Don’t Let Your Healing Get Stuck Between Second and Third Gear

Sometimes pain doesn’t go away as you wish it would

Examples include:

  • chronic back pain
  • plantar fasciitis
  • tennis elbow
  • patellofemoral syndrome
  • tight IT band
  • rotator cuff problems
  • tight muscle trigger points any where in the body

Why do these nagging problems persist? Why doesn’t the body heal itself in these circumstances?

A medical consensus is forming around some of the answers to these questions. And it’s requiring a shift in some of the core scientific principles that have served as medical cornerstones for more than a hundred years.

Medical genius of the late 1800’s

There’s a basic principle of pathology that has stood the scientific test of time since the late 1800’s. Back then, doctors discovered the key link between two seemingly different health processes: wound healing and the body’s response to infection.

normal healing cycle

In each of these situations, your body initiates a three-step reaction:

  1. Inflammation and immune response

    Extra blood speeds to the affected zone and, quickly, useful defensive forces – immune cells, inflammatory proteins, signaling molecules, and more – rush into action. The area swells up.

    The fire fighters are on the scene and are spraying their hoses and knocking down walls and windows as needed.

  2. Stabilization and proliferation

    Now the fire has been put out but there’s a heap of rubble where your functioning tissues used to be. Now that the damage has been contained, your body cleans up and braces the affected area. One type of cell that’s put to work is a scavenging white blood cell that gobbles up random molecular fragments that are still floating around.

    A second cell type that’s activated is a fibroblast, a connective tissue cell that “blasts” out fibers (structural proteins such as collagen) to provide physical scaffolding as the region rebuilds.

    By design, your body doesn’t use an “efficient” rebuilding strategy. Instead, your fibroblasts spit out an overabundance of collagen and other proteins that jumble together in a big random blob.

  3. Remodeling

    Slowly, the random blob of proteins that your fibroblasts produced gets re-organized into functioning tissue. This is the slowest part of the healing process – it can take weeks or even months.

    Movement is the key to remodeling. Your muscles, tendons, ligaments, and other connective tissues reorganize themselves based on the physical loads placed on them. Where a tendon needs to be tough, extra collagen is deposited, and the fibers align themselves in parallel along the lines of greatest force. Where bone needs reinforcement, fibers are deposited, align themselves, and then get filled in by calcium to forge strong bone.

The first stage of healing – inflammation – is initiated within seconds, and ramps up to full strength in a manner of minutes or hours. The stabilization phase might take place over a few days. But the remodeling phase can last for weeks, months or even more.

More modern understanding

This three-step model of the healing process has proved itself invaluable again and again. But in the past ten to twenty years, we’ve begun to understand that under certain circumstances, injuries can hang around – seemingly indefinitely – instead of getting better.

In the past, doctors prescribed anti-inflammatory medication to help people with chronic pain of the joints, nagging muscle trigger points, or tendonitis. Sometimes these methods would relieve the pain long enough for the patient to go about his or her normal business while the body worked its usual internal healing magic and the problem disappeared permanently.

But not always. Too often, a patient would have an injury that never fully cleared up. The problem could persist for weeks or months.

Now we know why. Tendons, muscles, ligaments and joints can get stuck in the no man’s land between second and third gear.

After the first week or so, these tissues are no longer in an inflamed state. They’ve left stage one of the healing cycle far behind. So taking anti-inflammatory drugs doesn’t really improve the underlying mechanism that’s maintaining the problem.

A different healing approach is needed

The new strategy is to do something to irritate the tissues – get them stirred up and create a cascade of hormonal signals that makes the body respond with a healing process. It’s almost as if an effective treatment reminds the body that a problem exists and jump starts a new round of healing.

There’s more than one way to accomplish this goal.

One medical approach that’s gained popularity is to inject the troubled area with the patient’s own compacted red blood cells. Another strategy is to blast the area with super-high-powered ultrasound.

But in the chiropractic world, we’ve used a technique for many years that can also be effective – transverse friction massage.

Transverse friction massage uses deep cross-fiber manipulation of the connective tissues of the affected area. It can cause a small amount of discomfort when the technique is applied, and the area can actually get reddened and inflamed afterward.

That’s the whole point.

The body is thrown back into the first phase of healing. But this time, you make sure your body heals the right way. You give the area the right amount of rest and support initially, but as quickly as possible challenge it with the appropriate movements so the fibers know how to align themselves and strengthen. In addition, you may need extra water and protein in your diet to have the raw materials to manufacture all the healing chemicals and structural fibers you’ll need.

So if your healing process is stuck in neutral, perhaps you need a more modern approach to healing. Transverse friction massage may be your answer to get unstuck.

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About Ronald Lavine, D.C.

Dr. Lavine has more than thirty years' experience helping patients alleviate pain and restore health using diverse, scientifically-based manual therapy and therapeutic exercise and alignment methods. His website, askdrlavine.com, provides more information about his approach. Please contact him at drlavine@yourbodyofknowledge.com or at 212-400-9663.
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