Accelerating Recovery from a Sports Injury: Part I – How the Body Heals

You got hurt training. Maybe you are a runner that increased your mileage and now have lingering knee pain, or a lifter who felt a tweak in your back, or a jiu-jitsu practitioner who got your elbow cranked on a little too hard during an arm bar.

Being injured can feel scary. And it means temporarily not being able to do what you love, not spending time with people you care about, and even losing a part of your identity. So how can you accelerate recovery and healing?”

Modern medicine has, for the most part, not figured out how to make the body heal faster. But, we can cooperate with our body’s natural healing process to make it as efficient as possible. And most importantly, avoid unnecessary setbacks. In this series we’ll understand the healing process. The second part examines the factors under our control that slow it down or speed it up. And finally, we’ll look at some case studies.

All soft tissue (meaning here everything that is not an organ or bone) follows a general three step healing process: inflammation, proliferation, and maturation. The length of these stages depends on the type of tissue involved, the severity of the injury, your underlying health, and how we manage the injury.

Inflammation gets a bad rap, but it’s a necessary step in the healing process. It starts almost immediately after the injury and can continue for anywhere from a day to a week. If we think of an injury as a multi-car pileup on the highway, inflammation is the rescue team blocking off the road, cleaning up debris, and directing other rescue services to the scene while redirecting normal traffic away. Inflammation is only bad when it becomes pathologically chronic; imagine the road crew, paramedics, and police decide to camp out on the highway for no good reason—you won’t have a functioning highway.

Next is proliferation. This stage  starts a few days after the injury and can last from weeks to months. It involves laying down new tissue. However, this new tissue is a scar tissue of a different type than the original tissue, and serves as a temporary scaffold. If you look at normal muscle, tendon, or ligament under a microscope it appears like uncooked spaghetti, all straight and lined up. During proliferation, the scar tissue looks like someone threw a bunch of cooked spaghetti all tangled up at the site of injury. This tissue is much weaker, and therefore more vulnerable to reinjury, than the original tissue.

Finally we have maturation, which begins after a few weeks and can last months to even years. In this phase, the spaghetti fibers straighten out and strengthen, allowing the new tissue to gradually approximate the quality and function of the old. Unlike the previous two phases which happen largely automatically, maturation takes place as a response to tissue loading. That means that since you can be in control of the loads you place on your body, you can be in control of how well and fast you ultimately heal.

These timelines might seem very long. But for most injuries, you can be back to training in a few days in a way that helps the healing and recovery process. Read on to Part II to understand how.