Recovery not your friend? Here’s why!

How we recover from injury isn't ever what we expect. Here's why!

Whether you’d class it as an injury or not, we’ve all had aches and pains at some point – some are short lived, some come and go and others linger. But why is recovery so variable? Can we speed it up and if so, how? 

It would be amazing if the body was straightforward, following a set course. In some ways it is – biology is largely predictable, taking a set amount of time to do a set amount of actions. The big thing that affects this is what we do and the conscious decisions we make. Given the chance, our bodies can recover from most things but the issue is, are we giving it a chance? Without the right factors, our recovery can wax and wane, making us frustrated and keeping us away from what we enjoy doing for even longer. Here are some of the biggest factors affecting how we recover: 

Sleep 

This is by far one of the most commonly overlooked factors. We all know we should be getting eight hours of quality sleep a night but many of us don’t know why. When we drift into deep sleep, our brain releases growth hormone helps with the rebuilding of soft tissues such as muscles. Blood flow to our muscles is also increased when we sleep, which brings oxygen and nutrients to our muscles, allowing further healing. Finally, a hormone called prolactin is also released, which helps to regulate inflammation. All of these are so important to recovery so try to sleep well if you can! (And don’t feel bad if you can’t, I’ve got some sleep tips coming up soon!). 

Nutrition 

We all know protein is a staple for body builders and athletes, but it’s also really important for those who are injured. Injured muscles, tendons and ligaments are rebuilt using protein fibres so if your diet is low in protein, there’s a good chance it will affect your recovery. I’m not saying to stuff your diet with eggs, red meat and fish, but a healthy portion of protein across the day will give your body the fuel it needs to recover (although all components of your diet are super important of course!). 

Age  

The reality is, things take a little longer as we get older and one of those things is recovery from injury. This is not to say you’ll never get better (a vast majority of people do!) but like wrinkles on our skin, wear and tear and scar tissue are normal age-related changes that may have an impact on how your body responds to injury. Be patient and get the advice and support you need to help. 

What steps you’ve taken to recover 

People often think RICE when they’re injured (rest, ice, compress, elevate). This is a starting point but misses a big part of the story. Hands on treatment from a qualified professional can really help to speed your recovery along…as long as it’s the right treatment! Soft tissue injuries in particular respond really well to graduated load, which rather throws the ‘rest’ part of RICE into question. Get yourself a qualified professional who will give you things to do outside the treatment room as this is just as important (if not more so) than hands on treatment. If your therapist isn’t giving you homework, they’re missing a big part of the story, but more on that another time! 

The injury itself 

This seems obvious but a lot of people don’t acknowledge how different injuries respond differently to treatment. For example, muscle sprains recover quicker than tendon strains as muscles are better supplied by blood vessels. Dislocations often take longer than fractures to heal as more muscles, tendons and ligaments are often affected in a dislocation. Hurting your shoulder may take longer to recover than a finger injury as it’s a bigger joint. Getting the right diagnosis can make a massive difference to how you view your recovery – have the right people on your team and you’ll soar. 

There is of course a whole mental side to recovery that we haven’t even discussed but again, that’s a conversation for another day. But hopefully this has given you some answers to why and how your body recovers in the way that it does. Best of luck! 

Stress – it just affects us mentally, right?

At some point or another, we all go through stress, be it physical or mental. We grow from it, we learn from it – it’s a necessary evil to progress in life. Many would even argue that it’s a positive thing and that pushing our boundaries is what we need (I would agree in many circumstances!). We all know how stress makes us feel but how does it affect us physically? 

In clinic, I see people every day who’s aches and pains can be put down to stress. Be it tight shoulders, headaches or back pain, we all have a place where our stress migrates to. A big part of what osteopaths do to help with pain is to identify this ‘stress area’ and show you how to strengthen and stretch it out. This helps with long term recovery and will help your body cope with whatever you through at it. Of course, this relies on reducing stress where possible too.  

During times of stress, we go through a ‘fight or flight’ response, a reaction that’s controlled by our hypothalamus, located deep in the brain. The hypothalamus communicates with the rest of our body via our sympathetic and parasympathetic nervous systems which act like the accelerator and brake for our body. During times of stress, the sympathetic nervous system kicks in and gets us ready to act (fight) or run (flight) by causing adrenaline to be released. This in turn triggers a number of other things to happen: 

How fight or flight affects us on a physical level

As you can see, stress doesn’t just affect us on a psychological level. All of these factors help to explain why conditions like type two diabetes, heart disease and digestive issues are so much more common in people who have stressful lifestyles or struggle to control their stress levels. Particularly in the early stages of these conditions, lifestyle changes can have a big impact on how the conditions progress and can in some situations reduce symptoms entirely. This of course is something to discuss with your consultant or doctor. Bear in mind medication and monitoring are still super important here! 

