Physiotherapists often have a reputation for working patients to the extreme and are commonly thought to have a “no pain, no gain” attitude. Patients that are attending their first week of residential rehabilitation have also given feedback that they expected it to be like an army boot camp! However, the physiotherapists at Dorset Orthopaedic understand that rest and recovery is equally as important as hard work during their rehabilitation journey. In order to improve our strength, flexibility, fitness and gait, we need to allow our bodies time to restore their energy cells, repair our muscles and generally relax – meaning we can get up and go again the next day! Where possible, we will help patients with their recovery at the end of their session in clinic, however it is important that you understand how to do this independently at home, in between your physiotherapy input.
We’ve all had that feeling the day after we’ve exercised like everything has stiffened up and you can feel muscles hurting that you didn’t even know you had! This muscle ache is referred to as DOMS – delayed onset muscle soreness. This is commonly thought to be caused by the build up of lactic acid in the muscle, however DOMS is actually caused by microscopic tears in the muscle fibres. Following the micro injury to the muscle, protein synthesis occurs – where new protein is produced to repair the muscle and subsequently promote muscle growth. DOMS should improve itself over a few days but below are a few example of things that can be done at home to speed up the process.
Stretching – something most people are guilty of neglecting! Quite often we focus so much on strengthening our muscles but if we aren’t using them through their full range of movement we are missing a lot of potential. If your muscles are tight and sore then it can affect your posture, joint range of movement and pain levels which can all impact on walking technique in a prosthesis. Holding a muscle in a stretch position helps to lengthen the muscle fibres, increases the blood supply to the area and reduces the likelihood of trigger points (patches of contracted muscle) forming. Bear in mind that a stretch should not be painful – uncomfortable maybe, but not painful.
Often our patients ask for a massage following a more strenuous exercise/gait re-education session and they’re expecting a relaxing and peaceful experience – not the case with a physio massage I’m afraid! Massage helps to lengthen the muscle fibres and flush away any toxins in the muscles meaning you’re ready to wear your socket again the next day! This is something you can do at home too.
Foam rollers also help to reduce DOMS. Foam rollers help to apply deeper pressure in the tissues and are really good at breaking down potential trigger points before they start to cause problems. The pressure from the foam roller also helps to increase the circulation in the area, bringing more oxygen to the tissues which helps them to recover quicker.
There is ongoing debate regarding which is most effective – hot or cold baths following exercise? Some arguments state that hot baths increase the blood supply through dilating the blood vessels which in turn helps to flush away toxins in the muscle and promote recovery. Whilst other papers argue that cold baths reduce blood flow through constricting the blood vessels which in turn reduces inflammation. Ultimately, there are many studies that argue the point for both so I often advise patients to use whichever one feels most effective for them post workout. It is, however, important to be aware that if you have any suspicion that your post workout pain is due to injury, not DOMS, avoid heat therapy.
Sleep and diet are also really important to aid recovery after exercise and are both things you can take charge of at home! Sleep gives our body time to recover and restore energy levels whilst a good diet provides us with essential nutrients to rebuild muscles and prepare you for further activity the following day.
It is also important to incorporate rest days in to your rehabilitation plan in order to prevent overuse of muscles, particularly if you are getting used to a new prosthesis or have started a new activity. Try and plan the rest days in according to what else you have arranged that week – for example, if you know you’re going for a longer walk one day, plan your rest day for the day before in preparation.