When to return after an injury

Published 12:00 am Monday, January 6, 2014

I have had many injuries happen in my life, especially in my martial art — judo. Too many times, I returned too soon and have paid the price for not letting my body to heal correctly first.
Two typical injuries are a strain or a sprain. A strain is an injury to either a muscle or tendon (tendon is the tissue that connects the muscle to the bone). Depending on how severe the injury is, a strain can “just” be an overstretched muscle or it can be a tendon with a partial tear or full tear. Sprains are an overstretch or tear in a ligament that supports a joint. The way I remember the difference between a strain and a sprain; sTrain — T for tendon.
There are three grades of strains and sprains:
Grade 1 strain is considered a mild strain. “Only” muscle fibers have been damaged, however, healing will occur within two to three weeks. Grade 1 sprain, also considered mild, is an overstretching or slight tearing of the ligament with no joint instability. Typically minimal pain and swelling with little or no loss of function; person usually can put weight on the joint.
Grade 2 strain is considered a moderate strain. There is more damage to the muscle but not completely ruptured. Healing usually occurs within three to six weeks. Grade 2 sprain, moderate, causes partial tearing of the ligament and is characterized by bruising, moderate pain and swelling. A person will have difficulty putting weight on affected joint and has some loss of function. Your doctor might need an X-ray or MRI of the affected area.
Grade 3 strain is considered severe with a complete ruptured muscle. Surgery is mostly needed to repair a level 3 strain and healing can be up to three months. Grade 3 sprain is severe and has a big tear or ruptured ligament. Pain and swelling and bruising are usually severe and person is not able to put weight on affected joint. An X-ray is taken to rule out a broken bone and immobilizing the joint is a must with possible need for surgery.
You need to see your doctor when you can’t put any weight on the affected joint, or the area is very tender when you touch it, or when it just doesn’t look right (lumps and bumps in area)
If you consider yourself a Grade 1, use R.I.C.E. therapy — Rest, ice, compression, elevation.
Any time that you are in doubt check, with your doctor or physical therapist. If you don’t correctly rehabilitate your injury, the chance of injury to that same area increases.
You can return to physical activity:
• When you are released from your doctor or physical therapist.
• You are pain free.
• You have full range of motion (ROM) in the injured joint/muscle.
• Your strength is close to where it was before your injury.
• On lower body injuries, when you can move normally with no limps and can put full weight on the affected area. For upper body injuries, when you can move your joints through normal functions.
As I have learned the hard way, when you have injured a body part, you have to “baby” it for a couple of months after you have returned to normal activities. Within that time, the chance to re-injure can be high, especially in explosive sports such as racquetball and basketball (to name a few). I am an avid believer in having your doctor diagnose your injury and follow his or her rehabilitating prescription. A physical therapist can be a huge help. The reason you injured it in the first place might be an imbalance between your muscles, and they can help you with preventative exercises. I know — it helped me tremendously.

Ester Marsh, ACSM Cpt Health & Fitness Director, JF Hurley YMCA.