Friday, October 8, 2010

Tissue Healing . . .

 

There’s always those people that “oh i heal really fast . . yeh . . it’s in the genes ” . .

We may be super humans but we CANNOT outrace tissue healing times . . you cannot outrace your own physiology.

All tissues have a “threshold” above which they fail. It may not be the 488th rep . . or the 499th rep . . it may take the 511th rep . . but what we do know is eventually they fail.

Obviously what we want to do is bring that tissue tolerance to MAXIMUM level . . so we can take advantage of that tissue as long as we can.

After an injury, those muscular-skeletal tissues never, ever return to normal . . not mechanically . . not architecturally.

An injured tissue is an injured tissue and will ALWAYS remain an injured tissue . . it has different extensibility . . it may take a little longer to warm up . . it may be a bit tweaky . . it will fail first before any of the other tissues . . it will fatigue faster . . earlier . .

You may be healed, but that tissue is not the same tissue. It’s been to the beautician and had a makeover . . it’s been remodelled. Your body has now layed down scar tissue.

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Your body is telling you “HEY YOU . . you trashed that one time motherfucker, I will NEVER let that happen to that tissue again.”

You’ll notice if you’ve pulled a hamstring . . or had a tear . . you’ll have a section of that muscle that’s critically short all the time . .  it’s always going to talk to you a little bit . . whisper in your ear for that extra bit of TLC. Now that doesn’t mean it’s not 100% or it can’t do what it’s set out to do . .  it’s just never the same.

Factors that slow down healing are:

  1. Age – A good blood supply is CRUCIAL for an injury to heal properly. As we age, our blood supply is often impaired.
  2. Nutrition
  3. Sleep
  4. Stress (increased cortisol, leptin)
  5. Being immobile – Rest & Lack of mobility = DEATH . . it’s the worst thing you can possibly do for an injury.
  6. Attitude
  7. Diabetes (insulin sensitivity)
  8. Anti-Coagulants (high blood pressure stuff)
  9. Corticosteroids (steroid inhaler for asthma, predisposed for ALL bad tissue stuff)
  10. NSAIDS – Non steroidal anti inflammatory - ibuprofen – good data supporting people who take ibuprofen for a long time A LOT of the big athletic compounds in Europe has banned this anti-inflammatory from the table.  Why? Because it stops the inflammatory process . . it impedes tissue healing. So how do you limit inflammation ? ICE.

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Let’s move on to the tissue healing phases:

Phase 1 – Inflammation – 0-36 hours

Phase 2 – Proliferation – 2 days – 2 weeks

Phase 3 – Remodelling – 2 weeks – 6 weeks

When we talk about tendon ruptures . . . especially in tendons like the Achilles Tendon . . which is the THICKEST tendon in the body . . why do you think it ruptures?

Maybe because the load that was placed on it was ENORMOUS? No . . it’s used to carrying around your bodyweight & more . . so why? Because they’ve had an unhealthy tendon for a LONG time . . and they haven’t done shit about it . . it’s been shitty for weeks . . and you’re hoping it will go away . .

Our body has freakin’ AMAZING healing mechanisms . . but you HAVE to give it the chance to heal . . or else you’re digging your own grave here.

So phase 1 we’re thinking “OK . . my ankle is the size of a melon . . let’s slow the inflammation down”. . that’s the number 1 step.

Swellings is MAXIMAL . .  the joint won’t move . . you can’t straighten your knee out . .  it’s ballooned out . .  this is the position where the joint has enough space to breathe and recover . . the “loose-packed” position of the joint. When you straighten out the leg it closes down the joint space, makes less room for swelling.

So what we want to do in Phase 1 is SLOW DOWN that inflammatory response . . we don’t want your body to freak out and do more than it’s supposed to . . best way to slow it down ? ICE.

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ICE.ICE.ICE.

We want to be icing it for 20 mins, every hour or two . . none of this bag of green beans type shit . . ice cup for 5 minutes . . if you’re using anything else . . 20 minutes . . why 5 minutes ? because you’re really isolating that area . . so grab a plastic cup . . put water in it . . rip a bit off the top . . freeze it . . and use that . .  BEST method out there . . cheapest method out there.

That ice will stop pain messages from getting to your brain . . we’re shrinking those spaces . . swelling is going down.

After you ice you’re suddenly getting a highway of blood flowing in to the muscle . . creating good blood flow.

Phase 2, we’re saying “Hey, i feel AWESOME . . but it’s only 2 weeks out . .  swelling is down but it’s best i start walking around on it . . “ You’re starting to lay down scar tissue . .

You don’t want to be pushing that healing process and start doing crazy acrobatics on its ass . . LAST thing you want is for inflammation to surface again . . and it becomes a cycle from phase 1 to 2 . . re-injuring the tissue then beginning to fix . . we want to fix the problem . . and get the fuck out.

Walking around with chronic swollen knees is not sexy .

Phase 3 – Is where you’re saying “Feeling good . . let’s try and move that joint a little bit . . “ The natural forces of gravity are now starting to reshape those tendons to maximally heal.

So main thing is . .  we want to ICE and treat that injury as soon as you realize something ain’t right . . don’t be stubborn . . don’t be the reason for your own downfall.

xx Mel

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