Injured - What´s now?

Sports can lead to muscle injuries. That´s why it is good to know what to do AND what not to do when it happens. 

No worries, many athletes bounce back from injuries, and not doing any sport, is much more harmful than 99% of sports injuries. 

Avoiding injuries is, of course, the best prevention. That´s why you want to build a good foundation ​​, train diverse, and build up your basics.

Still, I never met an athlete who didn´t have any injury. Some have to deal longer with them, some are back on track faster than expected, and yes, for some athletes, those injuries make it tough to build a high-end career. 

When this happens to you, I want you to be prepared with the knowledge about what to do. There is not much time for research, maybe there is no physician nearby when it´s happening, and you need to make some educated decisions that this muscle injury doesn´t make your life miserable. 

Let´s picture you pulled a muscle bad that you actually damaged something. 

First: If you can do it yourself or have someone near you, please passively move the muscle in the way it just moved, but without any pain! I really mean no Pain! That´s why it´s done passively, which means the insured muscle doesn´t do anything. All the movement is coming from your hands, or however, it gets in motion. 

Through this movement, satellite cells, cells specific for muscle, migrate into the injured area to rebuild muscle cells. If we don´t move this muscle, fibroblasts are the ones migrating into the injured area, the most common cells of connective tissue. This means through immobilization, we get connective tissue, where we would like to have muscle cells. That´s the so-called “scar tissue.” 

This injury is still going to heal, and it will be possible the use this muscle again even when some cells of it got replaced as connective tissue, but the chances of an injury of the same structure are significantly higher.

Second: I already said it: No Pain! 

Pain constricts the blood vessels, causes extra inflammation, and more. Muscle rehabilitation has to be pain-free from beginning to end. Again - this is for muscle injuries and only for the area of the injury. 

Third: At one point, we want to have an active moving muscle again. That´s why it is good to move as early as possible pain-free. After moving the muscle passively three times a day for 5 minutes, we want to move the muscle actively 3x a day for 5 minutes. Again - this is to activate those satellite cells, which are only activated through movement. 

Fourth: We don´t want to interrupt inflammation during the first three days. (while also not increasing the inflammation through pain). Give this injury time for a proper healing process.

This means:  

• no cold application of the injured area (it reduces the inflammation)
• no anti-inflammatory medication (like ibuprofen) or supplements (like Omega 3)
• painkillers only if necessary 

Fifth: Make sure to lose as less muscle mass as possible.

• supplement enough protein (1.5 - 2g/ kg body weight)
• contralateral training (if injured on the right side, train the left side, if upper body - exercise lower body) 

Now we covered the first three days of a muscle injury. I hope this gives you a good guidelines, confidence, and the patience needed to make smart, career-continuing decisions without trying to find the best way to heal on the world wide web or when not having an experienced sports physician around. 

Of course, your muscle will not be 100% back in function after those first days, but I also hope you were not expecting this. But those first days have a huge impact on this overall injury healing and risk for future injuries as well.

After having an injury, we want to be back-rolling as quickly as possible. Sometimes this means doing the right things at the right time and avoiding doing the things which are leading to a “second-grade” healing process. This might bring us back to practice a day earlier, but it doesn´t help in the long run. In this case, the long run can be as short as two to four weeks. It´s just not worth messing around for a day or two in the beginning when the difference can be a full-function muscle in four weeks vs. the risk of a re-injury at some point in the future. 

Do you have a Dream? Keep going towards it :)

Disclaimer: I am not a certified physician. All actions are taken at your own risk! I am sharing my knowledge as a therapist in psychoneuroimmunology.