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The Two Options You Have When You Are Injured…
The options are simple, but the process is complex. You can either decrease your activity or increase your capacity.
Person: “Doctor, my back started to hurt this earlier this week, and hasn’t gotten better. It hurts every time I bend forward.”
Doctor: “Ok, stop bending forward then. I want you to take the next few days off and just relax at home.”
Hmm… that IS one way to go about it. But what if there is a better way? What do you think the downside is of stopping your activities?
When you are injured, the activities you were doing before can be painful, whether it is deadlifting or washing the dishes doesn’t really matter.
To manage your injury, you essentially have two options….
Option 1: Decrease your activity level
The idea here is that you decrease your activities to a level that doesn’t cause pain.
This is a viable option for some injuries, but it is never a permanent solution. If you decrease your activity too much for too long, you will end up deconditioned, and then you live in a feedback loop where you keep getting worse… Just like this picture:
I recommend that MOST of my patients decrease their stressors for a period of time (but this is only for a few days). Then we get into Option 2…
Option 2: increase your capacity
With this strategy, you work to increase your strength, endurance, and recovery to improve your overall capacity to a level that can handle the stresses of your activity.
Personally, Option 2 sounds like a better solution to me.
The more we can increase your capacity, the larger buffer you have between your demands and your threshold.
In order to use Option 2 though, you need to have a plan. We need a structured, progressive and intentional exercise plan in order to build up this buffer. It can’t be done in a day, and it doesn’t work to just use random exercises with no intention.
Option 2 is a 3 step process.
Step 1: Calm Stuff Down
This often still consists of a period of decreased activity, but it is NOT a permanent strategy. It is only long enough to give us a window to build upon. We also use things like stretching, foam rolling, mobilization, and hands-on therapy during this phase to decrease your pain.
Step 2: Build Back Up
During this phase, the focus is on building strength and endurance around the body parts and systems involved in your activity. This means strength and mobility exercises, with less emphasis on mobility or hands-on treatment.
Step 3: Bridge the Gap
This is the fun part. After your symptoms are under control, we start to work on speed, strength and re-integrating your favourite activities. You like to run? Your rehab plan involved running. You like to ski? Yup, that’s part of the plan. Mountain Biking? You bet we include that.
Here are a couple of the components of Bridging the Gap:
Movement Quality and Capacity: how well do you move in relation to your sport/activity, and do you have enough range of motion for your task
Sport/Activity Specific Cardiovascular and Muscular Endurance: even though you are out of pain doing a simple single-leg squat in the clinic, doesn’t mean you maintain that same quality when you are out of breath
Rate of Force Development: can you generate force quickly enough, as you need it, during your activity?
Recovery: making sure you have the strategies and skills in place you need to recover from the demands of your activity.
This is also one of the most IMPORTANT parts. If all you do is get out of pain, but you don’t continue to improve your movement quality, recovery strategies, and overall capacity, it is extremely common to start sliding backwards, right back to where you started.
The reason I use this framework is that it is not only the most effective method that I have found, it also helps YOU develop the tools you need to keep your pain from coming back.
If you are ready to take control of your pain and get back to doing the things you love, I can help you.
Author: Dr Mark Murdoch, Chiropractor and Co-Founder at Base Camp Chiropractic and Sports Rehab in Vernon, BC.
Mark Murdoch is a Doctor of Chiropractic with a Master’s Degree in Sports Medicine.
Contact: drmurdoch@basecampclinic.com
Instagram: Base.Camp.Doc
What to do when you get hurt
Gone are the days of bedrest, ice and ibuprofen
What is the FIRST thing you should do when you get hurt?
Most people are familiar with the 'RICE' acronym, of Rest, Ice, Compress, Elevate... but what if I told you that RICE was outdated and could even hinder your healing ability?
Whether it is a new knee sprain, back injury, or shoulder strain, you can use these simple principles to speed up your recovery. Gone are the days of bed rest, ice, and immobilization.
Don't believe me?
Let me make my case.
RICE is based on out-of-date research and does some of the exact OPPOSITE things we need for healing. In order to heal, our body needs stress and inflammation. Rest and Ice actually decrease the body's ability to heal, if used for an extended period of time.
Healing occurs in 3 phases:
Phase 1) Inflammatory Phase (a few days)
Phase 2) Repair Phase (1-2 weeks)
Phase 3) Remodelling Phase (Months)
If you want to optimize your healing during all of these phases, you need to follow the PEACE and LOVE protocols. The goal of the PEACE phase is to calm everything down. Let the inflammatory phase run its' course. The LOVE phase is to start building things back up.
Here is the summary of PEACE and LOVE:
Day ~1-3: PEACE
Protect: avoid excessively painful and aggravating activities
Elevate: when at rest, try and keep the injured limb above your heart
Avoid anti-inflammatories: avoid ice, ibuprofen, and other anti-inflammatories whenever possible
Compression: use a tensor wrap, compression wrap or other compression tools to clear swelling
Education: learn about your injury and the typical healing times (that is where we come in)
Day 3+: LOVE
Load: start injury specific exercises as early as possible to promote proper healing
Optimism: stay positive. Injuries suck, but you will get back to it.
Vascularization: keep training cardio as often as you can to maintain your cardiovascular fitness and
Exercise: start reintroducing normal activities and get back to regular exercise as tolerated without a significant increase in pain
How long does it take to heal?
