In my previous blog An Ounce of Prevention is Worth a Pound of Cure – Part 1, I discussed my journey with my injury and how I struggled with leaving the sport I loved.
In Part 2, I am going to discuss the stages I believe we go through when we get injured and the science behind the injury and the healing process.
STAGE 1. DENIAL: I told myself it’s not that bad and even though the health care professionals told me it would take 6-8 weeks, in my mind, it would only take two. They don’t know how strong and skilled I am, I thought.
Acute phase (Inflammatory):
- Lasts approximately 7-10 days after the initial injury.
- The tissue is swollen, red, warm and/or all of the above.
- At this stage, the body needs to heal.
- Rest, gentle range of motion and/or protection of the injured area is important.
When the first two weeks passed and my knee was still very sore and I couldn’t bend it let alone run on it, I started to wonder what went wrong. “I should be healing faster than this; I should be back to at least straight line sprints,” I thought.
STAGE 2. TESTING IT: So I tested it – and before I knew it I was trying to convince myself that the sharp pain with every step is normal and it probably did that before.
STAGE 3. IMPATIENCE: I felt I was losing muscle strength and my skills were fading away while everyone else around me was progressing in their skills. So then I started to wonder what the therapist wasn’t doing to boost my healing process. How will I ever catch up?
STAGE 4. RESEARCH: I started researching all the options including consulting Dr. Google. Maybe they misdiagnosed it? Maybe they aren’t even providing the right treatment? I approached my Physiotherapist with my “research” and the therapist reminded me that it has only been three weeks since my injury.
(Three weeks can feel like an eternity when you’re 19 and itching to get back at the sport you love.) I started to feel myself get lazy. However, remember in stage two when I tested my knee? Well, this caused more damage. BAM! my first setback placing my recovery back to week one.
Subacute Phase (Repair and Healing):
- This phase lasts approximately 1- 6 weeks depending on the tissue that is healing and if there is good blood supply to those tissues.
- During this phase, you want to promote healing, oxygen and blood flow to the injured tissues. It is important to maintain mobility, strength and endurance through guided progressive exercises with your friendly healthcare practitioner.
Note: Stages1-4 can continue until you realize that everything has a process and that you need to trust that process. It isn’t until you realize that things take time, that you start to heal.
STAGE 5. ACCEPTANCE: It isn’t until this stage that you actually start to make gains by leaps and bounds – maybe because the required healing time has elapsed or maybe it’s because you are mentally ready to recover and go through the process. Whatever the case may be, you’re finally listening to the advice provided to you and you’re listening to what your body is telling you. You start celebrating and focusing on the little improvements and you build on them. Then over time you look back and think “wow” I’ve come a long way.
You then realize that you can modify your workouts and your training to fit what you can do and you stop focusing on what you can’t. Having an injury is frustrating and can throw a wrench in your plans — whether it’s leaving the sport you love, changing positions or careers, or how you play with your kids. But the process can never go fast enough.
Remodeling Phase (Maturation):
- It lasts two months to one year depending on the tissues involved and the damage.
- This phase encompasses a long period starting when the subacute phase is complete and continuing into a progressive return to sport/ function/life. In the beginning of this phase, around the 6-8 week mark, scar tissue is still forming and can still be remodelled up to 10 weeks.
The Equation for Recovery Time
Those stages are very familiar to me, both as a physiotherapist and as a patient. After having three knee surgeries and countless other injuries, I place a lot of importance on proper and careful recovery.
There really is no equation to determine the length of time it will take someone to recover (although I wish there were). It is a question I am asked all the time and even a question I ask when I’m the one lying on the physio table.
As a physiotherapist, I hope I can help others go through this only once or perhaps, with prevention, never really have to consider any of those stages. It is easy to look back and say, I wish I could have prevented that injury. But it shapes you, makes you stronger and teaches you patience. You learn more about your body and you learn the amazing things you can endure — physically and mentally.
We are humans, not robots, and there are many variables to consider when determining our recovery period. Including nutrition, sleep, stress (physical or emotional), and environment.
Each injury has been a different experience. Sometimes I recover quickly and sometimes it can nag me for years. But like I said in my last blog post, recovery from an injury is a lifelong journey, as is maintaining and improving our health, performance and longevity.