With stress being part of our everyday lives, it’s important that we learn to control the elements we have a say in. Here are some tips you could try to reduce your stress levels: 

  1. Mindfulness! Be it meditation, gratitude lists or other mindfulness strategies, taking your head out of the game for a moment can be really beneficial. Like everything, you have to be engaged with it for it to work – just sitting down for ten minutes won’t do a lot unless you’re able to commit to whatever it is you’re trying to do. For example, I’m a restless soul and so I find meditation quite difficult (clearing my mind doesn’t come easy!). Instead, I find gratitude really helpful – considering what I have to be grateful for. It doesn’t have to be anything major, even just having time to have a cup of tea is something to be grateful for at the moment! 
  1. Decide what is and isn’t out of your control! Traffic is out of your control but the route you take or the time you give yourself for a journey is within your control. The coronavirus outbreak is out of your control but staying at home is within your control. The amount of work your boss expects you to do is out of your control but how you plan your day is within your control. Do you see what I mean? Change what you can and work around what you can’t! 
  1. Be in tune with your body! Know your warning signs – be it a twinge of back pain, a nauseous feeling before a headache or otherwise. Recognise the signs of getting stressed and try to mitigate them (or better still the stress itself!) before it becomes an issue! 
  1. Ask for help! Don’t be afraid to delegate or ask for assistance. We’re all only human and there are only so many hours in a day. Make a plan, divide it into tasks and delegate or put things off if things get too much 
  1. Contact your GP! There’s no shame in asking for help and I’m sure your GP would prefer to help at the start of an issue than when things have become overwhelming and there are a number of factors to sort out. It’s the same with osteopaths – seeing us when you’ve got a niggle is better than waiting until it’s a full blown injury. Better to be sorted sooner rather than later! 

Really what this comes down to is good awareness of your own body, mind and stress. I’m by no means perfect at this but it comes with time. Don’t be too hard on yourself if you’re not quite there yet…that’ll just create more stress! One step at a time! 

Returning to Exercise

With gyms, sports games and exercises classes shut for three months now, people have had to change how they exercise. Some have had to invest in equipment to train from home, some have stopped exercising all together and some (like me) have totally changed how they’re exercising. But now the light at the end of the tunnel is in sight, how do we go back to what we were doing before? Here are my top tips to get you back on the straight and narrow! 

  1. Decide whether you actually want to go back to how things were! Lockdown has made us all reconsider certain parts of our lives and for some of us, that has included how and where we exercise. I found myself getting so frustrated with setting up bands and not having weights that I decided to return to forms of exercise I did years ago and it reminded me how much I enjoyed it! That being said, I do love lifting weights still so once gyms are back open, I’ll be mixing it up with weights on some days and other forms of exercise on others. This might be something you consider if you’ve enjoyed your new exercise regimes – use lockdown as a time to reflect and learn! 
  1. MobiliseUnless you’ve been able to maintain what you were doing before, your muscles will have adapted to your new exercise regime. If you are planning on returning, start with some simple mobility work to strengthen your joints and muscles. Controlled articular rotations (CARs) are a great way of doing this – check out my most recent Instagram IGTV series for more info on this 

  1. Do sports-specific training! If you’re into football but have spent the last three months running, start with football drills and once social distancing is relaxed, consider tackling drills. The same goes for any sport – everything you’ve done in lockdown will have kept your fitness up, now is the time for some sports specific work! This should also mean strengthening the muscles and joints that are most often used in your sport. For example, strikers in football may want to strengthen their thigh muscles with weights whereas cricket bowlers may want to strengthen their shoulder rotation muscles. If you’re unsure what muscles you should focus on for your sport, get in touch! 
  1. Take it easy at first! With so many months since gyms and sports teams were closed down, the temptation will be to go all in on your first session. MISTAKE! Remember, it has been a while so it will take some time to rebuild the strength, stamina and movement you had before. Consider staggering your exercise sessions, such as doing 30 minutes in the morning and 30 minutes in the evening. If this doesn’t work for you, you may want to consider reducing the amount of weight you lift or the time doing the exercise by 50% and then build from there. It’ll give your ego a knock but better that than an injury! 
  1. Listen to your body! Our bodies are strong and resilient to a lot of things but remember to listen to them if they start to throw up warning signs. Pain doesn’t always mean harm is being done but it is important to be aware of any tweaks or strains. If this happens to you, lighten the rest of your session, have the following day as a rest day with lots of mobility and prehab exercises and then try again the day after. More than likely, any pain you feel will be doing too much too quickly after doing too little for too long! Your strength and stamina will come back, just give it some time. 

