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December 05, 2017

Ask the Doctor: I'm Injured, Now What?

Written by Jennifer Van Allen

ashley perrott_familytri_smallOne of the most challenging parts of getting fit is staying healthy and injury free.  Dr. Ashley Perrott  is an Ironman finisher, busy mom, and family medicine physician at Novant Health Salem Family Medicine in Winston-Salem, North Carolina. (See photo, left, of Ashley with her parents and brother Brett Miller, our Director of Business Development, at the start of Ironman Florida, which the whole family completed together!) Dr. Perrott is answering some of the most-common questions our users have on staying on track.

One of the biggest mistakes runners and athletes make is that they rush back from injury, and don't give their bodies adequate opportunities to heal, repair, and gradually build back to the level of activity they did before the injury.  This prolongues the healing process, and in some cases, it can cause chronic pain and discomfort. Some athletes, trying to stubbornly run through the pain, end up altering their gait patterns to compensate for the discomfort, and end up with new injuries.

While each injury is as unique as each athlete, most strains, sprains, and soft-tissue injuries follow predictable patterns of recovery and healing. If you have any pain or discomfort that persists or worsens as you exercise, and continues even with two to three days of rest, be sure to see a medical professional to get guidance on the nature of the injury, and the collaborate on a plan for rehabilitation and return to running and other sports you do on a regular basis. 

Below are the typical stages of injury.  Respect each stage, take time to complete it and give your body the opportunity to properly heal so you can come back strong. Remember: you only get ONE chance to recover from an injury.  Don't rush it and end up chronically injured. Here are the general stages you can expect to go through on your road to recovery.
Phase 1: Protection/Acute Inflammation
With a soft-tissue injury, such as a pulled muscle or a twisted ankle, initially the pain, bleeding, and swelling continues through the first two to four days after the initial injury, depending on what type of injury it is. To help reduce discomfort, try over-the-counter NSAIDs and RICE (rest, ice, compression, elevation).  Ice the injured area for 10 minutes at a time to decrease the blood flow to the injury, which will decrease the inflammation and pain. Talk with a medical professional about what sorts of precautions—if any—you’ll need to take with daily activities, like walking, taking stairs, etc., and what types of exercise you can do to keep up your cardiovascular health (and sanity!) while you recover.
Phase 2: Transition
This is when repair of the injured tissues gets underway. This can last up to six weeks. During this time, the body is generating new soft tissue to replace what has been damaged. It’s important to avoid NSAIDs at this stage, as studies have shown that this can interfere with the healing process.  To facilitate healing during this time, talk with your doctor about the types of range-of-motion and gentle stretching exercises you can do without interfering with recovery. Inflammatory response and pain should dissipate during this phase.  If chronic or acute pain continues, consult your doctor.
Phase 3: Remodeling
At this stage, new soft tissue stretches and strengthens, but it may not be sufficiently strong enough to return to your normal volume and intensity of activity. Talk with your doctor about what kinds of activities you can safely do to keep up your cardiovascular fitness without interfering with the healing process. 
Phase 4: The Functional Phase.
This phase typically begins about two weeks after the injury, and can it can last up to six months, depending on the severity of the injury, and the success of the previous stages. This is the time that you can start returning to your regular level of activity. At this stage, you can start to work on returning to the sport—without risking re-injury as long as you have clearance from your doctor. Work on increasing strength, endurance, speed, agility, and flexibility under the guidance of a medical professional. Stop if you have any sensations of pain or strain.

Last modified on December 06, 2017
Jennifer Van Allen

Jennifer Van Allen

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