Sports injury recovery training

The core logic of sports injury recovery training is never to "wait until the injury is completely healed before exercising." Instead, after the injury occurs and on the premise of avoiding the pain threshold, through graded functional activation, strength strengthening, and movement pattern modification, complications such as muscle atrophy and joint adhesions can be reduced as much as possible, and finally a safe return to normal exercise or even improved sports performance is the best path currently recognized by the sports medicine and rehabilitation circles.

Last year, I met a marathon runner who had been running for 5 years. He sprained his foot while going down the steps for a night run. The X-ray showed no fracture, but a torn lateral collateral ligament. The doctor said that three weeks of rest would be enough, but he actually lay down for three weeks. As a result, his ankle became sore after walking two steps, let alone running. His calf became two centimeters thinner than the healthy side. It took more than two months of rehabilitation before he slowly returned to the previous running volume. This is a typical misunderstanding of "recuperation" as "not moving at all".

Speaking of which, the implementation of recovery training in the rehabilitation circle is now divided into two mainstream directions. There is no absolute right or wrong, but the applicable scenarios are different. One is the progressive resistance system introduced from Europe and the United States. The core is quantification. For example, the ankle strength must reach 90% of the healthy side and the peak torque difference of the muscles around the knee joint must be less than 10% before it can enter the next stage. The advantage is that the standards are clear and it is not easy for novices to make big mistakes if they follow it. The disadvantage is that it is too rigid. Some people have enough strength but still hurt when running. The proprioception of the joints has not kept up. Mere muscle strength cannot be used. It is useless. The other is the function-first approach advocated by many traditional rehabilitation practitioners in China. Instead of worrying about strength values, you should first practice balance and proprioception, such as standing on one foot and unstable plane training, so that the joints can cope with daily dynamic scenes first, and then replenish strength. This is especially useful for people with old injuries and habitual sprains. However, the disadvantage is that there is no quantitative standard, which tests the experience of rehabilitation practitioners. If you encounter unreliable practices, it is easy to overstep the limit and aggravate the injury.

Many people ask me whether they can move during the acute stage. Oh, yes, first of all, we must separate the acute and subacute phases. For acute injuries within 72 hours, when redness, swelling and pain are still obvious, you must first follow the doctor's instructions to apply immobilization, cold compress, and don't move blindly. But after 72 hours, when most of the swelling has disappeared, you can start to do the lowest intensity activation, such as Ankle pump and quadriceps isometric contraction means that the muscles are tightened and then relaxed. You don’t need to move the joints. You can do it while lying on the bed. Don’t think it’s too simple. I’ve seen too many people lie down for a month without even doing this. Their knees are weak when they lift their legs. The injury that should have healed in two or three weeks has been delayed for two or three months. In fact, resumption of training is like adjusting the chain of a newly repaired bicycle. You cannot pedal the fastest gear as soon as you get up. First, ride slowly for two laps to see if there is any lag, then slowly adjust the tightness and increase the intensity. If you pedal hard as soon as you get up, the chain will be able to be kicked off no matter how new it is.

As for when can you return to sports? There is really no standard answer to this. I have met two young men who also suffered first-degree meniscus injuries. One is a regular gymnast. After 4 weeks of training, he did not feel any pain when jumping on one foot or changing directions. He went back to play basketball and has not relapsed now. ； The other rarely exercised, but after practicing for 6 weeks, his strength reached 95% of the unaffected side. However, it still hurt when he ran, and he had to adjust his movement pattern for another two weeks. Nowadays, academic circles are also arguing about this. Some say it depends on strength data card standards, and some say it depends on functional movement screening. In fact, the simplest judgment standard for ordinary people is: if you do the movement you were injured before, it doesn’t hurt at all, and you don’t subconsciously hide when exerting force, and you can recover slowly. Don’t hold on, pain is an alarm sent by your body, don’t take it seriously.

There is another common pitfall that needs to be mentioned. Many people think that recovery training is to train the injured area, but this is not the case at all. For example, for people with knee pain, the problem often lies in insufficient hip strength. When walking, the hip shakes and the knee compensates for the force. It is useless to just train the muscles around the knee. You must also train the hip muscles. ； If you have recurring problems with tennis elbow, don't just rub your arms. First, check to see if your grip posture is wrong. Your core strength is not strong enough to swing your arms to exert force. If you don't change your movements, no amount of strength training will be in vain.

To put it bluntly, restorative training is essentially a process of dialogue between you and your body. Don’t believe the gimmicks on the Internet about “healing sprained feet in seven days” and “returning to the court in ten days.” Everyone’s degree of injury, muscle foundation, and tolerance are different. Being steady and slow is better than anything else. After all, being able to exercise healthily for a long time is more important than short-term results, right?