Reflections on an injury

Last summer, I tripped over a small wall and grazed my legs. Fortunately, I haven’t had any injuries for many, many years. However, watching the grazes heal over time reminded me how long it can take for the body to recover from injury. (I also recalled how sore grazes are and for how long!)

Below is a really useful graphic that illustrates how long it takes different tissues in the body to heal.

Image by Dr Caleb Burgess
With a graze, you can visually see what is happening. It took months for the skin to remodel and look normal (it was a nasty one!) When we strain a hamstring muscle or turn an ankle our expectations around healing times are different. I think that is partly due to the fact that we cannot see any physical signs of injury, particularly because in some instances there may be little or no bruising or swelling at the time of injury. We think there is no sign of damage so it should be healed but we still feel pain in certain movements or with overloading activity of the area.

More often than not we just need time.

Definitely keep moving but perform pain free exercises or work within a pain free range to start.

What exactly does that mean? iI you strained your knee and walking was painful, then try cycling instead so you can keep active and moving the joint but in a pain free exercise.

If lifting your arm forwards and up is fine until you reach 90 degrees then soon after that it is painful, well you can still perform many activities keeping your arm to 90 degrees and then perform gentle mobilisations of the arm to improve your range above 90 degrees but monitor the intensity of pain and keep it very low (say 3/10) and you will notice improvements.

If someone is young (under 18) or an older adult with persistent pain, then do get it checked out. However, typically musculoskeletal pain that would require further investigation would include[1] :

  • pain that radiates below the knee, or from the neck into left arm or both arms
  • major trauma
  • unrelenting pain, even at night
  • increasing neurological symptoms associated with painful site, such as weakness or numbness and tingling
  • bladder and/or bowel incontinence
  • previous history of cancer

Obviously if there are any associated medical symptoms such as fever, headaches, chest pain, dizziness, etc (and this list is not exhaustive) then get medically assessed. 

Do bear in mind that for many people, pain cannot be directly associated with structural damage to the joint or muscle. For example, it is widely known that 85% of back pain is non-specific[2], that is, there is no clear indication of any structural damage or inflammation even when scans/x-rays utilised. This is one reason why getting an MRI or X-ray is not necessarily the first port of call when you visit a health professional.

Usually, the most important thing is to keep the area comfortable but mobile and as we can see, often if just takes time.

This article is for general guidance and information only. It is not to be relied upon for planning individual medical care or as a substitute for medical care or advice. If in doubt seek professional help.

References

  1. Della-Giustina, D. (2013). Acute Low Back Pain: Recognising the “Red Flags” in the Workup. Consultant 360. https://www.consultant360.com/article/acute-low-back-pain-recognizing-%25E2%2580%259Cred-flags%25E2%2580%259D-workup. Accessed 6th Jan 2023.
  2. Koch, C.  and Hansel F. (2019). Non-specific Low Back Pain and Postural Control During Quiet Standing—A Systematic Review. https://www.frontiersin.org/articles/10.3389/fpsyg.2019.00586/full. Accessed 6th Jan 2023.