Brian Manning, MPT, CSCS, EMT-B shares his thoughts on the science behind injuries in this first part of a two part article over injuries and their rehabilitation
The Science Behind the Injury
Some of us are in tune with our own bodies enough to wonder what happens to our bodies when we injure them. Most of us know that when we sprain an ankle ligament or strain a muscle that something has either been stretched or torn. All of us know that when we sprain/strain these tissues that there is a lot of pain involved and our overall ability to function becomes limited. Ever tried to walk the next day after spraining your ankle? That probably didn’t go well. What about reaching into a cabinet for a glass after straining or tearing your rotator cuff? How did that work out for you?
What I have learned through an organization known as The Ola Grimsby Institute is the manual therapy lesion that tries to combine the biomechanics, histology, and neurophysiology into a better understanding of the injuries we sustain.
The trauma sustained in an injury starts out with collagen damage. When collagen is overstretched it loses the elastic component that helps hold the tissues form and thus reduces its functional capabilities. This leads to damage to the receptors imbedded in our connective tissue (i.e. ligaments, tendons). These receptors provide feedback to our central nervous system which in turn tells our muscles how to respond. If these receptors are damaged, there is a loss of muscle fiber recruitment which would mean a loss of dynamic support to the joint involved. Not only that, your ability to control the motion of the joint will be compromised. With the loss of feedback to the muscle, you start to get muscle atrophy due to pain and guarding that will also inhibit the muscles ability to contract or “fire” and, its ability to control the joint’s motion or simply support it. Without the muscle control, the joint will start to work around an axis of motion that is both abnormal and unstable. If this is occurring it can lead to further tissue trauma. Examples of this would include that sharp pain or pinching sensation in the shoulder when you reach for something or that wobbling sensation when you walk after spraining your ankle. What your body will start to do after it figures out the joint and surrounding structures are not functioning correctly is provide a guarding phenomenon for the joint that will relate to you as stiffness, tightness, and pain. This will continue until tissue healing starts to occur and the stimulus for reporting pain has stopped.
The healing effect can occur naturally, but this is not always the case. That is where a physical therapist comes in. How do we deal with pathologies? Well, that is a discussion for another article.
Submitted by Brian Manning, MPT, CSCS, EMT-B