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When will my injury heal?

When injury strikes, the first thing that most of us want to know is ‘how long will this take to heal?’

Unfortunately, the answer to this can be complicated and requires at least a little understanding of how the different tissues of the body heal. Each of the tissues of the body, including muscles, tendons, ligaments and bone, heal at different speeds and each individual will have some variation on those times as a result of their individual health history and circumstances.

Understanding the type of tissue injured and their different healing times is an important part of how your physiotherapist approaches treatment and setting goals for rehabilitation. On an individual level, a patient’s age, the location and severity of the injury and the way the injury was managed in the first 48 hours all affect the healing times of an injury. Unfortunately, as we age, injuries do tend to heal more slowly than when we are young. Any medical condition that reduces blood flow to an area, such as peripheral vascular disease, can also reduce the body’s ability to heal at its usual rate.

There are some guidelines that can be followed when predicting how long an injury will take to heal based on the tissue type affected. Muscles are full of small capillaries, giving them a rich blood supply, and as such, they have a comparatively fast healing time with 2-4 weeks for minor tears. This time will be extended for larger tears and more complicated presentations.

Ligaments and tendons have less access to blood supply and tears to these tissues generally take longer to heal. Larger or complete tears of all soft tissues, may not be able to heal themselves and in rare cases, surgery may be required for complete healing to occur. Similarly, cartilage, the flexible connective tissue that lines the surface of joints is avascular, which means it has little or no blood supply. To heal, nutrients are supplied to the cartilage from the joint fluid that surrounds and lubricates the joint.

While the different tissues of the body all have different healing times, they do follow a similar process of healing with three main stages, the acute inflammatory phase, the proliferative stage and finally the remodelling stage.

The inflammatory stage occurs immediately after an injury and is the body’s primary defence against injury. This stage is identifiable by heat, redness, swelling and pain around the injured area. During this phase, the body sends white blood cells to remove damaged tissue and reduce any further damage. This stage usually lasts for 3-5 days.

The proliferation stage is the phase where the body starts to produce new cells. Swelling and pain subside and scar tissue is formed that eventually becomes new tissue. This stage usually occurs around days 7-14 following an injury.

The final stage, known as the remodelling stage is when the body completes healing with the reorganization of scar tissue and the laying down of mature tissue. This stage usually occurs roughly two weeks after the initial injury is sustained.

At each stage of the healing process, a different treatment approach is required and your physiotherapist can help to guide you through your recovery. Ask one of our physios at Caboolture Physical Therapy Centre to explain how your injury can be managed best and what to expect in your recovery process.

Caboolture Physical Therapy Centre - serving people in need from the following areas: Caboolture, Morayfield, Elimbah, Wamuran, Beerburrum, Beerwah, Glasshouse Mountains, Toorbul, Donnybrook, Ningi, Woodford, Kilcoy, Bribie Island, Goodwin Beach, Sandstone Point, Banksia Beach, Bongaree, Bellar, Woorim, Burpengary & Beachmere.

On AC Joint Sprains (separated shoulder)

WHAT IS IT?

The AC (Acromio-clavicular) is a thick, fibrous joint that connects the top of the shoulder blade to the outer end of the collarbone. It’s required to be strong and supportive, and is the main way that weight bearing forces are transferred from the upper limb to the rest of the skeleton. The joint is connected by three strong ligaments: the Acromioclavicular, Coracoclavicular and Coracoacromial [as in the image below].

HOW DOES THIS INJURY OCCUR?

The main way this joint and its ligaments get injured is impact by a force that separates the shoulder away from the collarbone (usually in a downwards direction). This can occur from a fall where the top of the shoulder hits the ground first, a rugby tackle or a fall onto an outstretched hand. As with all injuries, there are many variations in severity and a grading system has been developed to classify AC joint injuries.

WHAT ARE THE SYMPTOMS?

After an AC joint injury, there is usually immediate pain on the top of the shoulder, swelling and bruising. There is often loss of movement in the shoulder, and pain from putting weight on the arm, or carrying heavy objects. In severe cases, there is a visible lump on top of the shoulder, known as a ‘step deformity’, which is where an obvious difference in height can be seen between the top of the shoulder and the collarbone. Pain may be felt when reaching across the body, like when putting on a seatbelt.

To confirm the diagnosis, your physiotherapist can perform some clinical tests and an X-ray can help to grade the severity of the injury. The classification that would be given to you by your physiotherapist or doctor help determine the optimal course of action.

There are different classification systems, some use three grades and other six. Injuries with a smaller number of ligament fibres being torn are given a lower grade classification, going upwards as further damage is incurred. Injuries classified as higher grades will require surgical repair.

HOW CAN PHYSIOTHERAPY HELP?

Your physio will be able to help ensure the joint is supported and given a chance to heal naturally, while maintaining the strength and normal movement of the shoulder girdle. They’ll do this initially by providing support to the joint. You may need to have your arm supported in a sling or brace for some of this time and your physiotherapist can show you some taping techniques to add support.

Most AC joint sprains take six weeks to fully heal, although many patients report shoulder problems in future years. For this reason, a comprehensive rehabilitation program is very important. More severe sprains are often treated with surgery to stabilise the joint and treat any possible fractures. Surgical repair will also require a proper rehabilitation program.

For more information, please contact Caboolture Physical Therapy Centre. Always see a medical professional for advice on your individual injury.

Caboolture Physical Therapy Centre - serving people in need from the following areas: Caboolture, Morayfield, Elimbah, Wamuran, Beerburrum, Beerwah, Glasshouse Mountains, Toorbul, Donnybrook, Ningi, Woodford, Kilcoy, Bribie Island, Goodwin Beach, Sandstone Point, Banksia Beach, Bongaree, Bellar, Woorim, Burpengary & Beachmere.

