In your life, you may know individuals who have been injured and who have never completely recovered from their injury. They walk with a limp, their posture is distorted, and they may complain of pain. If you see them in an athletic setting, you may notice that they may not move as well as they once did, that their athletic future is uncertain, or they frequently get re-injured.
Is there no hope for them?
Regrettably, the answer one has most often heard is, "probably not" -- that is, until recently.
Perhaps it's time for a fresh look at the answer to that question. To begin, let's take a fresh look at what happens in an injury situation.
Number one is tissue damage. Bones get broken, ligaments get
sprained, tendons get strained, muscles get torn, skin gets cut, etc.
The usual stuff of injuries.
Tissue damage heals. So why do the effects linger?
Adhesions and Trauma Reflex
One commonly advanced explanation is "adhesions".
Adhesions are the body's way of bandaging itself. Layers of
connective tissue become "glued" to one another during the healing process, and that gluing restricts movement -- especially desirable during healing.
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?
Here is where the number two explanation comes in, and it is at least as significant as the first: People cringe during and after injury and guard the injured part during healing. That action of cringing is a muscular action of the nervous system known as "Trauma Reflex." The Trauma Reflex is a self-protective mechanism with survival value. However, that reflex often persists past the time of injury. Such persistence is not malingering; it's a sign that the shock of injury has made an impression on a level of the brain that operates at a subconscious control. It turns the Trauma Reflex into a tension habit fixated in the person's life.
Such a tension habit 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.
Releasing the Cringing Response (Trauma Reflex)
The cringing response cannot be released by stretching, tissue manipulation, by drugs or by surgery because it doesn't originate in the tissue; it originates in the brain.
The brain is largely an organ of learning or conditioning. The
cringing response can be ended only by unlearning it.
The idea of "unlearning" is an odd one. We are used to thinking of learning, of gaining new abilities. Mark Twain once said, "It ain't what people don't know that gets 'em in trouble; it's all the stuff they know that just ain't so." When a person gets injured, they learn to protect the injury to avoid pain. It's not mental learning, as in the schoolbook or "life experience" sense, but a bodily learning at the level of reflex actions, conditioned responses governed by the level of the brain outside voluntary control. After tissue has healed, conditioned reflexes continue to protect the area by tightening muscles. What "just ain't so" is that you are still injured (even though you have pain). The lingering pain is caused by muscles in contraction to protect a non-existent injury. The result, shooting pains, spasms, and soreness,
come from the protecive reflex, itself, not your injury.
Since conditioned reflexes are learned action patterns, a learning-based approach is necessary for complete recovery from injury.
The term for this type of learning-based approach is "somatic education".
Read more about somatic education.
For a more technical comparison of various therapeutic methods to somatic education,
read A Functional Look at Back Pain and Treatment Methods.