SCIENCE OR MAGIC AFTER INJURY?

Key Points:

  • Stick with scientifically proven methods to get you back as quickly as possible after an injury, avoid experimental treatments
  • Always start with the correct diagnosis. This can be done through a Certified Athletic Trainer or a physician
  • Physical therapists can use manual therapy, ultrasound, electrical stim, and exercise therapy to help you recover

Aaron Rodgers made numerous references in his news conferences over the past two weeks to suggestions made by well-meaning Packers fans to speed his recovery from a calf injury. A brief description can be found in this New York Times article. Unfortunately for him and for the Packers, it did appear that the calf issue hampered his mobility especially in the second half yesterday. Maybe he could have tried an injection of horse placenta??? I don’t think so. therapy-ultrasound

If you’re a young injured athlete with an important event coming up soon, and you want to recover as quickly as possible what’s the best way to do this? You want to stick with proven and safe methods performed by skilled professionals. Here are some basic steps:

  1. Get the right diagnosis. If you’re at a high school or club with access to a Certified Athletic Trainer (ATC) then that’s where you start. An ATC can assess your injury and come up with a reasonable plan to return you to play. For more significant injuries you may be referred to a sports medicine physician, or if you don’t have an ATC I’d recommend you go to the physician. The diagnosis will guide every decision. Some injuries are mild and will allow return to play in a short time and others may need extensive rehab or even surgery.
  2. Get treatment from a skilled professional. Again, the ATC is an excellent resource if you have access, otherwise I strongly recommend a sports-focused physical therapist. A physical therapist knows when to push you and perhaps more importantly, when to back off. Here are the types of scientifically based treatments you can expect to receive:
  3. Manual Therapy Used for almost any type of injury. This hands-on approach separates physical therapists from other health practitioners. Although manual therapy may refer to many things, therapists usually employ common tactics like stretching, massage, and hands-on strengthening exercises to reeducate the body into proper movement and mechanics.
  4. Ice Especially useful for joint injuries. Ice can be a major component of injury treatment. By constricting blood vessels after application, ice is an effective way to reduce and even prevent inflammation immediately following an injury, potentially speeding recovery.
  5. Ultrasound Useful for muscle strains and other connective tissue injury. Ultrasound is essentially a way to apply heat. By using sound waves (undetectable to the human ear) to generate heat deep in the body, ultrasound can help loosen up tissues in preparation for manual therapy or exercise. The therapist applies ultrasound using a wand, and you’ll feel the heat deep within the tissue.
  6. Electrical Stimulation Excellent for maintaining and restoring muscle strength. Electrical stimulation, also referred to as ESTIM, is a common treatment option to restore muscular function following an injury. By applying a minor but steady electrical stimulus through pads placed on the skin, therapists can cause contractions from muscles that may otherwise remain dormant. I especially like ESTIM for maintaining muscle strength around a joint injury, but without stressing the joint.
  7. Partial Weight Bearing Running Outstanding way to keep running and maintain fitness for some lower extremity injuries. A truly outstanding tool is the AlterG Antigravity Treadmill, which provides precise body weight unloading while still allowing the athlete to run. The loads on the leg are reduced but the running mechanics are maintained. You can do running in a pool but the mechanics are different. The AlterG treadmill is available at many physical therapy facilities around the country.

By Dev Mishra, M.D., President, Sideline Sports Doc, Clinical Assistant Professor of Orthopedic Surgery, Stanford University

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