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Rehabilitating Injuries
07 October 2019

Rehabilitating Injuries

In this article I am going to explore one of my favorite joint and tissue rehabilitation techniques, one which can be used in addition to modern rehabilitation and physiotherapy techniques. This is a method that I have used for several serious joint and tissue injuries over the years and one which I always turn too first whenever an injury occurs.

elbow-injuryFor many injuries, usually caused by hard sparring or competition, the time frame quoted for recovery has been cut in half as a result of this approach. It is important to state here that I am not dismissing the common physiotherapy or clinical approaches, I am also not a doctor nor professional physiotherapist so please always go to a medical professional FIRST to understand the nature and extent of any joint or tissue injury you may have picked up.

This article is specifically talking about injuries where surgery is not required but which may still limit our ability to train. So, we are not talking about high grade tears or complete ruptures of ligaments or tendons, nor substantial injury to joint capsule tissues like the meniscus or labarum. This article is looking at more minor, but still significantly debilitating, injuries that are so common in the Martial Arts community.

Usually the recommended recovery of a tissue injury will go something like this. Rest the affected area for a period of time, perhaps in combination with anti-inflammatory techniques or medications. Then begin a program of ‘strengthening’ or in some instances ‘stretching’ the muscles around the affected area. This is often combined with Massage or similar bodywork techniques to improve blood circulation and healing.

There is no doubt that this is often an effective protocol. However, I believe that some other important steps can be added to make the treatment of joint and tissue injuries more effective.  These are the inclusion of some natural, but often overlooks systems that are common to some more traditional or ancient healing approaches, and which fit very well into the standard model.

The additional steps contain the following areas that are used in combination during the initial period of injury. The period that would usually be recommended merely for ‘rest’. These concepts are:

  1. Breathing.
  2. Release.
  3. Mind.

Let’s look at these steps individually and how they ultimately fit together.

Breathing to heal.

For thousands of years and in myriad cultures, breathing has been at the forefront of health practices and healing techniques. From the Yogis of Ancient India to the Slavic peoples of Eastern Europe or Russia, cultures across the globe have used breathing techniques effectively for all manner of ailments.

oxygenSpecifically, for joint or tissue injuries, the availability of Oxygen to the affected areas can be a strong factor in healing speed and recovery.

“The most essential substance in the repair of any tissue is oxygen. The body cannot store oxygen in the way it can store other substances … Without sufficient oxygen the strength of the tissue repair is much weaker than normal”

PROFESSOR PB JAMES IN ASSOCIATION WITH THE UNIVERSITY OF DUNDEE.
 

In a series of studies performed by Sports Science departments, Oxygen was administered via Hyperbaric chamber to injured athletes and recovery times assessed. Several interesting results were found:

  • Patient 1 developed Achilles tendonitis of the left ankle that was expected to take four days to resolve. A single session of hyperbaric oxygen allowed him to resume full training after one day.
  • Patient 2 suffered a severe sprain of the left ankle estimated to take three weeks to heal. He was able to undertake full training after four days following two sessions in the hyperbaric chamber.
  • Patient 3 strained the upper insertion of the left hamstring with significant localised tenderness. The estimated duration of unfitness was a week but, after two treatments, he resumed training on the third day

Of course, these conditions were outside of the scope of oxygen availability for normal breathing patterns but methods of ‘hyperventilation’ like those of Wim Hoff could possibly produce similar effects.

With this in mind, and the mountain of historic evidence for the efficacy of breathing techniques in recover, a rigorous multi session per day focus on Deep breathing methods could be a good key first step. I have undertaken this approach several times and think there could be some benefit in the rates of healing, especially regarding connective tissues.

It may seem hard to believe that ‘deep breathing’ could be such a valuable first step in the healing or recovery of injuries, especially those to the soft tissues. But availability of Oxygen to the damaged tissues seems to point us in that direction.

Opening’ the joints

One of the natural responses of the body when a soft tissue injury occurs is to protect the area of damage with tension in the surrounding muscles. Sometimes referred to as muscle rigidity or muscle spasm the purpose of this phenomena is thought to be to immobilize an area of injury or to ‘protect’ the stability of a joint, however it is also believed it can be a result of the inflammatory response of the body, a part of the healing process.

opening-jointsThis tension in the muscles surrounding the injury, or at the site of the injury itself will often take some time to subside. Indeed, if the spasm or rigidity is due to the inflammatory response it is very likely to take a longer period to release its grip on the injury.

As such, one of the issues faced by those wishing to rehabilitate tissue injuries is the tension and ‘stiffness’ that this muscular rigidity can cause. There are, of course, several ways that people will look to address this issue, most commonly Sports Massage will be a part of the process athletes undertake to soften up injured areas and allow them to move more freely. There is plenty of evidence for the efficacy of using massage in the healing approach of course, however, unless we are a professional athlete, accessing to massage therapists on a very regular basis may be limited by time, and finances.

