We all know the feeling: we get excited about a new activity or sport, we head into it feeling confident and strong – and then we feel incredibly disappointed when an old pain, ache or injury flares back up – and sometimes feels worse than ever before.
This is where prehab comes in – the rehab you do to help prevent old injuries that you’re concerned about from coming back, and it’s being used by sports teams, weekend warriors and leisure enthusiasts alike. As podiatrists that work extensively with managing foot and leg pains resulting from muscle, tendon and ligament injuries, and as those that believe that knowledge is power, today we’ve shared why your old injuries keep coming back and the ways in which you can best manage them before they start to bother you again.
Why do my old aches and pains keep coming back?
First thing’s first. The most common reasons we see in our clinic for the same injuries continuing to rear their heads include:
1. Whatever is causing the injury hasn’t been fixed
If your unsupportive, worn-out shoes were the reason that your Achilles pain started, and after rehabilitating your Achilles tendon you got right back into those shoes, that will explain the return of the pain. For this example, it could be the low-set heel of the shoe paired with its inability to adequately support your foot that keeps straining the Achilles with every step. While your Achilles may have had a chance to heal and recover during your careful rehab period, once that finished and you got back into those shoes, the same forces kept being applied to your feet and legs that were happening when you sustained the original injury. Before you know it, your Achilles is damaged and sore again.
The potential causes vary greatly, and we often see causes include an improper running technique or gait pattern, poor foot posture, muscle tightness, weakness or imbalances, and going too hard too fast when training – before the muscles are ready to handle the load.
The solution is simple: address the cause. This is something we always aim to do here at Perform Podiatry as part of your treatment plan, as our focus is always on the long-term and keeping you healthy and happy for the years to come.
2. Your injury has created long-term effects that need addressing
Our bodies are truly amazing – but they’re not invincible. Sometimes, injuries can have lasting effects, especially when they’re not rehabilitated properly or fully. A common example we see is ankle sprains. When patients suffer an ankle sprain, or multiple sprains, and they ‘walk them off’ without proper care, they may be left in a weakened state. Given the role of these ligaments is to stabilise the ankle, if they’re not functioning at 100%, the ankle is left vulnerable to the cycle of future sprains – and further weakening.
The solution is to work on reversing or accounting for the damage or long-term effects. For this example, this may be done by implementing an ankle strengthening program and wearing an ankle supporting brace until the strength has been regained. Strapping may also be used to temporarily support the ankle to prevent sprains. Your podiatrist will let you know when the impact has been sufficiently addressed and you no longer need to take additional precautions.
3. Your ‘time off’ has affected your feet or legs
There are good reasons why you’re often advised to keep moving and start a specific strength or exercise program shortly after an injury, surgery and the like. When we’re immobile, or we avoid using muscles a certain way because of pain, activating our body’s use-it-or-lose-it framework – meaning that if we stop using certain muscles for a prolonged time, they’ll weaken and become less flexible. Once enough healing has occurred for you to move without pain again, these areas are still weak – and so you’re more vulnerable to injury.
The solution: exercise programs. While many people give us a shy smile when we ask how their rehab programs are going – there’s a good reason we give you these exercises – and will continue to do so. Stretching tight muscles and strengthening weak muscles is proven to enhance your recovery and overall performance. It’s not a ‘maybe’ or a ‘possibly’. We see a large difference in the rate of recovery for those that complete their exercise programs compared to those that don’t, and we’ll always create a tailored program for you that works with what you’re able to do and your life.
Preventing injuries: Know if you’re at risk
If you’re at that crucial point where you’re about to start something new but you don’t want a previous injury to return and stop you in your tracks, it’s important to find out if you’re at risk, and how vulnerable you are to getting injured again. We can do this by performing a lower limb biomechanical assessment that checks the integrity, function, strength and health of the previous injury site, as well as your overall foot biomechanics, to give you an idea of your risks.
From there, we design a personalised management plan to help keep you from sustaining the same aches and pains, helping to keep you strong, active and pain-free. We recommend that you:
- Always follow your stretching and strengthening plan as each exercise will have specific benefits to help prevent your previous injury from coming back
- Warm-up and cool down appropriately before exercise – when we warm up, we increase our heart rate, our body (and muscle) temperature, improve our flexibility, get our circulation going and boost our mental focus. Each of these elements helps our body to reduce the risk of injury
- Don’t go too hard too fast if you have recently recovered from an injury
- Wear the right shoes for your foot type and the type of activity you’re doing to help stabilise, support and control your feet and legs
- Let your body recover – with the right hydration and nutrition – between training sessions and matches
- Use braces or strapping as directed by your podiatrist
- Don’t ignore niggles – no matter how small. If you start to feel a dull ache at your previous injury site, it may be a sign that damage is starting to recur and you need to act immediately to prevent it from turning into another injury
- If any pain or swelling does begin, follow the RICER principles – rest, ice, compression, elevation and book in with your podiatrist
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