Ready, Set, Heal
Dealing with soft-tissue injuries promptly can help you avoid chronic discomfort.
by Lisa James
What do rotator cuff tears, shin splints, muscle bruises, carpal tunnel syndrome and ankle sprains have in common? They are all soft tissue injuries (STIs).
In addition to damage affecting muscles and fascia, the membranes surrounding them, STIs include problems with tendons, which attach muscles to bones, ligaments, which attach bones to each other, and cartilage, a tough, flexible tissue found in the joints and other parts of the body. Besides causing pain, STIs can interfere with a joint’s range of motion, such as not being able to raise one’s arm fully over the head or completely extend a leg.
The term often used for tendon injuries, tendinitis, can be misleading. “The -itis suffix is used when inflammation is present,” explains Bob McAtee, RMT, CSCS, C-PT, of Pro-Active Massage Therapy (stretchman.com) in Colorado Springs, Colorado. “In recent years, a body of research has emerged to show that most chronic ‘tendinitis’ injuries are not accompanied by inflammation.” Instead, microtears develop in the tissues, leading to the formation of adhesions.
Sports or gym mishaps aren’t the only causes of STIs; repetitive motions, such as computer use, can trigger them too. “It’s not unusual to see teens with STIs in their hands from texting and playing video games,” says James Matchett, DC, ATL, of Capitol Rehab (drmatchett.com) in Sterling, Virginia.
Dealing with an injury immediately means fewer problems down the road. If damage is allowed to linger, “scar tissue sets in like cobwebs over an area and now the area doesn’t want to heal properly,” says Matchett. That damage is compounded when you try to compensate for the weakness, which throws the body out of balance.
Aging adds to the problem. “What you could repair in a week or two when you were younger may take a month or two in your 50s and 60s,” says Steve Frank, an herbalist in Longmont, Colorado. Blood flow also determines how fast an injury will heal. Blood-rich muscles heal the fastest; by contrast, cartilage heals slowly.
Getting Professional Help
Acute injuries should be treated with RICE: Rest, Ice, Compression and Elevation. Any but the least severe should be seen by an appropriate healthcare practitioner for assessment and treatment. Some STIs require surgery; others can be treated with massage and other forms of bodywork.
“The goals of clinically-oriented massage therapy are to reduce pain and increase range of motion by helping to restore normal tone and texture to the tissues, and to resolve the muscular imbalances that occur as the patient attempts to avoid pain,” says McAtee. He uses various types of massage including transverse friction work, in which the practitioner applies friction across the injured connective tissue, along with a variety of stretches.
Matchett, a chiropractor, does joint adjustments along with stretching. “My goal is to put the body in a optimal environment so that it heals itself,” he says. “If there is scar tissue, swelling and lack of motion, the body is not in an environment to heal itself.”
Office treatments aren’t enough to completely heal STIs; the patient needs to make an effort as well. “We always incorporate homework for patients to help them recover from their injuries,” McAtee says. “This may be as simple as gentle stretching or may include other components like self-massage, simple exercises and range-of-motion work.”
Matchett says such self-care is crucial. “Just spending a few minutes a day doing your corrective exercises means you are miles ahead of doing nothing at all,” he notes. But he warns that doing practitioner-supervised homework is not the same as resuming your original sport or activity. “You can never stretch or strengthen your way out of soft tissue injury without releasing the adhesion first,” Matchett explains. “You can possibly make yourself worse by trying to exercise your way through an injury.”
Patient education extends beyond assigning at-home exercises. “We are constantly teaching our patients proper ways to warm up and work out—and very importantly how to cool down, which is highly overlooked,” says Matchett. “Many people just simply do not train properly, which most likely is the cause of their injuries. Nutrition and lifestyle changes are key for maintaining health but also to make sure injuries do not return.”
Topically applied herbs can promote healing. Frank says comfrey and plantain stimulate production of tissue-repairing collagen. “As we get older the microcapillaries in our muscle and fascia get blocked,” he says. “Arnica helps to dissolve these blockages,” while thyme and rosemary increase circulation. White willow bark and peppermint help relieve pain.
Specific nutrients can speed the process. “Load up on vitamin C; if you don’t have vitamin C you can’t make collagen,” says Frank, who also recommends taking a copper/zinc mix to spur development of supple, elastic tissue. (You can also take collagen itself, such as a collagen hydrolysate formulation called TendoGuard).
Don’t ignore an STI—or worse, simply try to fight your way through the pain without help. The faster you treat a soft tissue injury, the faster you can be on your way to total recovery.