What's the Rush?

“I’m a Hare, I’m a runner, I’m as fast as I can be.
I speed and spurt and whisk along as anyone can see.
I burn out peelin’ wheelies. Even radar can’t catch me.”
~Tortoise and the Hare, 5th grade play St. Simons Elementary (1981)

My son has one of those Harry Potter wands from Universal Studios. I think we stood in line for at least 24 hour to obtain that wand. Of course, it was worth it. Thank goodness for the roving vendors that slaked our thirst with butter beer (cream soda) as we gnawed on turkey legs. Good times. Now, he runs around the house yelling, “Abracadabra!” and, “Hocus-Pocus!” followed by, “Daddy, you’re a newt.” I wish I could take that wand to work. There are many times when I’m sitting in clinic , listening to a patient, and at the end of his or her story, the patient looks at me and says, “Seriously Doc, how are we going to get this (sprain, strain, fracture, ligament injury) to heal quickly? I got things to do.” That’s when I want that wand. If only I could say, “ABRA- CAPOCUS !” or, “POCUS-CADABRA!!” You are healed; see you later.

Unfortunately, and yet naturally, healing takes time. Although we can predict a rough estimate on how long it may take for an injury to heal, there are certain guidelines that, if followed, can expedite healing. On the flip side, there are quite a few behaviors by patients that can prolong the healing process.

Although healing takes time, the ability to heal is influenced by a cast of other factors that can impact the body’s capacity to heal effectively:

• An overworked immune system: The process of healing is complex, utilizing different cell lines and mediators for tissue healing and repair. If your immune system is impaired from tackling a cold, or other illness, this could cause a delay in a proper healing response. Give your immune system an extra boost with dark green, leafy vegetables and fruit.
• Unhealthy choices: Your body is a representation of your overall general health and physical well being. Correlations have been shown between decreased healing potential and alcoholism, obesity and smoking.
• Sleepless nights: Body tissues need the chance to recover. When we sleep, the brain triggers necessary hormones for the repair process. In the athletic population, a minimum of eight hours sleep can lower the risk of injury. Therefore, increasing sleep may lead to a faster recovery.
• Inactivity: Strict bed rest to recover from injury is a dead concept. Exercise is a vital part of rehabilitation. As long as movement is comfortable and pain free , this can benefit healing by preventing adhesions and aiding in joint mobility.
• Stress: Excess stress can have negative health benefits. High levels of stress can delay healing because hormones released during stressful times can hinder a proper immune response to injury.
• Valuable nutrients: Getting the right nutrients to assist tissue healing and repair is important. Protein is essential for proper muscle repair. Good sources include animal protein, fish, eggs and Greek yogurt. Oily fish also provide excellent anti-inflammatory properties as a source of omega-3. Zinc found in nuts, seeds and chicken aids in tissue growth as well as a good immune booster. Vitamin C aids in tissue repair and help with calcium absorption for cartilage and bone health. High sources of Vitamin C can be found in tomatoes, peppers, broccoli and citrus fruits.

Now that I have talked about ways to improve overall health to allow the body the best chance to heal an injury, let’s talk about what to do in regards to the injury itself. Healing takes time, but it also takes rest. However, proper rest is trickier and more important than most patients realize. Many people pay lip service to the importance of rest but ignore the concept or defy the physician’s advice. Runners are notorious for this and are invariably the worst offenders for two reasons:

1. They believe that by resting, they are going to lose their level of fitness and quickly “go to pot.” First off you will “go to pot” if the injury never heals. Chronic pain and poor function is a greater threat to fitness than rest. Secondly, though peak conditioning may be vulnerable, the bulk of fitness is quite stable especially for fit individuals.
2. Most athletes believe they can exercise their way out of a problem. This is flawed thinking for two reasons. First, long before a tissue fails under strain it will become “sick” by being unable to match the strain with proper maintenance and repair. Secondly, the injured site loses its ability to tolerate even minor stresses, so activities that use to be fine (light jogs) become a problem. Therefore rest is critical to stop challenging the injured site, or it will never have a chance to recover.

The art of rest is by adhering to Relative Rest. Think of the injured site as the weak link in the chain and focus on other exercises or activities that provide fitness without stressing the injured site. I tell my patients that instead of focusing on the negative that they are not able to perform their normal exercise regimen, look at an injury as a good time to branch out. During this time of rest and rehab is the perfect time to try something new:

• Hurt shoulder or elbow playing golf? Get some lessons to work on the short game. Find a trainer and focus on lower body and core.
• Swimming is one of the most classic options for relative risk.
• Yoga. I have discussed in the past how yoga is great for improving joint flexibility and overall strength.
• Walking is a surprisingly good and non-stressful exercise.
• Find a trainer and learn a new workout in the gym.
• Knee or hip injury? Try kayaking or Stand Up Paddleboarding.

These are just a few ideas, but the concept is the same. Think outside of the box to find something new while your body heals, and the time will roll by. How long is long enough? That is truly the $64,000 dollar question. I agree with most physicians that patients need to rest until the injury feels better. Then they can SLLOOOWLLY get back into their regular activity starting around 25 percent of their normal pre-injury level and work back up to their full workout routine over four to six weeks.

As I tell my kids, “Go outside and find something to do.”