Exercising When Injured
We have all experienced some sort of injury while exercising. There are two types of injuries: acute, dropping a plate on your foot, and chronic, like plantar fasciitis (bottom of foot pain). When injured we think in extremes: work through the pain or do nothing, but there is a third option; active rest. Which is a very fancy way of saying working in a pain-free range of motion.
There are many kinds of acute injuries that can lead to innumerable kinds of diagnoses. For simplicity, I am going to talk in terms of strains and sprains. Strains are defined as muscle injuries, i.e., a knot in your back. Sprains are ligament (soft tissue that holds joints in place) issues, i.e., rolling an ankle.
Both strains and sprains have varying degrees or grades of injuries. They are typically described as Grade I, II, and III.
Grade I strains and sprains are small damage to the tissues of the body. In most cases you might have a Grade I sprain or strain and never even feel it.
Grade II strains and sprains are the injuries that you mostly feel. When you have one of these injuries you may have swelling at the injury site, deep pain, and difficulty moving in a normal range of motion. This category of injury has even more degrees of injury, but I am just keeping it simple here.
Grade III is the most serious injury you can have. This is a complete rupture of the tendon or ligament. In muscles, the tendon snaps and the muscle balls up at the origin of the muscle, i.e., the biceps balls up by the top of the arm. A common Grade III strain is tearing the ACL in the knee. The common report is planting the foot and turning, then "hearing a loud pop." For Grade III injuries, there is no pain. The reason there is no pain is because the nerves get severed, so there is no way to feel the pain. It is the one benefit to one of these gruesome injuries.
Chronic Injuries
There are two kinds of chronic Injuries: overuse and repeated injuries. On the surface they seem to be the same, but there is a difference.
Common overuse injuries are shin splints, golfers elbow, little league elbow, and plantar fasciitis. In all forms of chronic injuries it is doing the same motion over and over again. The damage is typically done by eccentric (elongating and activating muscles), which is the body braking or slowing down movement.
Repeat injuries are slightly different from chronic injuries. They occur in areas where you have been previously injured. An example of this is when you hear of a person constantly "rolling their ankle." This injury keeps happening because of some weakness around the joint, making you more prone to injuries later. Another issue unique to repeat injuries is the first time you injure something like a ligament, it swells up really bad. However, after the initial injury, the area does not swell up as bad in subsequent injuries to the same area.
Treatment
RICE - Rest, Ice, Compress, Elevate is the go to treatment for acute and chronic injuries. The purpose of RICE is to stop our bodies from overreacting to injuries. Our bodies are still in caveman days when it was life or limb and our bodies always chose life.
Rest gives the body time to heal.
Ice is used to alleviate pain and reduce swelling. Pain causes the body to react with a muscle spasm, which in turn causes more pain. The body is warm to the touch around a wound because it is trying to get blood flow to the area. The blood contains platelets to close a cut and other nutrients to help the wound heal. However, it is a positive feedback loop, which means left unchecked it will go for long periods of time before stopping. The ice helps to break the loop and stop the swelling.
Compression helps the body clear the extra fluid from the area that is swelling. It also helps the muscle milking process to get the blood back to the heart. All of this helps prevent clotting and swelling from cutting off circulation.
Elevate the area above heart height to help get the blood back to the art. In conjunction with compression, this helps clear out excess fluid from an area that is swollen.
Pain Relievers
Non-steroidal anti-inflammatory drugs (NSAIDs) and steroidal anti-inflammatory drugs can also be used to help with pain and swelling. The difference between the two is NSAIDs can take upto 2 weeks to build up in the body to get an anti-inflammatory effect. Steroidal anti-inflammatories can usually clear the issue up in about a week.
It will depend on the severity of your injury for what a doctor will prescribe. Obviously a steroidal anti-inflammatory is the gold standard, but it is not always necessary. My rule of thumb for a sprain or strain is to wait about 2 weeks with RICE and NSAIDs before I consult a doctor. However, if after a few days things are not getting better, I would go to the doctor just to be safe.
Exercising When Injured
You may be thinking to yourself that 2 weeks is way too long to not exercise. And you are right. Just because you are injured and waiting for an injury to heal doesn't mean you can't work out. The goal with your workouts is to find movements that don't hurt an injured area. You can also work a different muscle group that is uninjured. This is called "active rest."
Also, if you want to stretch an injured area, you should wait about 3 days for the area to get better before stretching and go rolling. It is possible to damage fibers more if you try to stretch while the area is injured. After 3 days, you can also heat an area instead of icing. The inflammatory response is usually over after 3 days and heat feels better than ice.