How did I injure myself?
I’m way too young to have an injury! I guess it’s old age. I’m younger in my head than my physical age.
Have you ever chalked up pain to old age and arthritis? At Break Free Physiotherapy, we believe that your age or x-ray results is only one factor. After seeing clients over 10 years of clinical practice, I’ve noticed patterns in people’s history and how they experience pain.
At Break Free Physiotherapy, we believe that in order to achieve health and wellness, challenging the belief that once you have arthritis you’ll need surgery is wrong. I’ve seen many clients with arthritis on x-ray but been able to move better after physiotherapy treatment. The fact is that everyone has arthritis as we get older. But the question is whether the x-ray results are relevant to how the person is moving.
The focus of today’s blog is to help us find out where the possible source of your injury could be from. What other factors could be involved when it comes to pain or injuries? Then we can move into the ways that we can prevent these injuries or get to the root problem.
How did I get injured?
There are several reasons why injuries occur and it is sometimes hard to pinpoint where it came from. One of the biggest concerns clients have coming into Break Free is “How did this happen?”. Many clients will often have no issues until one day, without reason, pain develops resulting in frustration. Below are a culmination of conclusions my clients and I have come to when thinking of their past injuries.
The unresolved and ignored injury
“Oh, I rolled my ankle 2 months ago but I kept playing and ignored the pain and it eventually went away!”
“I slipped and fell last week but didn’t think much of it.”
“My son awkwardly landed on me while rough housing and my back started hurting.”
These are just a few examples of clients sharing their stories about injuries they sustained before coming to see me for their pain. They recall something that happened within the last year but did not think much of it.
Most injuries that require immediate attention are the ones that have pain that intensifies or lingers. Pain is our body’s way of telling us something isn’t right. Instinctively, most people will seek their doctor or head to the emergency room. But after waiting long hours, they will often be sent home with a prescription for medication or advice to rest.
Minor injuries often get missed. They don’t cause lasting pain and the intensity of pain is low. They improve over time and are not serious. However, the long term implications are different in varying cases. Our body is quite amazing in that it has the ability to adapt to injuries to keep you moving.
An example of this is Georgia, a 45-year-old female who suffered a hip injury as an avid walker.
Georgia is a healthy 45-year-old female who has never had an injury. She slipped on black ice last winter and landed on her hip. She finished her walk and felt sore for 2 days but quickly recovered. Georgia continued to walk with no discomfort and took a break from activity when the weather got too cold.
In late spring, Georgia began walking again with the weather warming up. Halfway through her walk, she noticed lower back pain with tingling down her thigh. Distraught she looked online to find out what she should do. She tried stretches on Youtube which didn’t seem to help. Georgia had never experienced back pain before and was worried it was something serious. She visited her family doctor who diagnosed her with sciatica and ordered an x-ray of her lower back. The x-ray revealed arthritis and her doctor recommended physiotherapy.
Based on this story, where do you think Georgia’s injury started?
We often don’t pay attention to the injuries if we recover from them quickly. It is often hard to recall what may have happened. I asked Georgia if she had any previous injuries to her hip or back. She did recall falling in winter the year prior but did not think much of it. We checked her hip and noticed she had lost some mobility. This resulted in her back having to do more work for the lack of flexibility in the hip from her fall. After improving her mobility, she was able to quickly return to walking with less pain and no tingling.
Lack of Mobility
The above example is a very common presentation of someone who has a mobility issue. Is there a restricted joint somewhere in your body that is preventing you from completing an activity comfortably? Most people are unaware that they have a restriction in range of motion until their physiotherapist at Break Free points it out. Once range of motion is improved, there may be a noticeable improvement in their ability to complete an activity. The question is what movement is best for mobility? To shed light on these questions I can share a consistent scenario that repeats itself with my clients called the internet rabbit hole.
My client sustains an injury
They look on the internet to find a miracle cure
Youtube, Instagram and Facebook feeds show “Top three exercises for (fill in the injury)”
Exercises don’t work and there is increased frustration
Search online forums like Reddit and anxiety begins to increase
Try massage and chiropractic but only get temporary relief
When I listen to people’s stories, the internet rabbit hole is a very common one. Your internet feed shares these exercises that are touted as the best for a certain injury. You’ll read in the comment section that many people have found relief with these exercises. But for those who don’t find relief, it becomes very frustrating.
When people ask me whether there one holy grail exercise that fixes it all, I can confidently say no. Every individual has a unique story with individual needs. From their genetic make up to the daily tasks or recreational activities they enjoy – each human body needs something different. Now don’t get me wrong, there are some similarities and patterns I see with certain injuries, but ultimately you need something that is catered to you. This is why a comprehensive assessment from a skilled physiotherapist can help you get back on your feet without the frustration of information overload.
By listening to your story, your physiotherapist at Break Free can hone in on the source of your problem and give you the exact movement required. In the case of mobility, they can complete a range of motion examination where your physiotherapist assesses how far your joints move. They can determine whether you need an increase in mobility with a stretch you can do on your own. In many cases, this increase of range of motion will provide you with more mobility which can lead to a return to your favourite activities. But what if you are very mobile and have a lot of range of motion?
