Injury Recovery: Treating the Phases of Muscle Healing

Injury Recovery: Treating the Phases of Muscle Healing Blog

Proper treatment of sports injuries is necessary to facilitate healing and get you back on track with your active lifestyle.
Addressing each unique phase of muscle healing requires a different approach to ensure a full recovery.

Destruction

Sometimes referred to as the inflammatory or protection phase, the first step in muscle healing begins at the time of the initial injury. You may feel a sharp pain while exercising or notice a dull ache after your workout. The pain tends to get worse with activity, and the injured area often becomes red and swollen. Contusions and strains are the most common causes of these symptoms in active people.

During the week-long destruction phase, the body sends eicosanoids to the injured site to start the natural inflammatory process. Follow a rest, ice, compression and elevation (RICE) protocol at this point, and immobilize the injured area as much as possible. Avoid over-the-counter NSAIDs, as these may prevent beneficial inflammation from occurring.

Repair

Your body begins the cleanup process about two days after you sustain an injury. Macrophages enter the area to get rid of damaged tissue, satellite cells start building new muscle fibers, and fibroblasts join in to form connective tissue. Collagen and proteoglycans begin to form, creating bonds between tissues.

Muscle repair can take six to eight weeks, during which it’s a good idea to start working with a physical therapist. Gentle movements and stretching preserve mobility, and a healthy diet with clean proteins, omega-3 fats and antioxidants provides the building blocks your body needs for healing. It may be beneficial to supplement with l-glutamine, arginine, MSM and sulfur-based amino acids at this time.

Remodeling

As muscles and connective tissue begin to get stronger, the body enters the remodeling phase. This usually takes place around two weeks after you get hurt while repair processes are still under way. This is the point at which physical therapy and proper movement is critical. Without guided treatment, new muscle fibers can form in a jumble or tangle instead of lining up in a natural way.

The remodeling phase is the time when scar tissue begins to form. Massage can help minimize the potentially detrimental effects of scarring, and manual manipulation of the muscle performed by a physical therapist increases range of motion. If you’ve been treating with natural supplements, continue the regimen until you feel confident the new tissue is forming properly. Adding adaptogenic herbs can assist the body in dealing with the stress of recovering from damage.

Working with a qualified physical therapist and a doctor trained in sports medicine can help you avoid mistakes when going through the stages of muscle healing. Follow their prescribed treatment plan, including exercises and stretches, and avoid the temptation to return to your regular routine too soon. As the injured area gets stronger, you can ease back into more difficult activities until you’re right on track with your fitness goals.

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In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)

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Complete tear of rectus femoris
with large hematoma (blood)

image

Separation of muscle ends due to tear elicited
on dynamic sonography examination

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