Understanding Training Injuries and Supplementation
Understanding Training Injuries and the Supplementation to Facilitate Recovery
As a doctor that treats sports injuries on a daily basis, I find a general ignorance when it comes to understanding injuries and what can be done about them. The two most common misconceptions that I hear are, “I’ll just rest it for a few days and it will be fine”, as well as “it will heal on its own”. These phrases are like nails on a chalk board to me because I eventually treat these injuries that DO NOT fix themselves and GET WORSE with REST. By the time these patients seek treatment, the injury has spiraled out of control into a closed kinetic chain reaction affecting different areas of the body. A strong understanding of an acute injury can help you take the proper steps to prevent this snow ball effect from becoming a more serious injury.
The whole point of exercise is to induce a stressful load on the body (whether via weights, pilates, running, etc.) though a full range of motion at which point the body will be forced to respond by increasing its overall capacity for work. Exercise will break down muscle tissue and as a result, the body will regenerate itself with increased muscle mass and its efficiency to exercise. All exercise is good exercise as long as you are smart about it.
Now, let’s look at some statistics that you already know: you have one heart, two lungs, one spleen, two kidneys, one colon, and so on and so on. Did you know that you have over 650 muscles in the body? Did you know that you also have approximately 230 joints? There are thousands of tendons and ligaments that hold all of this together. So statistically, your odds of injuring a muscle, ligament, joint or tendon are much more likely than injuring an adrenal gland or eyeball. This is why we say there is no such thing as an athlete that performs at 100%. They simply do not exist. Because of the constant stress and strain you place on your body, you are never 100% healed, or functioning at 100% capacity. With that being said, though, these athletes have a much higher level of health. This is a good thing…..I would rather explain to you why your shoulder hurts rather than explaining why you need a quadruple bypass. The reality is most muscular, joint and tendon injuries can be alleviated in a relatively short time span of time compared to chronic disease that takes a life time to progress into a serious condition. The key is to educate yourself of how serious your injury is and what you can do to help recovery and get back on track to a healthier and happier lifestyle.
Injuries are broken down into two basic categories. There are MACRO-TRAUMAs in which the mechanism of injury is obvious. An example of this would be seeing an athlete fall and break a bone. The other type of injury is a MICRO-TRAUMA which occurs without any traumatic experience to the body. These include your common aches and pains, a tweaked shoulder, a tight low back, etc. Micro-trauma is the result of unseen repetitive stress on the body over time caused by low intensity forces resulting in an OVERUSE SYNDROME. These are the more common types on injuries experienced by the majority of the population. Micro-Trauma is THE MOST COMMON CAUSE of an overuse syndromes (which most people are unaware of until the injury is serious enough to elicit a painful response). These injuries in exercise commonly involve a sprain versus a strain. To differentiate the two, you will sprain a ligament or tendon and strain a muscle.
In overuse syndromes, the first thing you have to consider is that there are three stages of recovery time once you become injured. The first stage of injury recovery is called the Acute Inflammatory Phase. This is your body’s initial reaction to the injury and starts the inflammatory process. The acute inflammatory phase can last from 48 to 72 hours. During this stage, your body’s natural inflammatory process is up-regulated and this is where the initial pain, swelling, bruising, and reduced motion occur. After the acute phase, your body enters the Repair-Regeneration Phase. This stage can last from 48 hours to 6 weeks. Your muscles, ligaments and tendons will undergo plastic deformation and scar tissue formation in this phase. This is the part of the injury that starts to become a nagging discomfort or pain and most people will alter their workouts to avoid exacerbating the injury (which is the worst thing you can do for it). The last phase is called the Remodeling-Rehabilitation stage, and depending on the injury, can take anywhere from 3 weeks to 12 months to complete. This is commonly seen in serious injuries involving an actual tear or breakage or a ligament, tendon or bone. Most injuries that I treat, as long as it is within a relatively short period of time post injury, involve the first two phases and are completely healed within 2 to 12 weeks.
In general, if an injury is a minor interruption in muscular function, it will generally take a week to repair itself. For a moderate injury, recovery time can take from 1 week to 1 month which should be examined by a musculoskeletal specialist (orthopedic doctor or chiropractic physician). For major injuries, more than one month is needed to recover but it is hard to determine exactly how long it will take.
