Accelerating Post-Injury Recovery

While it would be philosophically degrading for me to to say that injuries in sport are inevitable, reality is that there are far too many variables involved to say that we can prevent them completely.

Minimizing risk or probability of injury has been discussed to no end but relatively speaking, much of what to do following injury can only be found in texts such as Brotzman's. Guidelines such as the ones he provides are "okay" to start, because you have to start somewhere, but in my opinion, this orthopaedic model is quite restrictive in its applicability.

Following the SFMA model in my opinion is better, as it respects both functional movement (whatever that is) and the influence of pain on motor control, but truly the great clinicians treat in high definition. That is, doing the things few people actually even think about when it comes to musculoskeletal injury.

Now this post isn't about teaching one how to fish, as I'm still in the process of learning myself, but what I can do is lead you to several of the bodies of water that I've recently been scoping out.

As a primer though, here's some basic information about muscle healing and tendon injuries.

Amongst the many considerations - and by no means will this be an exhaustive list" when it comes to taking it more "HD", some of the avenues I've gone down are as follows:

Tissue Stress & Rate of Circulation

• Optimizing soft tissue tone through an understanding of its various causative factors. Since it never is solely about muscle fibers and fascia, we have to understand and examine the level of stress (i.e. from the injury itself) such as examination of sympathetic or reactive tone and addressing accordingly. Patrick Ward talks about this at length so here is one of his examples. Diane Jacobs also has her Dermoneuromodulation technique and soon enough I'll investigate further. But ultimately what I'm trying to get at, is that we need to think about much more than simply "releasing the tissue". That there are other variables at play such as the many different components of the nervous system.
• We also know that following an injury, tissues go through several phases of healing (see above). The first phase, inflammation, is important and HD management goes far beyond ice and compression. Now because of its importance, and because we don't want to eliminate the inflammation stage altogether, my current line of thinking is simply maximizing the rate of circulation instead. Over the last few months I've been experimenting with H-Wave and Marc Pro technology and as of this moment, I am currently pleased with its results. By no means is it the be-all-end-all, but other than electroacupuncture, its the only modality I currently feel like I need. 
• Finally, the multivariate relationships to circulation are endless and I certainly need to start spending time on Willem's anatomy links website, but Lino Cedros of the URSA foundation recently taught us a few things about the relationship between locomotion and the immune and neuroendocrine systems, so there's more than enough fish here to catch in the meantime.

Neuromuscular Firing

• Post-injury, it's no secret that we want to minimize atrophy as much as possible. And it's also no secret that both amount of atrophy and joint mechanics are dependent on an optimal functioning neuromuscular system. What is relatively spoken little about however is how exactly to maintain optimal neuromuscular function in a load compromised athlete. Bill Knowles talked about this in his BSMPG lectures both this year and last and one of the examples he gave was through the use of a Compex. Now I don't have one myself, but it's one of the lakes I believe I need to start fishing in so if anyone wants to lend or buy me one, I'd be happy to share my results personally.
• Another variable spoken about at BSMPG, and one I've investigated somewhat over the last few years is Functional Neurology ala Carrick. Truthfully I've been a little turned off from their system because of their "how", but I do think there is a lot to be learned from their "what" and their "why". I've been digging through Beck's "Functional Neurology For Practitioners of Manual Medicine" and this is where I'll start. I may end up attending more of their courses in the future but again, the "how" that I learned in a previous course really wasn't my cup of tea.

Functional Medicine

• When I say functional medicine, I'm primarily talking about nutritional interventions. Having a naturopath in our clinic has helped my understanding of its role in high definition post-injury management as has Luke Wakefield's "Nutritional Strategies Post-Injury" webinar on RehabWebinars.com, but simply speaking with colleagues from the Precision Nutrition family has helped tremendously. I think it's finally time for me to go through their certification program this fall but in the meantime, some of the interventions I'm investigating further are the roles of protein, arginine, HMB, Glutamine, Bromelain, Garlic, Omega-3s and others in specific stages of the healing process.

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Again, ultimately it's about taking recovery to the next level so if anyone out there has other suggestions, I'm all ears. We all want to get "high def" and what better way than sharing knowledge.
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