This post was written by Jithmie Jayawickrema, PT, DPT, OCS, physical therapist, Parkview Therapy Services.
In the event of an injury, it is one’s natural instinct to completely rest and avoid movement. While an acute injury can require a brief period of rest, it’s important to note that prolonged rest and lack of movement can lead to stiffness, muscle atrophy, fear avoidance and increased sensitivity to pain.
How does movement affect healing post injury?
After an injury, movement:
- Improves circulation
- Brings in blood and other essential nutrients to assist with healing
- Stimulates the lymphatic system to reduce swelling and inflammation
- Prevents muscle atrophy and joint stiffness
- Pain modulation
- Exercise affects the way your brain perceives pain and assists with neurological desensitization which can increase your pain threshold
Fear avoidance and how to manage it
Fear avoidance is a way that your brain protects you after an injury. The protection mechanism can become an obstacle for healing, not only psychologically but physiologically as well. Some of the physiological effects of fear avoidance include:
- Muscle guarding
- Reduces blood flow
- Develop compensatory patterns affecting other joints/muscles
- Deconditioning
- Lack of movement will cause weakness and stiffness contributing to move fear of movement
- Decreased pain threshold
- Increases sensitivity of the nervous system leading to even regular movement becoming painful
How can physical therapy help?
After a thorough evaluation of the injury, your physical therapist will assist you with adding controlled and graded movement that is appropriate for the injury and stage of healing. Examples of this can include the following;
- Progressive walking program
- Graded loading of muscles and joints (mobility and resistance training)
- Starting at pain-free ranges
- Mobility routine
- Manual therapy to prepare soft tissue, joints for optimal movement
- Breathing exercises to assist with redirecting pain and help relax if there are a fear avoidant behaviors
An example of graded loading: If you are fearful of bending over, modifying the movement by starting in a seated position and progressing through different ranges of motion (starting at a partial range and progressing to full range of motion) within the patient’s tolerance.
Remember that everyone’s healing journey is different based on their injury, medical history, medications, diet, sleep and individual healing capacity! An individualized approach to recovery after an injury is important for optimal healing, so that you can return to your activities with confidence!