More than anything, try to not get frustrated. See lockdown as a time to reconsider and recharge. You may need few light sessions when we first return and then you’ll be able to hammer your exercises/sport with no concern. Your body is strong, stable and was made to move so don’t be afraid to get back into it! Best of luck! 

Working from home?

At the end of March, most of us were thrown into working from home. This meant enormous changes for us all and I’d imagine most of us spent the first few weeks working from the sofa or dining table. As a result, I had messages from lots of patients saying their backs were sore, their necks and shoulders were tight and they were getting headaches, none of which came as a surprise given the circumstances. But was it how they were sitting or how LONG they were sitting for that was the problem? 

Recent research has shown how it’s actually the length of time we’re sat for that’s the problem. In fact, being in any position for too long can cause aches and pains. Pair that with uncomfortable chairs and working from a laptop or tablet rather than a desktop and it’s no wonder we’ve all felt a bit stiff. Being at home can go one of two ways – we can either be distracted and get up every half hour or so, or the more common one, we can sit for hours on end, typing away and not realising the time. At least in the office, we get up to fetch something from the printer, chat to a colleague or walk over to a meeting room. With this not happening at home, we get stiff and uncomfortable and end up with our shoulders up by our ears by the end of the day. 

The other point to remember is that when we’re working from home, we are missing the commute. Being so close to London, a lot of you get the train into town and I can guarantee you’ll be moving more than you realise. Walking from home to the station, the station to the office, around the office, out for lunch and then back to the station and home – it all adds up so you’ll be doing far more steps than you realise. I certainly found this – on a normal day in clinic, I average 6000 steps. One day when working from home during proper lockdown, I managed a grand total of 623 – 90% less than normal. No need to ask if I felt achy that day! 

While the research is proving it’s less and less important, we should discuss desktop set ups. Cramming yourself onto the corner of the dinner table or sat on the same sofa morning to night isn’t great. Creating a healthy work environment needn’t mean expensive desk chairs with all the bells and whistles attached but it is important to feel comfortable and stable. More on that later on.  

One final point to address is stress! We can all agree dealing with coronavirus has been stressful, working from home has been stressful, social distancing has been stressful, finances have been stressful and worrying about our health and the health of our loved ones has been stressful. This has a massive effect on us both physically and mentally and is a whole other blog post entirely (keep your eyes out for that!). Stress affects us all in different ways – some get headaches, some get back pain, some get stomach ache and so on. Knowing your signs is really important and is something I’d encourage you to consider as sometimes our bodies feel recognise stress before our minds to.  

“But what can we do about it??” I hear you cry! Here are my top tips for working from home: 

  1. Have a structured schedule that you stick to and try to not work overtime where you can help it. There will always be work to be done! Oh, and a lunch break is mandatory! 
  1. Have your meals away from your desk and if possible, go into another room entirely to eat 
  1. Keep hydrated! I use a bottle with time markings on it which helps to keep me accountable and reminds me to drink. Some people find glasses to be better – a small glass of water by your side will need to be refilled and this will get you up and away from your desk 
  1. Set an alarm for every hour. When it goes off, take a walk around the house, do some stretches or get some fresh air. (Official guidance is to get up every 30 minutes but I appreciate it’s hard to get any work done if you’re up every half an hour!) 
  1. Desk set ups are so individual. I don’t have a desk and prefer to work sat cross legged on the sofa, which is completely fine as I feel comfortable in this position, but it won’t work for everyone. If this doesn’t work for you, find a position that does. Typically, sitting on a backed chair, back resting against the chair, with elbows at a right angle and wrists straight works for most people. If working with a laptop, try to at least get a separate mouse. Better yet, a separate keyboard so you can raise the monitor to your eye level without compromising your wrists and elbows.  

The take home point here is to do what works for you but be sure to be getting up often! Take this as your cue to get up and have a walk and then when you’re back at your desk, set a timer for an hour and repeat. With stress levels still very high, don’t let aches and pains add to your stress. Be kind to yourself and do what works for you. As always, if you have any questions, get in touch! 

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