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Managing Tissue Loading to assist Healing and Recovery

ankle 3135710 640Load management refers to the amount of mechanical stress and strains your joints, muscles, tendons, ligaments, and nerves have to cope with during sports and day to day activities.

Effective load management is essential to assist with healing and recovery from injury. Too much or too little load can slow the speed of recovery or exacerbate pain symptoms.

As a general rule, a pain level of 3 on the Numeric Pain Rating Scale (usually a manageable level of discomfort) during or after an activity should not prevent you from exercising or doing your rehabilitation exercises. If your pain levels exceed a level of 3 on the NRS, it is necessary to reduce the load.

 

Some ways to manage the load:

Sitting

  • Sit back in the chair, use the back and thigh support.
  • Ensure the hips are in line with the knees.
  • Ensure the shoulders are relaxed and your chin is not protruding forwards.
  • Get up from sitting and move around every 30 minutes at least.

Standing

  • Engage the deep lower abdominal muscles, to help support the lower back and pelvis.
  • Stand tall with the shoulders relaxed.
  • With your feet wider than your shoulders, shift your weight slowly from side to side. every few minutes.
  • Sit down for a few minutes, to unload the spine, every 20 minutes.

Walking

  • When walking, take shorter steps, try and land softly.
  • Reduce the walking time or distance.
  • Take more frequent but shorter walks.
  • Take longer breaks between walks.
  • Wear appropriate footwear - discuss with your physiotherapist.
  • After a walk, avoid prolonged sitting.

Running

  • When running, take shorter steps, try and land softly.
  • Run slower or a little quicker if it feels better.
  • Reduce the running time or distance.
  • Take more frequent but shorter runs.
  • Take longer breaks between runs, if recovering from an injury, at least one full day.
  • Wear appropriate footwear - discuss with your physiotherapist.
  • After a run, avoid prolonged sitting, do a few gentle stretches to help warm down.

Running sports eg. rugby, soccer, football, GAA etc

  • Reduce the number and/or duration of sports training sessions each week.
  • It is important to include at least 2-3 full rest days each week for recovery, your aim is to not feel an increase in pain or stiffness the next morning.
  • Improve your strength and stability - important to reduce the load on the joints and improve the resilience of your tendons and ligaments.

Tennis

  • Reduce the number and/or duration of tennis training sessions each week. It is important to include at least 2-3 full rest days each week for recovery.
  • Playing doubles reduces the amount of movement around the court.
  • Improve your strength and stability - important to reduce the load on the joints and improve the resilience of your tendons and ligaments.

In the gym

  • Reduce or increase the number of repetitions, sets, and resistance levels until you find the right combination that allows you to train without excessive soreness during or afterwards.
  • Reduce the amount of movement, for example, how far you bend the knee, hip or back, especially when doing exercises in a weight-bearing position like standing.
  • Reduce the overall length of your workouts and then increase slowly once pain symptoms are under control.

If you are struggling with an injury that is not healing, you may benefit from a course of physiotherapy, which, depending on the type of injury, may require a specific and individualised load management programme. Once pain symptoms are reducing, it is important to carefully increase the load on the tissues in a graded manner to ensure optimum healing and to restore strength and resilience. 

By Lorraine Carroll

Chartered Physiotherapist

 

Image by mrdjrlawrence from Pixabay

 

 

 

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