Last Sunday, we watched a gripping Australian Open Men's Final between Nadal and Federer - both of whom had seriously injured themselves last year and were unsure whether they'd even return to tennis. Federer had a meniscus tear in his left knee which required surgery, and Nadal had a left wrist injury which has been reported as a torn tendon which had to be immobilised for several months.
Elite athletes have open-access to the best medical teams in the world, so it's not very surprising that they recovered quickly, but it is remarkable that they both went from the bench to a grand-slam final in less than a year. That takes more than just money and a good therapist - that takes an exceptional, comprehensive rehab program and total focus and determination to get through it.
Below are a few line items that would have appeared on both Federer's and Nadal's program that you can do to quicken your recovery, and return to sport faster.
1. Release tight muscles before you strengthen weak muscles.
Every time a muscle contracts, its antagonist (opposite muscle) must relax. If the antagonist is too tight to relax, it will massively increase the load of the contracting muscle. That increased pressure might be enough to damage the muscle tissue, making any strengthening work you do, counterproductive.
As an example, if you are trying to lift your arms above your head while you've got tight lats and pec muscles, then your shoulders aren't just lifting your 10kg arm, they're also pulling against the 50kg strength of your lats and pecs. If you've already got weak shoulder muscles because you're recovering from surgery or injury, then they are going to get damaged.
2. Start moving ASAP (while following professional advice)
There is a period after injury or surgery where movement should be limited or even totally restricted. This time allows for healing on a tissue-level and is fundamental to recovery. You can't rush this time, but you also shouldn't unnecessarily extend it. Although immobilisation aids healing as a cellular and tissue level, it doesn't support healing at a musculoskeletal level - in fact, it hinders biomechanics and can prolong healing.
Surgeons know this too. The foot and ankle surgeon that I refer my patients to, for example, doesn't opt for stiff and restrictive tendon reconstructions, rather for a more dynamic approach which heals faster, allowing for earlier (albeit longer-term) balance and strengthening exercise. That approach isn't just his personal preference - he does it because it recovers faster, has fewer complications, and lasts for longer.
3. Re-learn your sport
You might think that kicking a football is simple, but it is a complex function of biomechanics which requires several processes to perform successfully. After surgery or serious injury, your biomechanics will change: muscle strength and elasticity will change, limb length with change by some millimetres, the joint movement will change - all of this will contribute to an increased risk of injury and decreased performance unless you re-learn how to play your sport.
To go back to the Australian Open as an example, Federer and Nadal both changed their style of play slightly as a result of their injury.
Federer has a wider stance, and squares his hips to the baseline - this takes the pressure off his knees when he needs to change direction quickly, thus decreasing the risk of reinjury, but also allowing him to use his reliable, uninjured hip to turn instead of his unreliable, injured knee.
Nadal keeps both hands on his racquet and uses his forehand more than he did in 2015. That will help to keep the racquet in his hand without putting pressure on the tendons in his left wrist.
The golden rule with surgery and serious injury recovery is to do what your medical team says, but let these three tips guide you in your expectations, and your conversations with your medical team, and let you recover much faster.
For more information on specific injury rehab, email me directly via the contact page. For specific information on an injury you have, or for treatment, contact one of my clinics directly. You can find that information here.
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Dr Mitch Clark