Luckily, there exists, in some of the old martial traditions, a number of methods for beginning to resolve muscle tension that results from injury. Sometimes known as ‘opening the joints’ or ‘releasing the tendons’ these methods focus on releasing tension through a series of extension, swinging and relaxation exercises.

These exercises always form a large proportion of any healing process I undertake, often performing them multiple times per day. The aim of the methods is to mindfully extend a damaged limb, with deep attention on the feedback from the body. This is extremely soft work and can be somewhat foreign to most athletes who are used to strong manipulations, contractions or stretching.

In fact, this work it so soft as to seem inconsequential, however, internally we are concentrating all of our effort into ‘releasing’ tension at or around the site of the injury. We will use breathing, concentration, attention, extension and sometimes movement in combination over multiple daily sessions to enter this state of release and ‘free up’ the injury site.

A big consideration when performing this method is that we don’t exasperate the healing by overdoing movement or extension. This is where our mindful attention on the task at hand becomes important, and where an understanding of ‘softness’ really fits in. Although antithetical to most hard charging Athletes, if there is ever a time to work softly it is when you are injured.

Mindful healing

‘Using the mind to heal’ has woo woo written all over it! And it would be very easy for us to veer off into the weeds on this topic. But there is solid evidence that both our mental state and our level of attention on the healing process has a direct impact on our bodies healing response.

One of the most powerful motivators to heal is the mental state we adopt when an injury occurs. Do we dwell on the injury, feel sorry for ourselves and get down in the dumps? Or go for the ‘Shit happens’ attitude and focus on how we are going to get better? There is interesting research to suggest that the latter will provide us with a better environment for healing an injury and therefore reduce recovery times.

Research suggests that maintaining a positive attitude and using mental skills are related to a shorter rehabilitation. In fact, when Ievleva and Orlick (1999) compared slow and fast healers, they found that the fast healers:

  • took personal responsibility for healing, had high desire and determination, had more social support, maintained a positive attitude, used creative visualization, were less fearful of re-injury upon return to full participation”

Dryw Dworsky, Ph.D. & Vikki Krane, Ph.D.
Bowling Green State University

Although this area is extremely interesting and some would argue as important as any other, it is not easy to put concrete parameters around the methods that can be useful to those reading this article. I could simple say ‘Be positive and have a high desire to heal’ but that ultimately will not mean a huge amount to most people. Really to gain benefit from mindful attention on healing, we need to first be mindful of the healing process and what changes are occurring over time as we focus our attention on our breathing and opening methods. But then we need to also have a positive outlook on the entire problem of injury and its place in our personal Martial Arts journey. This is hard to define with clarity as I am sure you can appreciate.

meditationFar clearer is how we can use the mind during our healing sessions. This, again, is something that is present in the ancient healing techniques that martial artists would use to ensure they could recover as quickly as possible and train the next day. Some people have speculated that the large adoption of mindful meditation practices by early martial artists was for this very purpose. An ability to focus the mind on the site of injury and especially during rehabilitation techniques is not only useful, it is vital.

When we are performing healing work on our own, be that breathing work, opening or conventional stabilisation methods we need to maintain a close inspection of how these methods are impacting the site of injury. Without mindful practice it would be extremely easy to go too far and set the healing process back. As you breath, open the joints, extend or move to recover you should be focusing deeply on the site of injury, feeling every millimetre of movement extremely clearly. Then you will get to points where you are working in the injury site without going past its healing range. Over time you constantly ‘feel’ and reach the injury site and this in turn directs the body to focus its healing more precisely.

Healing takes focus.

The concepts presented in this article are designed to point you in the right direction for techniques and methods that can be used to enhance the early phases of the healing process, during what would classically be called the resting phase of recovery. They are not replacements for other techniques and should be used and considered in addition to them. But perhaps the most important point to make, to those suffering with injury, is that you should approach it as a task to be completed rather than something that will just happen. If you ‘wait it out’ often the recovery will take far longer than if you focus on recovery with purpose and drive.

It takes focus, time and dedication to effectively heal yourself of injuries. If you place that responsibility in your own hands, and work hard … but with softness and attention, you may well speed up the healing of injuries that would have otherwise crippled you for much longer. I have improved the recovery time of muscle tears, sprains, joint damage and even a spine injury using the methods presented here in the early phases of the injury.

You too can Breathe, Open, and think your way towards recovery. Above all else, be mindful and respect your injuries, but be positive and understand that they will be resolved.

 

Links to studies 

Oxygen for sports injury recovery

https://www.omstc.org/wp-content/uploads/2014/11/Sports-Injuries-Article-from-P-Kliempt.pdf

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3382683/

https://www.hyperbaricoxygentherapy.org.uk/treatment/injury/sports-injury

 

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“It was rarely the techniques that impressed me when I met the Elite Martial Artists of various styles. It wasn't what they did ... it was how they did it! It was they 'felt' ... their highly developed  power, accuracy, subtly. When I realised this, I knew my training had to be focused on those things, not just techniques. "

Coach Chris Davis - MartialBody Founder