How long is a piece of string? The question of how long an injury will take to heal is a lazy question. Both for the practitioner and the patient. Not only is it difficult to determine how long something will take for an individual (complex system discussion, that we wont get into here), but it neglects the question of what does the patient need to return to. If a patient only requires the need to return to walking activity following a muscle strain, it may only take a few days to return to pain free function. But if they want to play a game of basketball they are going to need a lot more rehabilitation.
So what is the alternative to timelines?
The alternative to timelines is criteria based progressions. This means that patients progress from one level of function once they can achieve pain free or near pain free function in the previous level of activity.
Does this even work?
Well the short answer is annoyingly it depends. For some injuries that have stricter tissue healing times such as fractures, the timelines of healing may be relatively inflexible (not always the case, but again this is a discussion for another time). But in injuries to very metabolically dynamic tissue such as muscle strain injuries there may be significant benefit to using a criteria model.
And this model was recently tested by researchers at the Aspetar Orthopaedic and sports medicine hospital in Doha, Qatar. This is a world leading sports performance and sports medicine facility used by the best of the best. They looked to research the benefit of a criteria based model for return to sport for patients with acute adductor strain injuries.
What did they find?
They found that the system of passing through stages or criteria was highly effective in return to sport and reducing re-injury particularly compared to athletes that returned without meeting the criteria.
What were the criteria? As simple as it sounds achieving clinical pain free activity (such as manual muscle testing and rehabilitation exercises), pain free completion of controlled (modified training) and completion of full team training. These simple steps completed prior to return to sport, had a dramatic effect of effective return and reduction in re-injury.
So next time you have an injury the more poignant question may be, what do I need to do to progress to the next stage?
Read the article here:https://pubmed.ncbi.nlm.nih.gov/32064292/