Thursday, 18 October 2012

What does it mean when I am injured?

As runners we are all predisposed to getting injured and sometimes at a slightly higher chance than the sedentary population. But here is the catch,,, runners and fellow exercisers are more likely to recover faster and with better outcome than the sedentary population. Or to put it more simply,,, if a sedentary person gets injured the outcome may well be complicated.
The first implication of any injury or pain is that the body has reached its limit of adaptation. What this means is that at some point something happened which caused your body to alter the way it functions. This may have been a very minor and unnoticeable  event or it may have been something you remember. however something changed and your body would have began to adapt to this change.
If the causation of the adaptation was not resolved (either by your bodies ability to repair itself or by manual therapy) eventually your bodies ability to adapt will fail and injury or pain will be the result.
The initial event is what we refer to as either a predisposing or maintaining factor and this is what we as Osteopaths look for in the case history, it maybe something that can be corrected or it may be something that you have to factor into your lifestyle to avoid further injury,,, let me explain!

If you had a predisposing factor to the injury such as a structural change; slight curve in the spine or a slight leg length difference or an previous fracture then you will need to manage you condition and know your limitations to avoid further injury. However if there are no major predisposing factor and therefore no structural changes in the body as mentioned above, the mechanism of injury will be due to a maintaining factor. Maintaining factors are day to day habits and activities such as sitting with your legs crossed, poor posture and muscle strength, inappropriate footwear, inflexibility or running on uneven terrain to name just a few. You need to correct or remove this factor otherwise you will be prone to multiple injuries of the same muscle or joint OR further injury to more muscles and joints.
Injury by maintaining factors seem to be the most common in practice and they usually yield the best outcome. Often patients present with multiple maintaining factors to injury which they are completely unaware of in day to day life.

I recently had a female patient who came to see me because she kept getting a left calf muscle strain and could only manage a 3km run however she had been comfortable running 12km-15km 3 months previous without any problem. During the case history she explained that she had been a lot busier in work since the injury began. On further investigation this meant that she was giving 2-3 presentations per week whereas before she was doing 1 and often none. She only wore high heeled shoes when presenting and was now spending an estimated ten times the amount of time per week in heeled shoes. She had some osteopathic treatment and began to minimise the amount of time spent in the heeled shoes by wearing flat shoes to and from the presentation venues and within days the injuries began to subside.

That is a brief synopsis of the mechanism behind maintaining factors to injury and unfortunately not all cases are that straight forward but I hope it highlights the importance of being aware of you lifestyle activities in relation to your injuries.