This next post will focus on the physiological trauma that arises following a sports injury.
Trauma can be primary i.e. a direct result of the injury, or secondary whereby the body’s response causes further cell damage (swelling/vasoconstriction). There are also three degrees, first being mild, second is moderate, and third is severe damage. Speedy and accurate diagnosis is necessary to apply effective treatments to minimise further trauma and begin the healing process.
The Healing Process:
- Haemostasis – Basically the body’s reaction to blood vessel damage. It occurs in the first few hours following trauma. It includes vasoconstriction, primary haemostasis and secondary haemostasis.
- Inflammatory Cell Recruitment – In the first 48 hours, leucocytes are attracted in response to damaged tissue and chemicals from platelets. Acute inflammation is a cue for healing.
- New Tissue Formation – This occurs from around the 7th day onwards.
- Remodelling of Neo-Collagenous Structures – This takes places after 4-6 months, and inflammation stops.
- Scar Tissue – Complete within 12 months. To minimise the loss of flexibility, physiotherapists apply light pressure in the same direction during the healing process so scar tissue aligns the same/right way to give (mostly) full movement.
Who has ever injured themselves playing sports and got a bag of frozen peas out? One of the most common methods following an injury is that of PRICE. (POLICE has been suggested: Protection, Optimal Loading, Ice, Compression, Elevation).
- Protection: Generally speaking, continuing to be mobile on the injury leads to prolonged inflammation and denser scarring whereas protecting the injury through immobilisation will limit scar production and allow for soft tissue regeneration.
- Rest: However! Complete immobilisation for prolonged amounts of time can lead to symptoms of osteoporosis, muscle atrophy, and decreased cardiovascular fitness.
- Ice: Reduces temperature, metabolic rate, and inflammation, also aids in pain relief. Scientific evidence is conflicting, there’s no definite answer to how to apply the ice, how cold, how often, or what duration? Finally, can we really cool a muscle that is 3 inches below the skin with a bag of frozen peas?