Regeneration of injured skeletal muscle after the injury
So After I nearly tore my lat completely off it’s myotendinus junction I have obviously been doing some reading on recovery. I found a summary of information published in 2013 that outlines some guidelines for recovery. I thought this might be something useful to anyone else going through injury and here is my summary of what I read. Lets look at this from the point of injury and moving forward of that.
Click HERE to read the whole thing
In the journal they suggest complete immobilization for the first 3-6 days post injury. In this time you’re waiting for hematoma and the tissue to sort itself out. The summary talks about three phases to injury.
1. Destruction phase: Injury happens! Very quickly after that the tissue involved in the injury contracts and stops/slows bleeding by a “fire door,” like process. Hematoma then finishes the job of stopping any more loss of fluids to the injury
2. Repair Phase: Satellite cells of two types begin to go to work. They start to differentiate into myfibrils (turn into new tissue) and about 3 days post injury the site start to revascularize and blood starts to enter the area again.
3. Remodeling Phase: The scar tissue does a little help of pulling the two ends together again but never to the same degree as previous to injury. the damaged area has now filled with some scar tissue however the body is working to develop new contractile components of the muscle.
(See Fig 1. in the journal)
After the first week then begs the question when do you start any kind of rehab. There are two points made that appear to best describe when to start any kind of program:
“1) The ability to stretch the injured muscle as much as the healthy contralateral muscle. 2) The pain-free use of the injured muscle in basic movements.”
So do you have full mobility back yet and are you pain free in your movements? If either is not true then don’t start anything sport specific. As I write this, that’s where I am right now. I almost have mobility regained but not quite but i don’t feel any pain in contraction. So I am not starting anything sport specific, just going through shoulder mobility and promoting circulation to the muscle.
The study talks about NSAIDs, Ultrasound and Hyperbaric Oxygination treatments. They say that NSAIDs used for a short term at the beginning of recovery does not show any detriment to long term recovery. My NSAID of choice is TB-500 and I encourage you to check the stuff out. But the study makes no recommendation of what to use. Consult your sports medicine doctor for more on that one. As for ultrasound the study says that there’s minimal research to say it does anything long term positive for the injury. Won’t hurt if you do it, but doesn’t look like it gains you anything long term. They say that the Hyperbaric appears to have some positive results but lacks much evidence in the long term. Could be good, but just lacks much research.
I am simply going to copy and paste the conclusion as i think it summarizes everything pretty much word for word. The mark of a good writer!
“Clinically, the first aid of muscle injuries follows the RICE principle (Rest, Ice, Compression and Elevation), the principle common to the treatment of any soft tissue trauma. The objective of the use of the RICE is to stop the intramuscular bleeding and thereby limit the progression of the muscle injury to a minimum. [the researchers say Ice needs only be used very acutely post injury but nothing past that. If you injured yourself months ago Ice is not the best idea!! Remember that!] Clinical examination should be carried out immediately after the trauma and 1–3 days thereafter, at which point the imaging modalities (MRI or ultrasound) can provide useful insights into the severity of the injury and the injury classified according to the new classification scheme (). During the first few days after the injury, a short period of immobilization accelerates the formation of granulation tissue at the site of injury, but it should be noted that the duration of reduced activity (immobilization) ought to be limited only until the scar reaches sufficient strength to bear the muscle-contraction induced pulling forces without re-rupture. At this point, gradual mobilization should be started followed by a progressively intensified exercise program to optimize the healing by restoring the strength of the injured muscle, preventing the muscle atrophy, the loss of strength and the extensibility, all of which can follow prolonged immobilization.”
If you have any more questions on injury or rehab please don’t hesitate to contact me. I love this stuff and seeing as I’m injured I’m feeling pretty immersed in rehab reading.