerves to become more sensitive, out of the affected area while bringing a fresh supply of blood — and with it much-needed oxygen and nutrients — to the healing tissues. Lastly, moving a muscle is critical to maintaining its range of motion and preventing increased stiffness or motion loss. As more movement is tolerated, exercises should be progressed to continue facilitating the healing process, eventually allowing restoration of strength that matches or exceeds the pre-injured state.

Look out for the next article in the series about how cartilage responds to movement.

Written by: Dr. Scott Newberry

Making an Exercise Routine Fit Into Your Lifestyle

The World Health Organization (WHO) recently updated their exercise guidelines for adults to include 150-300 minutes of moderate intensity exercise and/or 75-100 minutes of vigorous intensity exercise. While this is the gold standard recommendation for maximizing the health benefits associated with staying physically active – and there are many such benefits – 2.5-5 hours of exercise per week can prove to be an intimidating prospect for many who don’t have a history or habit of hitting the gym (or home gym) on a regular basis.

I thus want to provide a less intimidating message for you to kickstart the habit of exercising on a regular basis: anything is better than nothing! The fear of failure associated with committing the time and resources associated with the WHO’s recommendations can foster an all-or-nothing mentality. This ultimately results in exercise “kicks” and burnout for many people, even when they have the best intentions of staying committed to fitness. I thus offer you an out: start small. Recent research has found even 30 seconds each of pushups and squats in the morning can yield benefits when it comes to strength and aerobic fitness. If you establish a routine this simple, you can gradually begin adding more exercises over time. Before you know it, it’ll become an embedded part of your day much like brushing your teeth or taking a shower. With time, you may even find yourself incidentally adhering to the WHO guidelines. No better day than today to get started!

Written by: Dr. Scott Newberry