Did you know that NOT doing your rehabilitation work may add more long term damage to your initial injury? Many injuries result in chronic muscle imbalances. The injured person usually adapts their posture to avoid pain or to enable themselves to perform basic functions. After the pain has subsided and motion restrictions and strength return, the person usually does not change their adaptive movement strategies.
A Physical Therapist will usually be involved at this point and will prescribe a regimen to correct the muscle imbalances and the new incorrect movement strategies adapted. If not corrected, the person's injuries may result in tissue that becomes restricted. Immobilizations through splinting or self-imobilization may allow tissue to shorten. Without restoring mobility, the opposite muscles are lengthened creating weakness. Muscles that are too short and tight are then paired with muscles that are lengthened and weak, disrupting the neuromuscular balance in the interdependent relationship. Postural changes due to the imbalances become evident.
BASICALLY: Your injured right knee has caused you to walk with a limp and put extra pressure on your left side. Now you've gotten used to limping while walking adding pressure and over working or straining muscles on the right side.
Sitting for hours keeps your hip flexors in a compressed position. Imagine Donald Trump's posture. It is likely that his hip flexors are tight which causes his butt to stick out.
Even the best of surgeries result in scar tissue. It is simply the way tissue heals. Scar mobility is often an overlooked aspect of the rehabilitation paradigm. Lack of mobility alters the alignment and pulls on the fascia, affecting joints and muscle function. There may have been some compensatory altered movement patterns utilized for functional mobility before the surgery or shortly after the surgical intervention. Balanced movement must be actively restored, or resultant muscle imbalances and postural changes will develop.
BASICALLY: Scar tissue is a collection of cells and collegen that cover the site of an injury. Think of a lump of dough bread on your kitchen counter. This is what your scar is like in the early stages of formation. If you knead the dough or use a rolling pin, it will soften. and thin out. Bending and extending the joints closest to your scar will assist in minimizing scar attachment.
Often times, the person begins to restore balanced movement but stops short of complete recovery due to lack of motivation, impatience, or even the end of physical therapy sessions. There is usually a limited number of visits for insurance covered rehabilitation. Many initiated it but were discharged before returning to required functional level.
Then they continue on their own but overlook the imbalances that were never resolved. Or they discontinue and are willing to just live with the limitations. The body will adapt to the available mobility and stability, creating compensatory movement patterns that are eventually reflective in postural imbalance. There is often still some pain during this time and it is common for people to turn to daily pills and potions for relief.
EXAMPLE: Physical Therapy ended and you decide to casually do the exercises on your own. But, you won't heal completely this way and you don't even realize it because you have found ways around your pain. You either walk with a new limp, raise one hip, never fully extend your hip flexors or fully raise your arms for examples. Additionally, you may be addicted to pain pills and not think so.
You can continue to treat symptomatic complaints using anti inflammatory medication, modification of activities, or simply pushing through the pain, all leading to further dysfunction adding layer upon layer of structural and neuromuscular adaptations.
I learned that anti-inflammatory medication may serves a purpose in the early stages but it is easy to become dependent on them. Be clear with your doctors and let them know you are willing to do the recovery work.
BASICALLY: I have found that most doctors do not believe their patients will follow directions so they automatically prescribe medication in cases where they might otherwise not do so. I believe they also predict outcomes based on the average person's determination when yours may be stronger. When they know you are about that life, you are willing to do the work - the conversation is slightly different. If you are having trouble doing the work, let's get you some DAMAMITE!