Complete Recovery from an Injury

by Lawrence Gold Personal Page

certified Hanna somatic sducator

Associate, The Novato Institute for Somatic Research and Training

What's the missing link in rehabilitation that makes recovery from injury take so long? What's needed to recover completely?

Y ou may know of an individual who has been injured and who has never completely recovered from the injury. But you may not know why he has never completely recovered. Here's why:

This person you know may be a professional athlete you may have read about (e.g., Andre Agassi) or a member of your team or a friend. His performance may have suffered or his athletic future may be uncertain. If it's someone you know personally, you may notice that he may not move as well as he once did or he frequently gets re-injured or wears that "athletic badge of courage", a brace or ace bandage. He may not complain of pain but the way he moves makes you feel that he may never be the same. You may be such an individual.

Can an injured person ever get to the point of complete recovery from injury, to the point where he can move as well as he did before he was injured -- and without fear of re-injury? How about better than before injury?

If muscle, ligament and bone are intact, no brain damage was involved, but movement patterns have changed, then the answer is almost certainly, "Yes."

That situation is more common than people know, so often are "ligament injuries" an incorrect diagnosis (because if it's hard to correct, "it must be a ligament injury"), so often is a "torn tendon" or "muscle micro-tears" blamed, so often are therapeutic measures to restore normal muscle function ineffective (for reasons I will discuss, below).

A missing link exists in therapy for recovery from an injury. To understand what that missing link is and how it can be filled, let's take a fresh look at therapy and and expectations of recovery. To begin, let's, look at what happens in an injury situation, then look at the recovery process to see what's been missing and what's now available and from where it is available.

The Common Understanding of Injuries

  • TISSUE DAMAGE

    Bones get broken, ligaments get sprained, tendons and muscles get torn, skin gets cut, etc. The usual stuff of injuries, these are all forms of tissue damage.

    Tissue damage heals. So, reason compels us to this recognition: If the person doesn't recover completely from their injury, it's not because of broken bone, sprained ligament, strained tendon, or torn muscle. It's something else.

    Why do some injuries become chronic injuries?

  • ADHESIONS

    One commonly advanced explanation is "adhesions", or "scar tissue adhesions".

    Adhesions are the body's way of bandaging itself. They occur when, during healing, layers of connective tissue become "glued" to one another. This actually happens. That gluing restricts movement -- especially desirable during healing, but becomes completely unnecessary and detrimental once tissue has healed.

    Adhesions can easily be freed by massage, and those who have received physical therapy after an injury often receive massage, especially athletes. Why, then, do the effects of injury linger?

    It can't be tissue damage or adhesions. It has to be something else.

The Missing Link: The Trauma Reflex

Everybody has experienced the Trauma Reflex. It happens when you twist your ankle during a game and limp to the sidelines. It happens when you burn yourself pulling something out of the oven and almost drop what you were holding. It's what happens in a motor vehicle accident when you get rear-ended and your neck gets stiff. It's "pull away, hold tight, and protect."

Trauma Reflex is the universal protective reflex; people cringe reflexively during injury and protectively guard the injured part after injury and during healing. That reflex is called "Trauma Reflex"; it's an instinctive, self-protective mechanism with survival value.

However, Trauma Reflex often persists long past the time of injury, commonly for decades. Such persistence is sometimes confused with malingering by those (e.g., Worker's Comp doctors) who don't recognize the reflex for what it is: a sign that the shock of injury has made a lasting impression on a level of the brain that controls muscular behavior at a subconscious level, on autopilot, causing the protective movement patterns to persist as if the injury is still in place or the injury event is still happening. The protective Trauma Reflex becomes a tension habit that interferes with the person's life quite outside their ability to control it. Can you recognize it in yourself?

Trauma Reflex prevents a person from moving as freely after injury as before; more than that, it predisposes the tense muscles to contract first and to relax last in times of stress. It prevents full recovery from injury and may predispose a person to further soft-tissue injuries. More than that, the heightened tension in those muscles creates muscle fatigue and soreness -- lingering pain.

Failure to release the cringing response predisposes one to further injury and creates the sensation of lingering injury.

Getting Free from Lingering Cringe-Response (Trauma Reflex)

Although each injury has its own unique pattern, all injuries have Trauma Reflex in common.

For that reason, retraining of the Trauma Reflex must be a part of every therapeutic intervention intended to complete your recovery from injury. To fail to do so leaves the effects of Trauma Reflex intact, which is why so many people take so long to recover from injury with standard therapeutic modalities such as ice, heat, strengthening, stretching, electrical stimulation (TENS, microcurrent), manipulation, massage, iontophoresis (ultrasound), laser treatment, and other common modalities.

You can't get free from from Trauma Reflex by stretching, tissue manipulation, by drugs or by surgery because Trauma Reflex doesn't originate in the tissue; it originates in the brain's conditioning, and you can't change the brain's conditioning by stretching, manipulation, drugs or surgery. You have to change conditioned responses by re-training the brain. This kind of brain-retraining process, called clinical somatic education, is the missing link in recovery from injury.

What does clinical somatic education look like? Click to see the actual process: clinical techniques and somatic therapeutic exercises.

Read more about clinical somatic education.

For a more technical comparison of various therapeutic methods to somatic education,
read A Functional Look at Back Pain and Treatment Methods.


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