My son Austin is a motivated and dedicated high school track and cross country runner. He has struggled with tibial stress syndrome (a lower leg condition that is on the spectrum between shin splints and a stress fracture) for nearly 20 months now. Austin has lofty goals; he wants to perform well for personal satisfaction and to help his team achieve its goals. However, Austin’s drive often gets the best of him.
For example, he recently overexerted during his healing by attempting to run through the pain in a 4 mile practice run and them running his personal best fastest mile in a track meet. He will now have to miss the rest of the track season to allow his body to heal and to prepare for cross-country season in the fall.
If Austin had listened to his body on the day of the four mile run, and instead had gone swimming or biking for exercise; he likely would have been able to continue his track season by modifying his work loads. Too much training as well as too little exercise can both have harmful effects on the body. For those parents dealing with injuries to their children, keep in mind, they will not always share everything with you as their desire to compete is greater than their honesty about how they feel.
As I tell my patients all the time, you have to respect your body and what your body is telling you. Running four miles with a limp is analogous to picking a scab. All you are going to do is cause the scab to re-bleed and the healing phase starts over. Sometimes your body needs rest, continuing to load your body in ways that it currently cannot handle is detrimental to healing and achieving a pain free and active lifestyle. At the same time our bodies thrive on movement and generally the stronger and more mobile we are the healthier our bodies will be.
So, how do you know when to rest and when to be active and how active to be? Excellent question, and the best answers come from your health care professional. The assessment begins with identifying the several factors: is it acute or chronic, what is the severity of the problem, is surgery indicated, the age of the patient, and the person’s general health. Generally, an injury initially needs rest or protection (time based on type of injury). However, if you continue to reinjure the same structure, then an assessment to determine underlying causes is required. Strengthening and stretching a problem area are often beneficial; however the dose of these activities is critical. When starting a program, start gentle and assess your body’s response.
My general thoughts are to push your body only to the point that you may experience a minimal amount of joint irritation or injured tissue irritation while performing exercise and expect that irritation to subside about 20 minutes after completed. Burn or pain from exercise in a muscle that is not the injured tissue is generally a good sign. Expect this pain to go away 24-48 hours after heavy exercise.
Pushing through pain at the site of the injury is usually detrimental and may result in greater irritation or injury. Stay active and work hard, but do no harm. Often, finding new ways to exercise that are not painful are the key to recovery. Physical therapists are excellent resources for assisting individuals developing a workout routine in the presence of an injury, arthritis, or any damage to the ligaments, tendons, muscles, and joints.