The Accepted Standard For Injury Recovery - Or How To Ignore Cellular Physiology And Make Money Doing So

I had the opportunity to attend the USA Track and Field SW Regional Masters Championship last month. I was there to consult with athletes and coaches on training- and injury-related issues. I always enjoy interacting with athletes at this level, given the range of ages and the broad variety of training backgrounds.

There is a consistent theme throughout the masters athletics population: most have sustained training injuries, and a large percentage are continuing to train or compete with them. But what is perhaps more troubling is the perception of what is acceptable should an injury occur – especially regarding the time frame for recovery and the treatments to be utilized in the process.

Sadly, the accepted standard for injury recovery these days is a little disconcerting.

You would think that clinicians working with injured athletes would want to “push the envelope” in the time frame for injury recovery. You would think that a progressive, aggressive, sports medicine approach would shorten the time to return to sport. But that isn’t necessarily the case. My time at this track meet reminded me once again of the sad state of affairs in sports medicine these days.

Why? Because clinicians have nonchalantly forgotten about the process of tissue repair and remodeling and the time frame required to move through the phases of tissue repair.

I heard plenty of tales of woe on that hot and humid day in central Texas …

“It took me a year to get over my IT band problem”.

… and …

“It took me 3 months before they started doing any activity for my achilles problem”

… and …

“They told me to rest it for a month and if that didn’t take care of it they would give me some medication”.

Those are just three examples.

Please tell me that at this stage in the history of physiology, this is not the state of the union in sports medicine. If it is, it is a blatant disregard for cellular function and the phases of tissue repair. Sure, a masters athlete may have slower training adaptations due to age and metabolic status. Fair enough. But if the human body takes that long to repair and remodel, then we have some serious issues in our ability to survive on the planet. Nature does better than that on its own, without interminable (and oftentimes costly) treatment.

Should it really take someone a year to recover from a problem that typically responds very favorably and readily to mechanical loading strategies? No. But we continue to hear these tales of woe. Worse yet, athletes assume that this is just what they are going to have to live with should they sustain an injury.

One thing I do know: a culturally-accepted slow prognosis and time frame for injury recovery is always good for business. A clinician can ignore cellular physiology, extend the time frame arbitrarily, and make money doing so. Clinician accountability? Zero.

Maybe that’s the real problem.

Photo credits: familymwr