A Physio’s Personal Perspective from Injury
By Physio, Sammy Yeung
This year I have dedicated to more “play time”- this means having fun trying new things that I have not done before.
A risk that comes with trying new activities is that we may end up performing the new ‘thing’ incorrectly. To perform a new activity with only a few repetitions incorrectly is unlikely to cause any problems (the caveat being rock climbing, skydiving or activities with high forces to which our bodies are unaccustomed – all of which we definitely advocate doing correctly!). With more repetitions or increased frequency of poor, or incorrect, movement patterns, comes the potential increased your risk of injury.
Unfortunately, just because I am a Physio and I know this does not protect me from injury (doh)!
As a personal example of this, I had taken-up calisthenics on parallel bars. On one occasion, I lost balance and fell forward on a parallel bar when doing a movement called ‘L Sit to Planche’. While trying this new maneuver, my left shoulder and elbow were caught under the bar and twisted as I fell forward. My right hand was caught into hyperextension backwards when I landed from the height of the bars. This episode resulted in a left shoulder labral tear, low grade elbow medial ligament tearing and a rupture of a ligament in my hand. As a Physio who uses manual treatment with my hands, as well as being active with lots of different exercise and sport, as you can imagine, this injury caused a fair bit of disruption to my life temporarily.
Here are some valuable lessons from this episode that I was reminded of from my attempt to add more ‘playtime’:
- Pain does not always equal damage
While I was in immediate pain following the accident, I was in immediate pain in my elbow. My shoulder and hand actually did not experience much discomfort. After proper clinical assessment and further investigation via imaging, we found out that my elbow was the least severe of all three regions in the tissue damage that showed up on scans. From this, I also experienced a decent amount of forearm pain, which retrospectively may be due to muscle protective guarding following an injury. This reminded me that where you hurt may not necessarily be where your prime injury is. It is therefore always worthwhile getting clinical assessment after an injury, no matter how big or small but a trained professional. Better still, find a Physio who understands the demands of what you are doing with yourself.
- There is always something you can do immediately following an injury in the acute phase
Clinically, I often see clients who present with injuries that may be 1-2 weeks old. They often report that they thought it would get better over time if they just rested it.
There are some injuries and circumstances where it may be better to rest immediately after injury – but often this initial period is shorter than you may think. In Rat research, for example, after an acute muscle injury, the Rats that had the best muscle repair were those who rested immediately for 1-5days (depending on the severity and location of the injury) and then were graded on an immediate return to movement and added activities.
So if you are acutely injured, I would encourage you to consider what you could do to optimise your recovery process. Options an experienced Therapist will guide you around include:
- modifying aggravating activities
- what does ‘relative rest’ for you look like and how long
- what recovery strategies are best for you
- and how/when to start introducing movement, activity and/or exercise for the best outcomes
- what are the alternative activities that you could try if your well-being is at risk
Personally with this episode, I immediately taped my elbow and thumb to temporarily immobilise it to minimise the risk of further injuries and this stopped me from aggravating these areas. I used ice and made sure I was guided in my movements by the pain, but without being scared of my injuries.
Pain does not always mean you need to stop training, again depending on the injury, your personal beliefs and what activities/competition you plan to engage in. Again, I would encourage you to engage a health professional early post-injury to guide you.
- Relative rest is important to settle things down, but you do not need to rest completely
Like the rest of the Gold Coast Community, I am an active person who is not naturally good at “resting” and doing nothing. ‘Relative rest’ is important to make sure we allow the injured area to settle and undergo it’s acute changes. Relative rest is very different for different types of injuries, depending on the condition, severity and location. For me in this episode, relative rest meant not putting weight on my hand for 1-2 weeks, while limiting the range of motion in my shoulder and elbow in exercises, but continuing to still complete upper limb loading during that time.
Depending on your sporting activity/ hobby and injury, part of my role as a Physio if I am doing my job well is to establish modifications that may still allow you to participate.
- Imaging (xray, ultrasound, CTscan, MRI etc) is only a part of the clinical picture for injury management
As a Physio, I will clearly educate you on the role of imaging such as MRI, CT scan and X-Ray in managing your injury. I don’t always need imaging to accurately and effectively manage an injury
It is, however, essential that your clinical presentation is thoroughly assessed to establish a good rehab & management pathway for your individual injury. In my personal instance, if I solely relied on the scan performed on my hand, I would have been put in a cast for 4-6 weeks where I was not able to use it at all. However, because we assessed my clinical presentation including my mobility, strength, function and other special tests, we were able to progress my hand rehabilitation a lot quicker, which meant for me no cast and no loss of time from work while managing this injury.
- Be patient and be gentle with yourself
Dealing with injuries is always frustrating, especially when it is one that involves a longer rehabilitation. In clinic, I am fortunate to work alongside a Sports Psychologist who can help navigate these difficult times.
Being injured often presents a good opportunity to check in with yourself. Are there any weaknesses that you can to target during this time? What are other things that you can spend time on with the extra time that you may have? What do I need to consider in the future to avoid or reduce risk of injury? and what level of risk am I prepared to take in the future around my life priorities. For me, dealing with my injuries gave me a great chance to develop my lower limb strength and aerobic capacity- area’s that I often pay less attention to.
- Have a plan
“If you fail to prepare, prepare to fail.” Having a thorough plan that goes from rehabilitation to performance, not only allowed me to check in to see how I am progressing, but also give me guidance through the entire rehab journey without feeling lost.
I cannot recommend enough having a session with your Physio to talk about:
- how to approach your individual rehab needs,
- set milestones and realistic expectations because this will allow you to maximise and get the most out of each phase of your rehabilitation.
- use technology and equipment to accurately assess your progress (our Physio Liam Ryan talks briefly about this in his article about some of the technological pieces of equipment we use in clinic to make sure we are assessing you accurately, and not guessing! Read his article here)
Like yourself, we as Physio’s also get injured from our respective activity, exercise & sports.
The benefit of this is it allows us to understand your pain and frustration, and most importantly, adds to our experience in being able to help you get from being in pain to performing again.
If you would like to Book an Appointment with Sammy, Book Online mygcphysio.com.au or phone 07 55006470.
