2. Hurt vs. Harm Tissue Healing & Recovery Presented by:[name]

3. Definitions Soft tissue Whiplash injuries Sprains Strains Muscle spasms

4. Soft Tissues  Except bones and teeth All tissue of the body Muscles, tendons, ligaments, skin, and fat

5. Whiplash Injuries Injury to the cervical vertebrae And Adjacent soft tissues

6. Whiplash Injuries

7. What Causes Whiplash? Rapid acceleration & deceleration Flexion & extension of cervical spine One source - vehicle suddenly & forcibly being struck from the rear

8. Sprains The forcible wrenching or twisting of a joint with partial rupture or other injury to its’ ligaments without dislocation. It occurs when ligaments are stressed beyond their normal capacity.

9. Ankle Sprain

10. May Also Damage Blood vessels Muscles Tendons Nerves

11. What Causes Sprains? Trauma directly to the joint causing the joint to move into a position which it was not designed to move.

12. Results Joint and/or muscle pain Swelling Discoloration of skin ( bruising) Impaired joint function

13. Strains Overstretching a muscle Use more force than they are capable of handling Becoming inflamed, swollen, & painful

14. Muscle Spasms Sudden, involuntary contraction Very tight and often painful Often after a joint sprain Body is attempting to protect joint By immobilizing or splinting it in the form of sustained muscle contraction

15. Tissue Healing & Recovery 1.Acute Stage a)0-1 months post injury 2.Sub-acute stage b)1-2 months post injury 3.Chronic Stage c)3+ months post injury

16. Acute Stage (0-1 Months Post-injury)

17. First 7 Days Inflammatory process Swelling Varying degrees of pain

18. Treatment First day-icepacks Modalities Hot packs Infrared TENS Muscle relaxants

19. Inactivity Continuing this inflammatory phase by rest and avoidance of activity can actually be counter productive.

20. Inflammatory Phase Excessive swelling Scar tissue formation Pain Decreased mobility Weakness

21. Inactivity In fact, prolonged bed rest, longer than 3 days has not been shown to reduce disability or dysfunction.

22. Early Activity Increase blood flow Promotes healing Maintain muscle tone

23. Cardio

24. Flexibility Strength

25. Days 7 - 21 Regeneration of damaged tissues Promotes proper soft tissue healing Healing tissue needs specific stress or new fibers may become useless scar tissue

26. Early Stages PainDiscomfort Does Not Mean further injury

27. Protective Response Often, when a particular movement causes pain, it is our immediate reaction to avoid that movement.

28. Sub-acute Stage 1- 2 Months Post-injury

29. The goal of this phase is to fully restore function to the injured area and supporting structures. GOAL

30. Passive Treatment TENS Ice packs Acupuncture Hot packs

31. Active Treatment Specifically, restoring full range of motion and improving muscular strength are essential components of this stage of recovery and can be achieved through physical activity.

32. Restore Improve Range of Motion Muscle Strength

40. Chronic Stage 3+ Months Post-injury

41. Chronic Stage Think of pain as injury or disease Assume it indicates bodily harm Makes sense when pain is acute

42. Persistent Pain Assuming that pain indicates bodily harm Does not apply long after injury has healed

43. Hurt Vs. Harm Synonymous Not Hurt Harm

44. Why Does Pain Persist? No one knows for sure Injured area becomes “hypersensitive” Stress factors result in pain By producing muscular tightening And irritation of local nerve fibers

45. Normal Response to Pain Stop the activity that causes pain May cause temporary relief, but not for long.

46. Continued Lack of Activity Muscle shortening Muscle tightening Weakness Joint stiffness Poor posture

47. The Cycle Develops Pain Stop Rest Activity Relief

48. The Cycle When activity is resumed, pain often results. It is then likely that a person will return to a sedentary state to avoid more pain and a vicious cycle will develop.

49. Consequences of Inactivity

50. Prolonged Inactivity Loss of muscle size (atrophy) Loss of strength Flexibility Endurance Coordination

51. Physical Activity Is Needed Maintain muscle tone Joint mobility

52. Decreased Physical Activity As a result of decreased physical activity, people become “out of shape” or de- conditioned. De-conditioning typically occurs for 3 basic reasons.

53. 1. Avoiding Activity Avoiding activity because it is painful results in a vicious cycle. Unused muscles tend to weaken and shorten. This makes resuming activity even more difficult. As a result, people often avoid further activity, and so on.

54. Braces and canes weaken muscles in the long run because muscles are prevented from doing their job. If muscles in these areas remain unused for a long time, the body comes to depend on the support that these artificial devises provide. 2. Braces & Canes Overuse

55. 3. Protective Responses Develop

56. Protective posturing and responses are often developed to avoid pain associated with use of the injured area. For example, limping to avoid leg pain will eventually lead to weakening due to under use, while muscles and joints on opposite side become over stressed. Imbalance and stress leads to more pain. Protective Responses Develop

57. Proper Exercise Positive affect on muscles/soft tissue Can reduce stiffness Increase strength Improve oxygen delivery Increase endurance Decrease body fat

58. Did you know?

59. Lack of Physical Fitness One of the primary causes of injury.

60. Physical activity has been shown to promote the release of endorphins, one of the morphine like substance that we have in our bodies.

61. Essential Physical Activity Conditioning Good HealthRecovery

62. Everyone should try to incorporate an exercise routine into their daily lives!