Motus

The other day, I was scanning some of my old Fit Mornings videos and started watching David Berman’s talk. If you don’t remember the Fit Mornings series, you can read about it here.

David’s talk was a good one.

He came in to discuss muscle strains and to provide his system on recovering as quickly and efficiently as possible.

As the weather warms and many of you begin to pick up the summer activities like mountain biking, basketball, and other fitness endeavors, I think it’s timely to discuss muscle sprains so that if you find yourself in that unfortunate place, you will have an idea for how best to recover.

What is a sprain?

First off, you may notice that I use the word sprain and strain interchangeably. They are really just two words for the same thing.

So, is it that happens when you sprain your soft tissue via some injury?

Simply put, it’s a disruption of your soft tissue. And this can mean disruption to your muscle, tendon, ligament, collagen, fascia, or all of the above. Not all sprains are created equal. All sorts of factors come into play when you sprain something. Some of the driving factors that dictate whether you will get a sprain in the first place are (1) your level of fitness, (2) your movement proficiency, and (3) your tissue’s tonicity (how tight it is in the first place).

On the low end, a sprain can be very minor. It may heal in a matter of days. On the high end, sprains can be the complete tearing of tissue and require months to heal.

Your body is trying to help you

Believe it or not, that pain and localized swelling is your body’s way of trying to fix itself.

When our body senses a tissue disruption, it immediately gets to work and creates the chemicals that transmit pain signals to our brain. Our body is trying to scream, “stop moving!”

Sometimes you will see redness. And most certainly swelling.

The swelling is in response to chemicals that call for more blood flow to the area. Your body is doing some renovating. It’s trying to flush out the damaged cells and bring in white blood cells to help rebuild.

Also, the muscles around the affected area go into what is called “guarding mode.” They lock up, so to speak. Become hypertonic. This is the feeling of tightness that we experience after a sprain. And yes, it can be a little scary to not have the movement that we once did in that area. And it’s completely natural to question if we will ever get that movement back. But you will. Your body is trying to protect itself and that’s not a bad thing at all.

Treatment

So, you have a sprain.

What can you do?

Well, Berman believes that your body is overly aggressive in trying to heal itself. That a lot of the swelling and inflammation, although important for healing, can be too much sometimes.

Consequently, reducing the inflammation to a more manageable level is key to his treatment process.

1. Tame it.

Remember RICE? Rest, ice, compression, and elevation? It’s very much the prevailing wisdom when it comes to nursing an injury back to health. I think all four components are very important and beneficial.

But Berman makes an interesting point about icing. When you have a warm and swollen sprain, the natural tendency is to want to put an ice pack on it and just leave it there. But for how long? In the video, he makes the argument that icing works to an extent, but that it usually won’t do much for inflammation control.

And that for it to be most effective, you only need to ice for about 1 -2 minutes at a time. When you ice your muscle sprain, what you want to do is to check to make sure your skin is still white. You then wait for the temperature to go back to normal, then re-ice if you like.

The rationale is that when ice is applied (and always use a towel or something similar, never put ice directly on your skin), your body constricts the blood vessels in the area. Now, this is good, but after a few minutes, your vascularity opens up again and blood rushes back to the swollen area. So, now there is more fluid in an area that already has too much fluid. Indeed, it will dissipate eventually, but all this extra fluid isn’t really helping your healing.

What else can you do?

Well, over the counter NSAIDs (nonsteroidal anti-inflammatory drugs) are often a good option. As is an anti-inflammatory diet.

But here’s the number one thing you can do to tame your muscle sprain: Give it rest!

Stop doing things that will aggravate the injury. Simply put, if something causes you pain, then stop doing it to the extent possible. This can take a lot of willpower, especially if you have a lower extremity injury, but it’s extremely important to not do any activity that causes you pain. You’re just prolonging the healing process.

2. Tape it.

Berman is an advocate for kinesiology tapes (elastic therapeutic tape) – those colored tapes that you sometimes see professional athletes wearing.

Kinesiology tapes are a bit controversial. According to Wikipedia, a 2015 study “…found that the taping provided significantly more pain relief than no treatment at all, but was not better than other treatment approaches.^[1] The same meta analysis did not find any significant changes in disability as a result of taping.”

So, the jury is sort of still out.

That being said, David has found success with the tape and uses it on his clients as part of a well rounded healing system. In the video below, beginning at 24:15, David provides a great demo on how to tape a muscle sprain.

I personally don’t have any experience using these tapes, but Berman makes a compelling argument. I encourage you to do a little more research on your own and decide where you stand.

3. Tense it

When the pain has subsided, and only when you’ve healed to this point, then it’s time to start thinking about introducing some more movement.

What you want to do is begin introducing some tension into the tissues that had been disrupted. We do this to help realign the collagen fibers that were used to heal the torn tissue. Generally speaking, when you injure yourself, your body goes in and does the appropriate repair work, but it’s of inferior quality to the original tissue – the collagen fibers are stacked up in all sorts of different directions, and not aligned with your muscle’s movement direction. Therefore, when we “tense” our formerly sprained tissue, we are helping it to relearn the direction of movement. And during the tail-end of the healing process, we can help our body to realign those collagen fibers in a more optimal manner.

Take a look at 39:00 in the video to get an idea for how Berman likes to begin tensing muscles. The whole idea is to move a muscle only so much within the range of motion that is pain free. Then, as the healing improves, the range of motion may increase accordingly.

What not to do

Don’t rush

Healing takes time. The system outlined above may help to stimulate the healing process and get things moving along. However, healing still takes time.

Don’t stretch too soon

Your muscles near the sprain location are going to feel tight, and you’ll have a strong urge to want to stretch. But don’t! Your body will only react by tightening up all over again. And if you stretch too much, you run the risk of tearing the very tissue that is in the process of healing. That can set you back to the starting point, if not further behind.

Don’t ignore the pain

Remember, pain is your body’s way of telling you that something is off. That your body is asking you to restrict movement so that it can heal. Listen to it.

Wrap up

I remember renowned physical therapist Gray Cook commenting that he thought that nature usually does it best, but that we can do it faster. He was referring to how humans learn movement as babies – that they begin with mobility, then develop stability (walking), and finally strength. But I think his comment is equally applicable to recovering from a muscle strain.

And this natural system works. If we listen to it. But it can also take more time than may be necessary, to Berman’s point. And if you are like me, you want to get back in the game as soon as possible after an injury. Which brings me to the other half of his comment, that as humans who have science in our back pocket, we can facilitate our body’s healing and accelerate the whole process.

But we have to be careful about how we do this.

***

Muscle sprains happen to the best of us from time to time.

Given enough time, sprains do heal. Sometimes they take a few days, maybe a few weeks, and sometimes much longer. But if you follow the system above, you will be on the road to recovery.

By Ryan Wagner

Resources

David Berman can be reached via his website, here: Physical Therapy Professionals

Wikipedia, Elastic therapeutic tape

RICE: Rest, ice, compression, and elevation. WebMD