Chances are that many of you reading this have come to our clinic for a soft tissue injury (meaning injury to muscles, tendons, and ligaments). Since we started our practice we have been advocates for early treatment interventions after acute soft tissue injuries as we feel by starting early, patients tend to have the best outcomes.  We find ourselves constantly pondering two questions:

How early is too early? And,
Is some rest best?

Recently, an article published in one of the most important medical journals in existence, The New England Journal of Medicine, finally provided some answers to our questions. The study looked at 50 athletes (primarily soccer and track and field) with acute muscle injuries (strains/tears). By starting treatment 2 days after an acute muscle injury instead of 9 days after the injury, athletes in the study were able to return to their respective sport 3 weeks earlier…and both groups used the exact same therapy protocol. You read that right, starting treatment 7 days earlier saved 21 days in the end.

Now we know you have some questions and we can read your minds (did I mention we are psychic?)……

“But the study must have been on pro athletes” – Nope. Average age was 45 and all were amateur athletes.

“But the therapy protocol must have been too tough” – Nope….in fact the regimen was very rudimentary and only included easy exercises with progressive loading. They couldn’t even add in manual therapy like we would because it’s impossible to standardize that.

“But if it’s just the average person that came back 3 weeks earlier, some must have taken longer to come back by not resting”. Wrong again. The longest it took an individual in the early intervention group to return to their sport was 77.8 days. The AVERAGE for the delayed treatment group was 83 days. That means the worst outcome from the 25 people in the early treatment group STILL DID BETTER then the average of the delayed intervention group.

Now we know ‘early progressive loading’ is something that we are purporting as the common elixir for most sport injuries, and this landmark study essentially says the same. But also important is the finding that “Immobilization [rest] can swiftly and adversely affect muscle and tendon structure and function and has detrimental effects on connective tissue cells”. That’s medical speak for “REST SUCKS”

 

Now we hope you don’t go and injure yourself, but in case you do, we hope to see you at our clinic….the sooner the better!