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 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

Common Injuries At the Gym

1. Muscle Strain– There are different degrees of muscle strains from a minor overstretching injury to a tear. To avoid muscle strains, make sure you warm up appropriately and do not lift more weight than you can handle.

2. Tendonitis-is caused by a repetitive strain to the tendon of the muscle. If you overwork a muscle, you can develop tendonitis.

3. Bursitis– is inflammation to the bursa. A Bursa is a fluid filled sac that provides decrease friction and helps to give a fluid movement to the joint. Avoid doing the same exercises all the time; change it up to avoid overuse of one particular area.

4. Back injury– due to placing increase stress on your back muscles with exercises. Avoid forward bent over postures at the gym. Bend with your knees and tighten your abdominal muscles during exercises. This will help decrease the likelihood of a back injury.

5. Shoulder impingement injury– can occur when you overuse the rotator cuff muscles. The rotator cuff muscle can rub against the top part of the shoulder blade, producing pain. Avoid overhead weighted exercises.

If you experience pain while you are working out, you should stop and apply ice. If the pain persists for more than 3 days, contact your physician or your local physical therapist at Harbor Physical Therapy.

Free Injury Screening at Federal Hill Fitness

Do you continue having that same ache or pain, which is preventing you from exercising or doing day-to-day activities? Are you unsure what to do about it? Or do you just not have the time to take care of it?
Join us on April 29th at 5:00pm at Federal Hill Fitness for a Free Injury Screening assessment with Dr. Amanda Macht from Harbor Physical Therapy. Dr. Amanda will assess your concern and provide you with recommendations for next steps towards healing. If interested, email info@machtmedicalgroup.com or stop by Federal Hill Fitness.

Auto Accident Injury

After an auto accident, sometimes it takes up to 48 hours before you feel discomfort from the injury. The delayed reaction is due to your body responding to the injury by tightening muscles. Your muscles stay in a contracted state which leads to discomfort and limited range of motion. Physical Therapy helps to decrease muscle tightness through manual techniques, postural education, modalities, and prescribed exercises. If you have been injured in an auto accident, please contact Harbor Physical Therapy to receive treatment.

Tips for Walking in Snow and Ice

1. Wear boots or shoes with textured soles. Avoid shoes that have smooth surfaces on the bottom.
2. Watch where you walk. Avoid dark and shiny patches. Walking on the snow will give you better traction.
3. Avoid being off-balanced by carrying things in your hands. Use a backpack if you are walking long distances and keep your hands out of your pockets so you can use them for balancing yourself.
4. Take small, quick, shuffling steps if you are walking through an icy spot and keep your weight slightly forward. It’s usually better to fall forward than it is to fall backwards.
5. Make sure you remove snow quickly from your steps or walk before it hardens and turns icy. Put some type of ice melt product down to ensure it won’t be slippery.
6. Avoid walking in shaded areas where ice tends to build up.

During the winter, physical therapists see many patients with injuries from falling on the ice. Thinking ahead and taking your time could prevent a lot of bruises, sprains and even fractures.

How to Decrease the Likelihood of a Running Injury

Most running injuries are caused by overuse, overtraining, wearing the wrong shoes, and overcompensating for a muscle imbalance or biomechanical problem. Here are some ways you can prevent the likelihood of a running injury.

1. Gradually increase your mileage. Increasing your weekly mileage by no more than 10% will help prevent injury.
2. Wear supportive shoes that are not worn out. It is suggested you replace your running shoes every 300-500 miles or every 6 months. Also, make sure your shoes address any biomechanical issues you may have with your feet and arches. Most running stores provide an analysis of your feet.
3. The best surfaces to run on that provide the least amount of impact is grass and woodland trails. Avoid running on concrete which is the hardest surface you could run on. Asphalt is a little better than concrete. If you run on grass, look for a flat area of grass. While running on a trail, watch out for slippery, muddy areas.
4. Stretch after you run to prevent your muscles from being too tight.
5. Cross train instead of just running. This way you will be strengthening various muscle groups and one particular muscle group will be less likely to be strained.

If you are unsure how to progress running safely to meet your goals, need help creating a stretching program, and or cross training programming, contact Harbor Physical Therapy for an appointment. We also offering running assessments to uncover your specific running stride and provide you specific tailored exercises to help diminish any muscle imbalances.

Core Strengthening

The core muscles include upper abdominal muscle, rectus abdominus , lower abdominal muscle, transverse abdominus, internal and external oblique muscles, and lower back muscles.

Strength and power originate from the center of the body. The core stabilizes the body with arm and leg movement. If the core is weak, you have a greater chance of back injury. If the core muscles are strong, it decreases the likelihood of back injury with pulling, pushing, lifting, bending, and reaching. A strong core improves posture, balance, stability, and endurance during activity.

If you want to learn how to perform core strengthening exercises, contact Harbor Physical Therapy.