There are several components to understanding injury, and in large part it is variable on a case-by-case basis. We will get into just the basics: what causes injuries, how they are classified, and how to prevent them; we will not go into treatment. Your physical therapist or healthcare professional should determine the classification of your own injury and where to begin treatment.
What are the causes of injury?
An acute injury happens due to a sudden overload to a tissue. With a muscle strain it may be due to a runner accelerating to very large strides without warming up first, leading the hamstring muscle to get strained. With a ligament sprain it may be due to a twisting of the ankle putting a large load on the ligaments and causing slight tears.
Another way to get acute injuries is to perform exercises too quickly with poor form, losing your concentration, or performing past failure without someone to spot you or support you should you not be able to complete an exercise. It’s always a good idea to have a training partner to watch out for you.
The final way to get an acute injury is is of course by accident. You have a misstep, or a fall, or get overloaded in some way and you become injured.
A chronic overuse injury may occur due to repeatedly overloading the tissues inappropriately. For example, if you exercise a certain body part too frequently without giving adequate days of rest you will start to fatigue the muscle leading to weakness, compensations, and eventually injury. Postural deficiencies can also lead to chronic pain. A great example is sedentary individuals who use their upper traps excessively to lift their arms (this is due to a postural deficit outside of the scope of this blog post). Eventually these individuals will complain of constant nagging neck pain and/or headaches. If you have this type of injury it is important to consult a physical therapist to determine which movement patterns are causing it and how to keep it from getting worse.
It is important to prevent your acute injuries from becoming chronic acute injuries. This commonly happens with ankle sprains. The individual may wait for the sprain to just heal on it’s own without going through any rehabilitative process to strengthen the muscles around the ankle. Over the following years they may have a misstep here and there and reinjure the ankle until it becomes a chronic pain and the individual stops performing at a high level. Consult your local physical therapist to determine if your injury requires rehabilitation by visiting www.moveforwardpt.com.
How are injuries are classified?
Injuries are, for the most part classified by stages of time. There are acute, subacute, post-acute, and chronic injuries. Chronic injuries can be further divided into chronic recurring and chronic overuse. The importance of this classification has a lot to do with tissue healing and how to best progress towards recovery and avoid re-injury.
Acute: Injuries that happen suddenly due to an overload in force. Examples include strains, sprains, or contusions. Time frame: 0-4 days after injury. For the first couple of days after an acute injury PRICE should be followed: Protection, Rest, Ice, Compression, and Elevation.
Subacute: An acute injury that has progressed past the 3-4 day but is under the 2 week mark.
Post-acute: 2-4 weeks.
Chronic: Past 4 weeks. Chronic recurring: these are acute injuries (sudden onset) that occur repeatedly over time (such as a chronic sprained ankle). Chronic overuse: these are caused by low-intensity forces over a long period of time (such as a tendonosis).
How do I prevent injury?
In order to prevent injury it is important to perform exercises with the correct form. You also need to have the habit of performing dynamic warm-ups before introducing a lot of load to your tissues. When progressing yourself it is important to adhere to the SAID principles discussed in our previous blog and not progress too quickly. In order to prevent the chronic injuries that are due to movement patterns it is advisable to get an evaluation by a physical therapist for any movement pattern deficiencies you may have already. Most insurances do not currently pay for any such preventative screening, so the cost may be out of pocket. Consider trying to locate a concierge physical therapist in your city who may be able to provide some wellness programming for you as these clinics tend to spend more 1-on-1 time with their patients.
If you are beginning an exercise program and looking for good information on how to perform an exercise both correctly, and want to know what it will look like if it is performed incorrectly, follow us on Instagram @thedoctorsofpt. You can also find us by searching the hashtag for our exercises #thisnotthat.