We have all heard the old RICE metaphor (Rest, Ice, Compression, Elevation), or have gotten the advice, “If running hurts, then stop running” or “You need to put a brace on it to heal”. These are also common instructions a patient with an orthopedic condition may receive, and in some cases, a brace, splint, or cast is necessary to begin the healing process, however, that is not always the case. Did you know some injuries actually worsen with no movement? Let’s talk about why you may need to give rest a rest.
Traumatic injuries often have some degree of damaged tissue in need of healing, but in many cases, specific movements used to stress and strain the damaged tissue allows new, healthy tissue to grow in an organized manner. Immobilization of the affected area plateaus the healing process and results in scar tissue which has approximately 15% the tensile strength of normal, healthy tissue. To achieve full tissue regeneration and strength, the damaged tissue must be stressed and strained at an appropriate frequency/intensity over a determined period of time. Without appropriate remodeling, the damaged tissue will also remain susceptible to future injury when exposed to tissue- stressing activity.
When considering “resting” or “stabilizing” a joint with a cast or splint, it is also important to consider the impact that immobilization will have on the other structures surrounding that tissue. The human body thrives on movement and limiting movement through long term stabilization methods affect the bodies’ normal musculoskeletal sequence and may lead to altered joint mechanics.
In cases involving fractures, wound healing and post-surgical protocols, the healing tissue is often of greater priority than maintaining proper movement, but the majority of other conditions should be tested to determine the correct care pathway. A movement assessment should be the first tool used to test the condition to identify whether the joint will respond best to mechanical movement or stabilization.
When performing the movement assessment, putting the injured tissue under stress or strain will have one of three potential results:
1. Pain is produced each time the movement is performed, but the pain returns to its original state when the movement is discontinued. A soreness can be expected for twenty to thirty minutes post testing, but this result indicates it is ok to continue testing the injury through movement.
2. Pain is produced each time the movement is performed, but the pain diminishes in intensity with each movement and is the same or better after completion. This result also shows it is ok to continue testing the injury through movement.
3. Pain is produced each time the movement is performed, but the pain increases in intensity with each movement and remains the same or worse after completion. This result is not appropriate for continued movement testing.
One of the most common reasons we tend to discontinue movement following an injury is because we fear causing further damage, but did you know nearly 80% of injuries respond positively to movement over stabilization? That means, for most patients, there are movements that will improve your condition, the important thing is to identify which ones -- that’s where we come in!
The JointStrong® application performs an assessment of your pain and builds a personalized treatment plan specific to your condition. JointStrong® allows you to affect your symptoms in real time, interpret the results, and track your progress. It will empower you with the knowledge to avoid future recurrence through preventative practices, and in the event you need assistance with your treatment plan, Health Coaches are available to assist you in answering technical questions or connecting you with a Virtual Care / In-Person JointStrong® clinician in your area.
You deserve to have a say in your treatment plan, let us help you move from healthcare to self-care!
Take the first step back to full functional wellness today by downloading JointStrong® for Pain Relief in the Apple or Google Play Store.
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