Understanding Hamstring Tears

Let’s get clued up on hamstring strains; why you may have one, what you can do to help and how to prevent a future injury.

The hamstrings are a group of three muscles; the biceps femoris, semimembranosus and semitendinosus. You can feel these muscles if you place your hands on your sitting bones where the muscles originate and slide your hands down the back of your legs. The main action of these muscles is to bend your knee, take your leg out behind you and to assist rotation of your knee, especially when performing accelerating and decelerating actions.

A strain/pull/tear is when the muscle fibres are overstretched. Injuries are frequently felt as a short sharp pain in the back of your thigh whilst exercising. A hamstring strain will typically happen when running just before your foot hits the ground. At this point, the hamstrings are working eccentrically to control the forward motion of the two lower leg bones, your tibia and fibula. Pain is often the most debilitating symptom affecting your ability to continue exercising and may cause a limp. Other symptoms include swelling, bruising, muscle spasm and reduced movement at your knee.

Strains can be categorised into 3 different grades; 1 being the mildest with a small number of fibres being torn to grade 3 being the most severe which can be a complete muscle rupture. The good news is muscles have a fantastic blood supply and should heal within 3-12 weeks depending on the degree of injury. However, the flexible skeletal muscle fibres, which your muscles are made up of, are replaced with much more inflexible tough scar tissue, which is where physio’s come in. Specific rehabilitation such as specialist stretching, strengthening, taping and soft tissue techniques can dramatically influence how muscle fibres are restructured reducing the amount of scar tissue speeding up the healing process helping you return to sport quicker.

With any soft tissue injury, R.I.C.E (rest, ice, compression, elevation) should always be your first response.

A physio will be able to perform a thorough assessment and educate you on why you sustained a hamstring strain in the first place. Common factors that can predispose you to hamstring strains are not warming up or cooling down properly, tight hamstrings or hip flexors, weak hamstrings or gluteal (butt) muscles, training at a high intensity without adequate training or altered biomechanics.

Runners often have short, weak hamstrings, tight hamstrings will restrict the length of your strides when running meaning you have to work harder to cover the same distance as you would with adequately lengthened hamstrings. Chronically tight hamstrings can cause not only hamstring strains but can contribute to back pain, knee pain and leg length discrepancies. So even if you have never stretched before it may be a good time to start stretching!

So to prevent yourself pulling a hammy make sure you warm up and cool down properly including effective stretching of not just your hamstrings but hip flexors, quadriceps and calf muscles, do sport specific strength and conditioning and avoid sudden increases in intensity of exercise. On your next visit why not ask your physio and find out how healthy your hamstrings are.

Caboolture Physical Therapy Centre - serving people in need from the following areas: Caboolture, Morayfield, Elimbah, Wamuran, Beerburrum, Beerwah, Glasshouse Mountains, Toorbul, Donnybrook, Ningi, Woodford, Kilcoy, Bribie Island, Goodwin Beach, Sandstone Point, Banksia Beach, Bongaree, Bellar, Woorim, Burpengary & Beachmere.
Separated Shoulder (AC Joint Sprain)

Separated Shoulder (AC Joint Sprain)

WHAT IS IT?

The Acromioclavicular  (AC) Joint is the joint between the collarbone and the shoulder blade. It is the only bony joint attaching the upper arm to the body and is essential in transferring forces from the arm to the trunk. To keep the joint stable it is reinforced by three thick ligaments; the Acromioclavicular, Coracoclavicular and Coracoacromial ligaments.

HOW DOES IT BECOME SEPARATED?

A tear of the AC joint usually occurs from force directly on the shoulder, often from falling, car accidents or tackles during sport. As with all injuries, there are different degrees of injury. With mild injuries, only a few fibres are torn or stretched. In very severe injuries the collarbone and shoulder blade are completely dislocated. This injury is referred to as ‘separated shoulder’.

WHAT ARE THE SYMPTOMS?

After an AC joint injury there is usually immediate pain on the top of the shoulder, swelling and bruising. There is often loss of movement of the shoulder, and pain from putting weight through the arm or carrying heavy objects. In severe cases there is a visible lump on top of the shoulder, known as a ‘step deformity’.

To confirm the diagnosis, your physiotherapist can perform some simple tests. An X-ray can help to grade the severity of the injury.

Separated Shoulder (AC Joint Sprain)HOW CAN PHYSIO HELP?

The first line of treatment is RICE (Rest, Ice, Compression, Elevation) to minimize inflammation over the first 48 hours. Ultrasound and NSAIDS can also be used to reduce swelling.

After this initial period it is important to note that a severe sprain of the AC joint puts quite a lot of stress on the muscles that support the shoulder. The role of physiotherapy in this case is to ensure the joint is supported and given a chance to heal naturally, while maintaining the strength and normal movement of the shoulder girdle.

This is done initially by providing support to the joint. You may need to have your arm supported in a sling or brace for some of this time and your physiotherapist can show you some taping techniques to add support. Heat and ultrasound are other treatments which can speed up healing.

To maintain the health of the surrounding muscles, your physiotherapist will prescribe exercises, ensure the muscles keep a normal length and treat any trigger points.

Most AC joint sprains take six weeks to fully heal, although many patients report shoulder problems in future years. For this reason a comprehensive rehabilitation program is very important. Very severe sprains are often treated with surgery to reattach the joint and treat any possible fracture.

Caboolture Physical Therapy Centre - serving people in need from the following areas: Caboolture, Morayfield, Elimbah, Wamuran, Beerburrum, Beerwah, Glasshouse Mountains, Toorbul, Donnybrook, Ningi, Woodford, Kilcoy, Bribie Island, Goodwin Beach, Sandstone Point, Banksia Beach, Bongaree, Bellar, Woorim, Burpengary & Beachmere.