Home' Trinidad and Tobago Guardian : May 31st 2013 Contents A77
Friday, May 31, 2013 www.guardian.co.tt Guardian
I really have to set the record straight on
something when it comes to the application
of modalities which can be anything from ice
to laser therapy and that is, these applications
assist with only one of the stages involved with
full healing. For the purposes of this article let
us say that the number of stages through which
the body goes for complete healing is three:
inflammation, proliferation and remodeling,
and a full return from an injury involves going
through all three albeit to varying degrees.
Depending on the extent of the damage to
the tissue, an athlete will need to be guided
through all these phases to allow the individual
to move past the injury rather than continue to
be limited by it. An active person with a minor
injury can reduce the inflammation and with
some short-term adjustments to their training
regime, return to full strength with relatively
little inconvenience or expense. However, beyond
a certain point, there are a great many number
of instances where the athlete or fitness enthusiast
simply needs to invest in their body and receive
the proper treatment their body requires.
When an individual is injured, the body goes
Various stages to healing
into "self-preservation" mode. Muscles shut down, others
become over-involved and this leads to over compensations
and imbalances in the body. The ripple effect to this is
a change in the movement mechanics which can lead to
the development of other injuries or conditions if allowed
To keep it in perspective, to some extent what therapists
refer to as "chasing the pain" has a place in injury man-
agement, however this should not be misconstrued to be
a cure. "Chasing the pain" reduces the inflammation and
tenderness and having accomplished this, the body
becomes more encouraged to function more normally.
The muscles that shut down are more inclined to engage
again and the ones that were compensating can return
to its normal function, assuming that the body was func-
tioning "normally" prior to the injury.
Most competitive athletes in particular are guilty of
not spending enough time stretching following their train-
ing session making the individual more susceptible to
injury to begin with. Having sustained an injury, such
individuals would likely have to spend some time retraining
his/her body s motor functioning.
A few weeks back, I mentioned the use of modalities
for inflammation control particularly electric stimulation,
ultrasound, laser therapy and dry needling. Certain injec-
tions are also very effective forms of inflammation and
swelling management. However the individual whose
treatment in any of these modalities that become on-
going or recurrent needs to recognize that they are merely
addressing the symptoms and not dealing with the cause.
As such, they are doing their body a grave injustice and
limiting their ability to perform at the highest level in
practice and competition and maybe even shortening
their sports career.
The solution to avoiding this trap is to see the appropriate
specialist. A therapeutic exercise specialist, kinesiologist,
personal trainer, massage therapist... while these individuals
will carry some deeper understanding on injuries this is
not their specialty, just as an athletic trainer/therapist,
physiotherapist or sports doctor will also have some in-
depth knowledge on fitness training or soft tissue manip-
ulation but without specializing in those areas of study,
they will be limited in their abilities.
Some injuries can be more complicated than others,
while some injuries may stem from movement habits
developed from childhood. In both these cases, complete
recovery can take a longer time; however, the constant
application of pain management modalities is not a
solution but more like a "quick fix." To address and undo
the heart of the problem first requires a commitment by
the individual followed by the proper guidance by a reha-
bilitation specialist. Otherwise you simply become what
I tend to call "job security" for these short-term solution
providers. Further to that, a lot of times, the effects of
the modality plateaus out and you no longer find that
you get the same relief and/or it does not last as long.
An inflexible groin will remain inflexible regardless of
whether you are in pain or not. Dry-needling it simply
gets rid of the pain but without improving that range of
motion, you will always be less and/or an injury waiting
to happen. A painful shoulder that is mechanically mal-
functioning will always be painful regardless of how strong
or how big the muscles become because the right muscle
with the right therapy application is not being applied.
Here is some advice, if you have a massage therapist
you trust, a good strength trainer and a reputable athletic
trainer/therapist or physiotherapist, get them all talking
to each other and your chances for long-term, successful
outcomes will be greater. Happy training!
Asha De Freitas-Moseley is a certified athletic trainer
with the National Athletic Trainers' Association of the
USA. She has over 10 years of experience working with
athletes and other members of the active population,
rehabilitating and returning them from injury to full play.
She can be reached at #17 Henry Pierre St., St. James.
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