Tissue Repair 101: What Should You Be Doing?

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by THERESA LARSON, DPT, Marine Corps Veteran, CrossFit Coach

Tissue Repair 101: What Should You Be Doing?

It is natural to have our bones, muscles, joints, tendons, and ligaments stressed in workouts — it helps us grow, get stronger, and continuously perform at higher and higher levels.
Do you think quarterback Mark Sanchez or defensive tackle Kenrick Ellis have quality recovery and repair tactics post-football practice and games? Besides being injured right now, they both still have to have a game plan in order to repair their tissues and play and compete at such a high level.

Athletes (yes YOU!), how do you help your tissues repair after strenuous workouts or activities?

There are several key important components of tissue repair, including nutrition, sleep, and positioning. Today’s posting, however, is focused in particular on repair time; the physiological inflammatory response of your tissues post-exercise; and how you can help speed up that process with some simple modalities.

How Our Tissues Get Inflamed and Why It’s Important

It is natural to have our bones, muscles, joints, tendons, and ligaments stressed in workouts — it helps us grow, get stronger, and continuously perform at higher and higher levels. Remember Wolff’s Law? This “juice,” or inflammation, that our body releases when we stress is a natural process. You probably already know how long it takes your body to repair after longer bike rides, flag football games, or met-con workouts versus shorter/more intense workouts. Healthy tissue inflammation may only last a few hours; whereas for an actual injury —  like both Sanchez and Ellis are dealing with — swelling can last 24-48 hours to 2 weeks before it becomes chronic.

In times of acute inflammation following an injury or even a workout, simple compression and elevation is MOST useful.
Think of inflammation like troops deploying to a war zone: Your white blood cells are the troops and the damaged or strained tissue is the battlefield. Initially there is a neural reflex to cellular injury that causes vasoconstriction right away, then following this short period there is a vaso-dilation, or opening up of vessels, to allow blood to flow to the wound. This increase of the troops’ ammunition such as blood flow brings nutrients, oxygen, and phagocyte cells to the area that needs repair to help it heal.

Mission accomplishment in the above description is achieved when you are able to flush the “juice”  to the lymph system, which is an open highway of helping the body eliminate waste quickly! The following are methods that are aimed at supplementing and even expediting the recovery process following bouts of hard training.

Repair Tactics

Compression

Using a band of some sort (Vodoo floss band)

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Elevation

I do not mean go to 18,000 feet; rather raise the limb and let the “juice” flow towards the lymph nodes located at major highways of the body such as the groin, armpit, and abdomen.

Heat

Used by the Chinese for many years, heat can be applied prior to and following workouts as long as there is no acute (24-48 hours to up to 2 weeks) injury incurred.

Please note: Heat is contraindicated or may have adverse effects with acute injuries.

Heat causes capillaries (small blood vessels) to widen, which is not needed if there is already inflammation in the tissue. If the injury is chronic (3-4 weeks to months/years), the need for blood flow and opening of that capillary network is important. In times of acute inflammation following an injury or even a workout, simple compression and elevation is MOST useful.

Marc Pro Device (MPD)

Helps with electromyostimlation (EMS). The MPD was designed to stimulate an ultra low frequency, low tension, non-tetanizing (continuous contraction of muscle tissue), and non-fatiguing contraction. It helps with the healing in the tissues by pumping arterial blood — fresh with the “troops” of fluids or inflammation — into the muscle and into capillary beds. This ammunition of  fresh, oxygenated blood forces venous blood return and lymphatic draining, which carries all the metabolic waste products and damage away from the muscle.

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Model is Anneke Marvin, owner of CrossFit Temecula South.

Sleep, Proper Nutrition, Hydration, Time Off, Total Health

These are probably the most essential pieces of recovery. What I shared above is for immediate repair post-workout, but the following links below will help you take a good look at your lifestyle and provide information to help you make healthy changes where they are needed. For more information regarding these topics, please consider this reading list:

The Enemy to Natural Tissue Repair, or What NOT to Do

Use NSAID’s
  • Non-Steriodal Anti-Iflammatories such as ibuprofen or motrin  will help with your pain, but the reason the inflammation is occurring will not be fixed.  It merely covers up the problem.
Icing
  • Also just masks the problem because it slows down the inflammation and further congests tissues that are working to drain into the lymphatic system. Icing can back up the lymphatic system, which alone can cause problems with allowing tissues to heal in a normal period of time.
Supplements
  • Taking a bunch of supplements you are not educated about is probably not the best idea for aiding in tissue repair.

And on the note of proper recovery, Dr. Theresa Larson will be leading a retreat to Costa Rica January 4th-10th, 2014. If you are interested in getting away and learning from some leading professionals, please click here for more details!

References

1. Athletic Lab. Inflammation Friend or Fo. Available at: http://athleticlab.com/blog/comments/inflammation-friend-or-foe/. Accessibility verified 4 Sept 2013

2. Hertling D, and Kessler RM. Management of Common Musculoskeletal Disorders; Physical Therapy Principles and Methods 4th Edition. Pennsylvania. Lippincott Williams and Wilkins. 2006

3.Cantu RI, Grodin AJ, Stanborough RW. Myofascial Manipulation: Theory and Clinical Application. Pro-ed. Texas. 2012 

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