So how do you determine just how bad your injury is? Well I am glad you asked because this is one of the most overlooked aspects of injuries. There are four phases of overuse syndrome/micro trauma. Phase one is determined by when you experience pain. A phase one injury is when you experience pain, discomfort or tightness after athletic activity. The pain is not very serious but there is a conscious awareness of the injured site. These are mild injuries and usually heal within the first two stages of recovery time. Most of the time, these types of injuries will respond well to anti-inflammatory compounds, ice, active movement, CHIROPRACTIC MEDICINE, and a little bit of time.
Phase two syndromes usually present pain approximately three quarters into the workout or towards the end of activity. This is when we know that you are past minor injury and the injury is either not healing properly or becoming more serious. This in also when athletes should seek examination of the injury to determine its severity. For younger athletes, I recommend to parents and coaches that they should pull young athletes from the activity in an attempt to prevent further more serious injury when this occurs.
Phase three is where we see impaired performance. The pain is consistent throughout the exercise or workout and athletes usually can not finish their activity. In this phase, injuries start to get serious. The danger about phase three injuries is that you will subconsciously start to compensate to relieve stress from the injured area causing further injury by placing abnormal stress in a dysfunctional manner on your body. We call this a closed kinetic chain reaction. If you injure your left knee, you will put more pressure on your right leg and hip causing spinal and muscular dysfunction on the opposite side of your body.
Phase four is the most serious type of injury. In phase four, your body can not function normally, and patients usually need crutches for lower extremity injuries and slings or casts for upper extremity injuries. These injuries also involve a closed kinetic chain reaction in the body and can be difficult to treat. This is where I see hip injuries cause shoulder pain and a dropped arch cause migraines if left untreated or undiagnosed.
There are many things you can do to help repair, or in a perfect world, prevent your injuries through proper supplementation and preventative maintenance at a competent chiropractic physician’s office. The most important thing you can remember is that 99% of the pain you feel comes from inflammation. All injuries result in inflammation and if you can control the inflammation, you can control the pain. I see people treat injuries all day long externally with compression, ice and elevation, but do very little to treat the injury from the inside out. By treating an injury with supplementation and nutrition, you will greatly reduce the time needed to heal. Let’s take a look at how you can facilitate the healing process of the body though nutrition and supplementation.
Omega-3 Fatty Acids are a natural anti-inflammatory compounds with anti-oxidative properties. Omega 3 fatty acids should be consumed daily by everyone to help control inflammation in the body. Omega 3 fatty acids will decrease your pain levels and supply your body with essential raw materials it needs to facilitate its own natural healing process.
Whey Protein is great to supplement the healing process because it supplies the body with a readily available and healthy protein source. Whey protein contains the highest BV (Biologic value) of any protein including egg, casein, milk, soy or beef. Whey protein contains all essential and non-essential amino acids as well as being an excellent source of branched chain amino acids (the building blocks of proteins).
Creatine is a supplement that is commonly used to speed recovery, build muscle mass, and prevent further muscle soreness. Creatine Monohydrate can increase your body’s cellular energy production system. This is a key component to healing because the more energy that is available for healing, the faster the recovery time.
B complex is commonly used as a satellite supplement to help your body’s support systems that maintain normal cellular function. B6 is used for tendon strength and nervous system health which is beneficial for any sprain and strain because it will involve a tendon or ligament in some capacity.
Magnesium is also a great additive to muscular recovery. Magnesium is an essential mineral that your body uses to heal its damaged tissues. In fact, I usually recommend Magnesium to all of my female patients and athletes alike. Magnesium is usually coupled with Calcium since the two works well together.
Joint support has always had mixed reviews but I personally find it beneficial to an injured athlete. Joint support products with natural anti-inflammatory compounds are much more beneficial that glucosamine and chondroitin alone. Look for additional ingredients like Bromlein, Papain, Curcumin, Tumeric, Boswelia and Arnica. These are naturally occurring compounds that will help reduce the inflammation and speed recovery.
You can take these supplements individually or there are a few quality products out there that realize the importance of recovery and have produced an overall recovery supplement. The one I recommend to my patients is JBN Recovery Fuel. Not only is this supplement an essential component of healing, it is also a great supplement to take after every workout.
Remember, with so many muscles, joints and ligaments involved in exercise, sooner or later, injury is impossible to avoid. Be smart, exercise smart, and train hard. Know how to decide how bad an injury or ache is and what to do about and when. Good nutrition is one of the most overlooked components of a healthy lifestyle and the addition to them, many times, will give you the advantage you need to recover faster, train harder, and live a healthier life.
Dr. Philip O’Brien