This depends on the body part injured, the severity of your injury, and your overall health.
For example, a Grade 1 Ankle Sprain? Typically resolved within 2 weeks.
A Grade 2+ Hamstring Strain? Can take MONTHS to fully resolve, or longer without proper rehab.
Anxious and afraid of your pain? Fearful or every little twinge? That will slow your rehab and prolong your recovery.
There ARE a few things you can do to speed up your recovery:
Move OFTEN: keep moving within pain-free range (or tolerable increases in pain)
Manage SWELLING: swelling can limit your activity and cause considerable discomfort
Stay OPTIMISTIC: a positive outlook is extremely valuable and can actually speed up your recovery
Not sure where to start?
That is where a qualified Chiropractor or Physiotherapist in Vernon, BC can help. A good Chiro or Physio will put you through a thorough assessment and help identify the extent of your injury and your pain triggers. Then, they will help you put together a rehab plan to get you back in action.
Author: Dr Mark Murdoch, Chiropractor and Co-Founder at Base Camp Sport and Spine in Vernon, BC.
Mark Murdoch is a Doctor of Chiropractic with a Master’s Degree in Sports Medicine.
Contact: drmurdoch@basecampclinic.com
Book an Appointment with Dr Murdoch: book here
Instagram: Base.Camp.Doc
The Truth about Posture
Many factors contribute to proper posture when sitting at a desk. While these many things play a very important role in limiting the development of low back pain, or neck pain while sitting, they still do not answer the question, “What is the best posture?”
As a Chiropractor in Vernon, one of the most common questions I receive is, how can I improve my posture while sitting at my desk?
My colleague and friend, Dr. Kurtis Gryba, has lots to say on this one:
Written by Dr. Kurtis Gryba. Chiropractor at E3 Chiropractic and Wellness in Saskatoon, Saskatchewan. www.e3chiropractic.com
Many factors contribute to proper posture when sitting at a desk. Most commonly discussed are the strength and mobility of your neck and mid-back along with the ergonomics of how your desk is set up. While these all play a very important role in limiting the development of low back pain, or neck pain while sitting, they still do not answer the question, “What is the best posture?”
“What is the best posture?” is a trick question. It is not a static position, but rather the best posture is to move around and frequently change positions to allow your body a chance to reset.
“Perfect posture” is typically described as sitting up straight, with your shoulders pulled back and your head tall. The problem is, if you are sitting in “perfect posture” for 8 hours a day, there is a pretty good chance you will still feel low back pain or neck pain by the end of it. The reality is that even in “perfect posture” the body does not tolerate being immobile for long.
A truly perfect posture cannot be static, instead, we need a more dynamic strategy. Performing exercises to build strength and increase mobility is essential to helping your body tolerate extended periods of static sitting, however, the key to feeling better at the end of a long workday is simply getting up and moving around.
Hierarchy of Posture
I often talk about a “hierarchy” of posture.
Dynamic Posture
Take frequent breaks throughout the day to stand up and move.
Movement encourages fluid movement within our joints, which transfers nutrients to the bones. This keeps our bones healthy!
Good Posture
If you’re not and move throughout the day, a tall posture is better than a slumped posture.
This may be the case during a flight or a long drive.
Consider taking a rolled-up towel and placing it along your low back just above your belt line.
Poor Posture
Avoid this posture as much as possible for extended periods of time!
Poor posture stretches our ligaments and tendon. If they stay stretched for a prolonged time, it can eventually lead to injury.
When is Posture Important?
Although a static posture is the most ideal posture throughout the day, there are 2 circumstances that having good posture is ideal.
Weight Lifting
This is more so referred to as having proper form for your lift.
Proper form will ensure that your bones, muscles and joints are sharing the load equally.
The equal sharing of forces will reduce your risk for injury.
Long Drives or Flights
Poor posture is notorious for stressing and stretching our ligaments and tendons.
Our ligaments have an elastic nature to them, and if elastic materials are stretched for too long, a phenomenon called “creep” can occur.
“Creep” is not referring to your weird neighbour. Creep is when something elastic is stretched too far, for too long, that it begins to lose its elastic properties.
Creep of ligaments can result in joint laxity.
Micro Breaks
Good “dynamic posture” does not require long breaks throughout the day that disrupt your workflow. Instead, we recommend performing “microbreaks” throughout the workday. This may include incorporating simple neck stretches every 20-30 minutes or taking a posture break. These microbreaks are designed to take place every hour or so, for only 30 seconds to a couple of minutes. I recommend setting an alarm to remind you to get up and move around once every 20-30 minutes
A simple posture reset is the most powerful tool you can use against the pain that begins after a long day of desk work.
If you can’t seem to shake the low back pain or neck pain you develop while sitting for long periods of time, schedule an appointment! Base Camp Sport and Spine can provide anyone in Vernon with further strategies to help you work pain-free!
Author: Dr. Kurtis Gryba, Chiropractor and Founder at E3 Chiropractic and Wellness in Saskatoon, Saskatchewan.
Instagram: @E3chiro.yxe
Disclaimer: This blog is intended for general informational purposes only and is not intended for the delivery of medical advice. No doctor/patient relationship is formed. The use of information on this blog or materials linked from this blog is at the user's own risk. The content of this blog and website is not intended to be a substitute for medical advice.
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