The road to recovery takes many paths….
Every one knows that injuries can be very frustrating. Not only do they cause pain and disability, but they also result in time away from your chosen sport, and even work. Once an injury occurs it is important to get a precise and accurate diagnosis of the structures involved in order to get a specific recovery plan that will return you to your chosen activity without injury recurrence. Understanding the structures involved in injury, and how they heal, is key to understanding how to recover.
Not all injuries heal at the same rate. The two most important factors in injury healing are the severity of injury, and the actual tissue structure involved. Different tissues heal in different ways and time frames. This relates to both the natural regenerative capacity of the tissue, and to the amount of natural blood supply to that tissue. The higher the natural blood flow, the faster an injury will heal. This is more important than other factors such as your age, or whether you are a “quick healer”.
Muscles have a very high blood flow and generally heal up quickly, with partial return to activity within a week or two, and complete return within a few weeks. Bone is very similar with rapid healing in most cases. Generally speaking, bone has the best capacity to completely regenerate itself once damaged. Tendons and cartilage on the other hand have a very poor blood supply and can take many months to heal once damaged. A common example of this is “tennis elbow” – the tendon becomes inflamed (“tendinitis”) and then degenerates, causing pain and weakness. All tendons in the body are composed primarily of thick fibrous collagen with very few blood vessels within the tendon itself. The poor blood supply hampers recovery and makes treatment difficult. Medications rely on blood delivering them to the tissues, as does the body’s natural healing mechanisms.
Tendon injuries require careful and elaborate rehabilitation programs that are designed to regenerate damaged tendon without aggravating or overloading them. Many therapeutic modalities are employed to try and recover from these injuries, ranging from anti-inflammatory medication, to physiotherapy, injections, or surgery. Cartilage, particularly articular cartilage (joint surface cartilage) is the tissue least capable of healing itself naturally. It has almost no blood supply at all and thus its natural ability to regenerate once damage is severely limited.
There are many effective treatments for managing sports injuries, but no single treatment is wholly effective in every situation, and many treatments are inappropriate. However, RICE (Rest, Ice, Compression, Elevation) is universally accepted as the most effective immediate treatment of any injury to any tissue until a more definitive assessment and treatment plan can be obtained.
Dr Elise Reid is a specialist in Sports Medicine at the International SOS Clinic in Phnom Penh. She has a Masters degree in Sports Medicine and a degree in Medicine. Prior to coming to Cambodia she was a sports doctor for Essenden AFC.
