The People ­ Monday
Date: 28.11.2016
Page 27
Article size: 933 cm2
ColumnCM: 207.33
AVE: 261654.66
Understanding proper sports injury rehabilitation
oft tissue
contraction, and therefore by combining the ef­
fects of ice with static stretching, we have the
particularly
no healing and therefore, although vital, it is im­
portant during this phase to protect and control
movement across the injured area, and prevent
to rehabilitation in orderto speed up the healing
process. As static stretching decreases muscle
spasm, it is therefore important to use progres­
common,
increased swelling over a wider area. This is
sive stretches to increase elasticity and reduce
It is importantto rememberthat there should be
where the familiar rest, ice, compression and el­
further complications.
a gradual build­up to maximal contraction so as
injuries are
especially
in the lower limb and when any stress (injury)
occurs it results in damage to the tissues.
The first response to the stress of tissue
damage is inflammation, which is the body's
natural defence mechanism. Its fundamental
role is to remove the irritant and to prepare for
the repair of the tissues.
Different things happen at different stages
whenever an injury occurs, for instance in the
early stage after a muscle becomes damaged,
there is an inflammatory phase for up to five
days depending on the extent of the tissue
damage. Without inflammation, there can be
evation (RICE) regimen is employed. Therefore,
during this acute phase, applying ice reduces
the energy requirements of the tissues and also
reduces the blood supply to approximately 60
percent of its resting value.
However, as the drainage system is passive
stage, new cells lay down haphazardly increas­
ing the tensile strength across the site of injury,
restoring the structure but not the function. It is
Once the wound has healed, the rehabilita­
to avoid the risk of further muscle tear, and pain
tion process can enter the next phase (recon­
must be used as a guideline. In training, we often
hear the expression "no pain no gain". However,
this may be all well and good during general
conditioning but has no place during rehabilita­
tion following injury. It is therefore important to
remember at this stage during rehabilitation that
all exercises should be pain free, as pain during
an activity is an indication that it is too vigorous
therefore essential at this time to use controlled
ditioning). However, as new fibres can continue
to have a tendency to contract for up to six
months post­injury, continued stretching and
exercise to create gentle tensioning across the
adequate warm up prior to exercise is essential.
wound to help tissue orientation in preparation
Pain can inhibit strength, flexibility, speed and
power; thus it must be controlled prior to com­
mencing this stage. This is when ice can be
very effective, as it diminishes pain and muscle
spasm thus encouraging movement.
movement, ice, compression and elevation
for the final stage of remodeling.
Although there is tensile strength, there
can be a lack of elasticity and adhesions (hard
lumps) can form restricting movement making
the area vulnerable to further injury. Therefore,
(MICE) regimen. As the tissue enters its second
controlled exercise soon after injury is essential
relaxation is often greater than it was before the
and therefore dependent on external forces to
promote movement of fluids, such as during
a muscle contraction, moderate activity dur­
ing this acute phase promotes drainage and
hastens healing. This is why we now use the
benefits of pain relief and increased relaxation.
After a near maximal muscle contraction,
and should therefore be toned down.
The writer is a physiotherapist,
Harambee Stars & Mathare United
wyclef_200@yahoo. com
Ipsos Kenya ­ Acorn House,97 James Gichuru Road ­ Lavington ­ Nairobi ­ Kenya