When I go to my dentist she tells me that I need to floss. I hate flossing. To be honest I don’t floss. Not unless I have an upcoming appointment. Then I do. Vigorously. Now she knows I haven’t been flossing. She’s not a mind reader but there are tell-tale signs. The angry indentations on my bloody gums from that mornings power flossing session are the dead give away.
We recently celebrated our eldest sons 3 year old birthday party. Two days later I caught him red handed pigging out on some of the remains of his birthday cake.
“What were you eating, Charlie?”.
“I know you were eating something. Daddy knows these things”.
“How do you know Daddy Pig?” (because that’s just what he calls me now)
“I know you were eating something because there’s chocolate all over your face”
When patients attend for physiotherapy assessment, based on the findings they will more often than not be prescribed exercises: strengthening, stability, mobility or flexibility work generally. And I, like the dentist, have a good idea if that regime is being adhered to on follow up appointments. While there may not be traces of chocolate nor blood (not usually at least) there are indications of compliance or not. Not remembering what the exercises were is never a good start! Objective measures give a structured way to monitor progress, e.g. scoring better each week on a functional task. In an ideal world pain and function would be inversely proportional, i.e. pain would reduce while function increases. But this is not always the case. Adaptations need to occur during the rehab exercise regime which can sometimes lead to soreness in muscle that may have been dormant for some time. As a result these adaptations can take time. It takes 6 weeks to see significant physiological changes in muscle strength. This would explain why on most radio bulletins from the weekends sporting action the magic number of weeks for return to sport following muscle injury will be what? That’s right. Six weeks.
People need to take ownership of their problem and not expect the “fix me”, passive approach. Your health care professional should empower you to take over some of the responsibility of the problem and manage the condition as best you can cutting down the need for ongoing treatment and intervention. If a structure in the body lacks stability, there is an exercise for that. Likewise if an injured structure is too short or lacks flexibility, there is an exercise to address that too. Ask your healthcare professional is there is anything you could do to help the situation.
Should we stop flossing or brushing our teeth because we no longer have a tooth ache? No. Equally should we floss vigorously and sporadically, potentially causing some damage? No. Exercise for prevention of injuries needs to be treated in a similar way. Not enough will lead to problems but too much too soon may likely lead to similar outcomes. We should stay on top of the things that likely caused the problem in the first place, even if that problem is long gone. An ankle or knee sprain will benefit from continued balance work long after the sprain is resolved and the athlete is back playing their sport or activity. Much like obesity, type 2 diabetes and tooth decay let’s take preventative measures (as best we can) when it comes to injury and exercise.
For more information on any of the issues addressed throughout this article please contact Rob via email at firstname.lastname@example.org, Twitter @mccabephysio, Facebook at McCabe Physiotherapy or visit http://www.mccabephysiotherapy.com
Rob McCabe MISCP
MSc (pre reg) Physiotherapy, BSc Sport Science and Health, MSc Sports Physiotherapy, PG Dip Orthopaedic Medicine
Orchard House, Moorefield Rd, Newbridge, Co. Kildare