post-treatment exercise

I treat a lot of athletes.  Many of the problems that I see LOTS OF in my clinic (for instance, PIRIFORMIS SYNDROME), tend to occur in athletes or people who love to exercise.  Sometimes that love could arguably be described as ‘pathological‘.  For instance, I just got an email from a middle-aged person who developed a hip / piriformis problem after competing in a dozen (that would be 12 as in “twelve“) marathons in a year’s time — with other ‘smaller’ races in between.  If this person ultimately decides to come see me, I can assure you that one of the first things out of their mouth will be, “When can I start exercising again?“.  As an ex-athlete and current wannabe-athlete, I very much understand this question and the mind-set behind it.  Let me answer as clearly and concisely as I know how.  The truth is, I am never sure when you should start exercising again, because everyone’s problem is different and everyone heals at different rates.  Let’s dig a bit deeper.

When muscles shorten (contract), it gives you the ability to move.  Typically, the more often or the more intense the muscle contractions, the greater the potential movement (I say ‘potential’ because with isometrics, you contract the muscles without movement taking place).  Many of the people I deal with on a day-to-day basis are dealing with long-standing problems (just look at some VIDEO TESTIMONIALS to see what I am talking about) that are based in SCAR TISSUE and ADHESIONS OF THE FASCIA.  After we break up these scarred areas, it is critical to STRETCH the treated area because that’s how we are going to pull the tangled, twisted, and wadded tissue apart so that it can heal normally.  Fail to pull the injured tissue apart, and you’ll fail to gain any sort of long-term benefit from this sort of treatment.  When you engage in either CARDIO OR STRENGTH training, it will, by its very nature, involve repetitive motions, intense muscle contractions (shortening), or both.  I probably do not have to tell you that this is counterproductive to what we are trying to accomplish. 

How long does it take to heal?  Good question.  There are so many factors involved.  How old are you? How good a shape are you in?  Has the area been injured previously?  Are you overweight?  What are your VITAL RESERVES like?  How good is your diet (this one covers a lot of ground)?  What form(s) of exercise do you engage in?  How long had you dealt with your problem before coming to see me?  Have you considered that your problem could be SYSTEMIC?   There are numerous factors to consider, not to mention the fact that I think everyone’s connective tissues are different (i.e. what makes some people more injury-prone than others?).   Just be aware that if you start exercising too soon after treatment, you can seriously disrupt the healing process.

I would recommend that for people with problems that were either caused by severe trauma (i.e. an MVA), or have been going on for a long time (months or years), you should take at least two weeks before you begin doing anything physical that you have not already been doing.  If you could previously walk around the block one time without causing pain, by all means do it (just don’t forget to stretch).  But before you try to walk any farther, wait two weeks.  And then start adding to your regimen slowly — a word that some of you have a tough time understanding.  It may take you several weeks to get back into the groove of things; and several months to get back to where you were before you developed your problem.  The hard reality is that you may never get back.  Despite all the things I can do after multiple severe ankle sprains and Avulsion Fractures in my younger days, to this day I cannot ride a bicycle, and haven’t been able to for a decade.  It’s the result of piriformis issues that are fired off by the goofy biomechanics of a mostly resolved foot problem that at one time had me wondering if amputation would be better than the pain (HERE).  But I can do so much more than I used to be able to do.  This past year, I can even do some easy leg workouts in my gym.  And I have learned through trial and error that as long as I don’t do them more than once a week, I can SWING THE KETTLEBELLS as well.

The point is; you’re reading this because you have been dealing with your problem for a long time.  You are better since coming to see me.  By all means, do what you feel your body is capable of — but don’t screw up and re-injure yourself.  It’s not worth it.  Go slow, and hopefully your body will take off and heal. It takes 2-3 weeks just to heal a paper cut.  And your body is dealing with far more than that.  For an explanation of specific soft tissue healing times, look for “The Phases / Stages of Tissue Repair & Healing” section of our COLLAGEN SUPER-PAGE.   Good luck and Happy Healing!