Why do Injuries Occur?

The simple fact is that injuries occur when demand exceeds supply. That is, when the stress on the tissue is greater than the structure's ability to withstand this stress. Musculoskeletal injuries can occur from a single incident, a fall skiing, twisting an ankle, or lifting a heavy weight. Injuries can also occur because of a slow process as the result of repetition of movements and postures that, slowly over time, decrease the strength of the structures until they are no longer able to withstand the stresses that are demanded of them.













Several factors may predispose us to injury. Some factors are more important than others for various injuries and in different regions of the body. We will only discuss them in general terms, and to simplify, we have divided them into two categories, intrinsic factors and extrinsic factors. Intrinsic factors are elements within our body that may predispose us to injury, usually by affecting the body's ability to withstand the stresses demanded upon it (the supply side). Extrinsic factors are outside factors that predispose us to injury usually by increasing the demand made upon the structures of the body.

Injuries may occur as the result of a single trauma (macrotrauma) or from repetitive motions and postures that weaken the structure over time (microtrauma). In either case, the response is the similar. The structure(s) become damaged resulting in inflammation and pain.  The healthy body has an inherent capacity for healing.  In order to do so, it requires a proper conditions and environment.

Injury prevention and rehabilitation is geared to creating an environment that is conducive for healing, decreasing the stresses placed upon the injured structures, and increasing the resilience of the different structures of the body to withstand what is asked of them.  When a tissue is injured it's strength and resilience is compromised and is therefore weaker.  
Progressive stress that involves functional increase in demand of the tissue as the tissue is healing, encourages adaptation and healing.  This allows for the structure, be it muscle, tendon, ligament, inter-vertebral disk or other to heal more quickly and decreases the risk of re-injury.  
  

A demand on the tissues is caused by stretching, or in the case of tendons and muscles also by contraction.  If the strain is greater than the tissues capacity to withstand (macrotrauma), failure (injury) occurs.  A continuous strain at low intensity but for prolonged periods also may weaken a tissue and result in injury​ (microtrauma).  This occurs when the tissue is not given sufficient time for repair.



Source of image: http://www.somastruct.com/wp-content/uploads/2012/08/stressstrain.jpg

The key elements for injury healing are:

An injured tissue is weaker.  It needs to be protected initially. As it is healing the structure gains strength. Progressive exercise and treatment that incrementally increases the stress on the structure is beneficial and will stimulate repair and regeneration.  Under normal circumstances your body is the inherent knowledge and machinery to heal.

Functional progressive treatment and exercise helps promote healing. The structures of your body react to the stressors we impose upon it.  Our body reacts to stress in order to meet the demands, and if this stress is repetitive in nature, and time is given for your body to make adaptations, long term changes will also occur.

Too aggressive therapy, exercise, or activities may re-injure the area and retard healing while a lack of stress may not stimulate the adaptive changes necessary to drive healing. 

Osteopathic treatment attempts to help the natural self-regulatory process of the body by attempting to remove mechanical or other forms of obstruction that may have contributed to the etiology of the injury or illness, and to create an environment the most conducive for healing.

Your mindset, your beliefs and expectations all have an influence on your capacity to heal and conversely in the development of chronic conditions.  For example, psycho-social variables are better predictors for the development of chronic conditions of the back than are the physical findings.
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© 2018 by René Pelletier, D.O.