Muscular imbalances
Muscles are the main movers of our body. They attach to our bones and contract to move our limbs in a coordinated fashion. Muscles are a wonderful illustration of how intricate our body systems are and how muscles are dependent on each other to help us move. If one of these muscles is weak, it can put strain on other areas of the body.
Your physiotherapist at Break Free knows their anatomy. They can find weak muscles and help you strengthen them with a customized treatment plan. This will include exercises that use bands or weights to strengthen a weak muscle. You will be given specific instructions on how many times you repeat the movement, how many sets in the session and how often throughout the day they must be completed. Physiotherapists can assess your form and make adjustments so you are activating the appropriate muscle groups.
Finding weaker muscles can be of great benefit in preventing injuries or recovering from an injury. It is important that you seek care from a skilled physiotherapist who knows the human body well. Physiotherapists at Break Free are trained to look for underutilized and undertrained muscles of the body so you don’t have stress about another injury.
Repetitive strain or muscular overuse
I will often see people after training extensively to the point of overuse or repetitive strain of a muscle. These injuries will often create inflammation within the section of a muscle known as the tendon. A tendon is the section of the muscle where the muscle attaches to the bone. Injuries at the tendon are a bit trickier and require a greater understanding of exercise physiology to achieve healing. It is a careful balance of rest followed by gradual exposure to training load. One skill that physiotherapists have is finding ways to decrease pain initially. This includes:
Use of modalities like dry needling and acupuncture
Manual therapy
Use of a brace
Taping techniques
These are all tools that your physiotherapist has in their tool box to make recovery smoother. By using these skills, physiotherapists decrease pain quickly so that you can begin the strengthening process to get you back to doing what you love. But what if the above treatments don’t help?
Rest
This four-letter word sometimes has some stigma on it. Rest? But what will I do in the meantime? Rest does not mean a complete halt of activity; it means that you will need to let what is injured calm down and do some alternative work in the meantime.
Your training will look different. Instead of playing your sport or participating in your activity, you may need to work on other exercises that are required for your muscle to heal. Your physiotherapist may ask you to work on your posture and form without participating in the activity that caused the injury. An example is long-distance running causing ankle pain. Instead of continuing to run, biking in lieu of running will help you maintain your fitness without aggravating your ankle.
Or perhaps you need to decrease how many times a week you complete an exercise or the amount of weight you are lifting. There are many ways to allow your body to rest. But it does not mean stop moving. In some cases, it is appropriate for absolute rest, but this would be in the case of a more severe injury where pain is very high and movement is extremely limited.
Practical ways to prevent injury
With that being said, what can you do to prevent injury? There are several ways this can be done.
Warm up
Warming up can be a great way to bolster your mobility and lower chance of injury.
We stated above that mobility is key! It is important to receive a mobility program from your physiotherapist that you can complete before your activity. Your physiotherapist will know your story and the problem areas that need attention. By maintaining your mobility, there may be a lower chance of injury or reinjury.
Form, Posture, Body Mechanics
Posture, form and body mechanics are the key to injury prevention. If you have had an injury before, you know that certain positions may bring on the pain whereas other positions may alleviate your discomfort. Together with your physiotherapist, you can find ways to adjust the way you complete a movement to prevent further injury. There are certain cues your physiotherapist will give you such as a verbal cue, visual cue or a physical cue.
An example of these are:
Verbal Cue: “Think of a string attached to your breast bone and pull it up towards the ceiling”
Visual Cue: Using a mirror to prevent your chin from tipping upwards
Physical Cue: Using a posture roll in your mid back to prevent slouching
Tarra cueing Corey during an exercise to ensure proper form and prevent injury.
Regular Activity and Strength Training
Engaging in a targeted strengthening program to develop underutilized muscles can help prevent muscular imbalances.
Our bodies are meant to move. Getting adequate blood flow through some level of physical activity will help maintain the health of nerves, muscles, joints and connective tissue. Remember that a strength program that will offset the muscular imbalances developed by playing a certain sport or participating in an activity will help maintain the longevity of your pain free streak. All activities will have a grouping of muscles that are not used because of the repetitive nature of the task or sport at hand.
Final Thoughts
Mobility, strength, body awareness and a good strength training program are key in maintaining a healthy and strong body. If you are struggling to find the source of your injury, seeking a physiotherapist trained in the McKenzie Method will help you hone in on the exact location of your injury. Booking with one of our physiotherapists will give you a blend of knowledge of multiple disciplines while also providing a means of understanding your injury and how to manage it long term.
Corey Kim
Co-Owner and Physiotherapist
Hey, my name is Corey, and I’m a co-owner of Break Free Physiotherapy and Wellness. I was born in Seoul, South Korea but grew up in London, Ontario. I finished both my Bachelor of Arts in Kinesiology and Master of Physical Therapy degrees at Western University. I’m passionate about helping people find pain relief through movement and believe in self-empowerment by sharing knowledge of the human body and its ability to heal. [full bio]
