After an injury or surgery to the musculoskeletal system the physiotherapist can assist you in the healing process. After a thorough evaluation she can explain to you what happened and what you need to do to rehabilitate the body to its full function.
Let's discuss the example of a sprained ankle here, but the principles of the treatment stays the same for any musculoskeletal injury:
In the acute phase (just after it happened and the first few days after the sprain) the structures need to be immobilized and the body given a chance to heal. There might be swelling and inflammation, and pain and discomfort. It is then necessary to ice, elevate, compress (with braces or taping) and rest the structures. Give the body a change to go through its inflammatory phase so that it can heal. The rest of the body can be exercised without putting weight on the sprained ankle.
Dry needling and electrotherapy modalities like tens and ultrasound are used to treat the pain and help with the healing process.
The sub-acute (regeneration phase) phase is the first 3 weeks after the sprain where the collagen is formed and you still need to be careful what you do with your ankle so that the new collagen can settle down. The physiotherapist starts with mobilization of the joints and does light massage and gentle stretches of the soft tissue of the ankle and the surrounding tissue. You can also start doing gentle exercises of the ankle and foot without putting too much strain and weight on the joints.
At this point you can add mobilizing movements that “stretches” the nerves and improves blood circulation to the nerves. This helps with pain relief and mobility of the area.
Next is the remodeling phase where the collagen settles down and a healing scar is formed. This phase can last from 3 weeks to 6-12 months depending on the severity and in what structures the injury was. You need to be patient and give the body time to heal, while you do modified exercises that will help with healing, while not harming the structures. The physiotherapist will use longitudinal and transverse massage and myofascial techniques to mobilize the scar tissue so that it can become functional.
Rehabilitation exercises are introduced progressing from low weight to full weight bearing, giving resistance with bands and weights to doing balance, proprioceptive and plyometric exercises to help strengthen and stabilize the joint. You need to do your exercises regularly if you want to see great results.
When you have dysfunction or pain of a joint or soft tissue for more than 3-4 months it is then classified as a chronic condition. This can become very frustrating and debilitating and cause depression. You need a careful, thorough evaluation to determine why you’re injury has turned into a chronic condition, and then the right course of action needs to be taken to help with your healing. It takes patience and perseverance. It may be that you didn’t do enough rehabilitation exercises and need to step up and do more consistent exercises, or you’re doing too much and you’re not resting enough. Maybe you’re posture or lifestyle is compromising your muscoloskeletal system or your nervous system is hypersensitive and triggering your alarm system.
Your musculoskeletal system is a wonderful intricate system that needs respect, care and understanding to function at optimal level.