Old Injuries coming back to haunt you.

Ouch.  This broken arm apparently came from a bout of arm wrestling.  Modern medicine is excellent at sorting out acute situations.  Acute means it has just happened.  So this break to the upper arm will be mended toot sweet.  A few weeks in plaster and, if lucky, a few physiotherapy sessions and job done.  But is the job done??  When a bone breaks – or a joint is severely traumatised as in an ankle sprain or strain ((The difference between a strain and a sprain: strains tear muscles, sprains damage ligaments.  Neither is good, but muscles will repair properly if treated well throughout the healing process.  Ligaments, due to their non-elastic nature, tend to suffer from permanent damage.  Not good. )) – the muscles, especially the deep structural muscles,  surrounding the traumatised area contract as much as possible to try to protect it and as a result will now be in spasm and may or may not be damaged.  This means they will not be able to relax, return to their original length and work properly to move the adjacent joint about.  Added to this, whatever the injury it certainly hurt and was painful for quite a time afterwards which causes us to protect the joint.  If an arm, we round our shoulders, and hold the arm into us.  If a leg/ankle injury, we put as little weight on the leg as possible.  If the injury was to the head or neck, those shoulders will be up around the ears and rolled forwards and the head poked out.  These changed movement patterns are learnt deep in the brain and will remain lifelong unless properly addressed.  And, as a final insult, with this shortening around the joint the overlying fascia also shortens, making muscle lengthening impossible.

So if we take the typical course of events following the above arm break.  The arm is plastered up, usually with the elbow bent to a 90° angle. In due course, it is pronounced healed.  If we can move the arm through most of its full range of movement, we are considered fit to go. Of course, the muscles of the arm are now completely puny and it still hurts to move the arm.  But after a few days of use, it feels as good as new.  In truth, the muscles will still be in spasm, the fascia in front of the elbow crease will be shortened and our brain’s ‘map’ of how the elbow, wrist and shoulder joint should move has become blurry ((The brain is far more wonderful than we can yet understand.  Each joint in the body should be able to move throughout its full range of motion.  Due to lack of use or injury, this range of motion slowly goes down.  Now the brain has a map, like a GPS or SATNAV of each joint and with injury or lack of use, this map literally becomes blurred,so the brain is a bit unsure how to move the joint about. This makes it shut the muscles down around the joint, which starts to affect adjacent joints – and so it goes on until we are crawling along through our senescence – unless we start the great battle towards reversing this whole thing.  Crikey, one huge subject dismissed in a couple of sentences in a footnote.  Bravo for getting this far.))  This is unlikely to be noticed until we are either ancient and wizened, holding our arm bent into ourselves.  Or until we decide to become more active and join a gym and start shoving weights about – or take up cycling, squash, yoga or resume arm wrestling, come to that.  Things go well at first, then, after a bit, as we work harder or spend longer on the bike, the grip weakens and the arm becomes very painful.  We may get headaches or neck ache. Typically this is ignored at first and we continue to work through the pain.  Eventually the pain is too great and the activity ceases.  Now we are in a real mess and it will take months if not years to sort it all out.  It depends how long it has been ignored.  If we are not active, then, as I said, the problems will not become apparent until we are old.

Typically, due to the pain and protective instinct, the shoulder will be lifted and rounded, so all the muscles that lift the shoulder will be over tight.  Incidentally, these are also the muscles that contract first when we are surprised – they are the muscles that get tight when we are unhappy or stressed, so upper body injuries have emotional consequences too.  When the shoulder is permanently lifted, the muscles that should hold the shoulder down and in position become completely weak, and the shoulder very unstable.  The fascia surrounding the shoulder and the elbow is shortened, and, as said in the blog on fascia, fascia is interconnected so this will be having an effect throughout the body.  It is entirely possible that the injury to the upper arm can be a prime cause of knee or ankle pain because of fascia.  So if this person were to take up running instead of arm wrestling, he or she will almost certainly have problems in the leg.  And, of course, an injury to the lower body will cause the shoulders to lift in response to the pain and so can lead to upper body injury due to shoulder instability.  Any major trauma to the body affects the whole body and mind.  Simply putting the break into plaster until mended is only the start of the journey to recovery.

So if we have an injury that causes pain and swelling or a fractured bone, no matter what age we are, this injury needs more attention than merely waiting for it heal.  It needs good massage, stretching, full movement regained in the surrounding joints and then strengthening.   If we have to stop an activity because of pain and discomfort, the worst thing we can do is just give up on it.  The best thing we can do is work out why it hurts, do all we can to get to the root cause – and then, when ready, resume the activity.

This applies to adults and children.  So if your child has a horrible fall, for example, down the stairs or flies over the handle bars of their bike and bangs his or her head, yes, take them to A & E to get them checked over and, once the initial trauma is over, take them to a high quality massage therapist or trusted chiropractor/osteopath to get the neck and back alignment checked out. It is wise to pay attention to a child complaining of, say, back ache.  Incidentally, if the child is a baby and, say, falls out of its high chair landing on its head or had a forceps delivery, hanging them upside down by their ankles will re-align the neck.  If worried about doing this, then take them to a professional to do it.  Whatever we do, ignoring major traumas will store up years of pain in years to come.  Paying attention to sudden aches and pains coming on for no apparent reason, doing something to sort it all out gives us a chance of growing old gracefully and actively.

Dedicated to Jo.