Many athletes ask a common question: How long until I fully recover? With many conditions, injuries, and surgical procedures we see have different rehabilitation time frames, but here are some general tissue healing guidelines –
The healing process for different injuries
Tissues include different categories – muscle, tendon, ligament, and bone. Each tissue comprises Cells, elastin, collagen and proteoglycans. The make-up of each substance gives each tissue-specific properties such as extensibility (the ability to stretch), elasticity (ability to recoil), strength and overall structure.
Tissues are a bit like clothing; E.G., different blends of fabrics produce the effect of being stretchy, wrinkle-free and soft. Tissues are also composed of different materials; thus, they do not all have the same healing time.
Different injuries and tissue types
Over 400 muscles in the body allow an individual to maintain their movement and posture and absorb shock while moving. Muscles can become overworked, causing muscle strain. Muscle strains are categorized from grade one to three depending on the severity of the tissue damage. Severe injuries need three months or longer, while minor injuries may take only two weeks to heal, extreme cases may require surgery, which also lengthens the healing time.
Tendons are also a common injury. Tendons are connective tissue that connects muscles to bones and transmits forces generated by the muscles, allowing a movement to happen. Tendon damage results from a cut, bruising, or over exertion causing failure. Tendon injuries heal in about the same time frame as muscles, except when surgical treatment is required, in which case recovery is four months to a year. Tendons heal 80 to 90% at seven weeks, but complete healing may take up to one year. There is a risk of recurrence If too much stress is applied to the tendon during the healing phase. Physical therapy is essential so the optimal levels of stress and motion are used, and the tissue can re-form properly.
ligaments are another commonly injured tissue. Ligaments connect bones to bones and provide stability to joints. They facilitate motion and also prevent extreme movements that could cause injury. The ACL is one common ligament prone to injury that may be far too familiar to some, and some ACL injuries may require surgery; minor ligament sprains can take up to four weeks to heal, and moderate sprains may take more than ten weeks. If surgery is needed, the healing time increases from six months to a year.
Broken bone injury
Lastly, bones support the body and serve as attachment points for ligaments and tendons. Breaking a bone is not uncommon; A fracture in larger bones can take up to 12 weeks to heal, and they may fully recover for up to a year. Interventions typically involve surgery, immobilization in a cast, or time spent in a boot. Regardless of the treatment course, time and patience are necessary to reduce stress on the area and allow the bone to heal properly.
How serious is my injury, and when will it heal?
Soft-tissue injuries are usually graded from 1-to 3 by physiotherapists and healthcare professionals.
Most soft-tissue injuries are grade 1 or 2; if you had a grade 3 injury, you would most likely be in A&E or seeking help immediately.
Grade 1 – Used to describe a mild sprain, strain or tear. These injuries will present with swelling and tenderness but usually, heal within 2-3 weeks with the right care at home.
Grade 2 – More extensive damage and with more soft tissue involved. These injuries can take 4-12 weeks to recover fully and may require input from a physiotherapist.
Grade 3 – Used to describe a serious or complete rupture or tear, sometimes accompanied by a bone break. These injuries require urgent medical attention, X-rays and sometimes surgery.
If you are worried about your injury, seek urgent medical advice.
What should I do within the first 1-3 days? During the first three days of an injury, your body enters the ‘inflammatory stage’. This stage is often the most painful and needs the correct management, known as PEACE:
P Protection – avoid activities and movements that increase pain for the first few days
E Elevation – elevate the injured limb higher than the heart as often as possible
A Avoid taking anti-inflammatory medication as they can reduce tissue healing. Avoid icing for more than 5 minutes.
C Compression – use a compression bandage or taping to reduce swelling.
E-Education – your body knows best. Avoid unnecessary treatments and medical investigations and let nature play its role.
What else should I avoid?
You should remember the ‘NO HARM’ protocol for the first three days after an injury. Avoid
These activities may prevent or slow down the healing process.
What should I do after the first three days?
After this time, and for the next 7-14 days, the injury needs LOVE:
L load – let pain guide your gradual return to normal activities. Be patient; listen to your body as you safely increase the load.
O Optimism – condition your brain for optimal recovery by being confident and positive
V Vascularisation – choose pain-free cardio-vascular/aerobic activities to increase blood flow to repair tissues. Compression boots are a good option.
E Exercise – restore mobility, strength and balance by adopting an active approach to recovery.
Here’s some more information about some of these stages:
Avoid any activities that increase pain and protect the area from further damage. However, complete rest should be kept to a minimum as this can delay the repair.
Move your injured part little and often into directions that do not cause sharp pain when sitting down or when no weight is going through the area. Do not move into any positions that caused the injury in the first instance. For example, if you twist your knee, don’t twist it in the same direction or position again.
Using a brace or splint may be helpful, depending on the severity of the injury.
Keep the affected area supported and higher than the joint above it.
For example, if the injured area is your ankle, sit with your leg straight, supported on a pillow to raise it higher than your knee; this will prevent excessive swelling.
Swelling this should be addressed within the first three days.
Avoid anti-inflammatories and icing for long periods.
Icing the area can help with pain relief, but it may also interfere with healing tissues if applied for long periods. If you’d like to use ice for pain relief, follow the steps below during the first three days; after this, you can use ice for up to 20 minutes.
Rub some barrier oil or moisturizer on the area you are going to ice. This can be olive oil, vegetable oil, almond oil or whatever you have. This helps to avoid any sticking.
Wrap crushed ice, frozen peas or a chill pack from the freezer in a clean and damp tea towel.
Place over the area and secure with another towel.
Never place your calf or thigh on top of the ice. Always place ice on the body part as the extra compression can increase the risk of an ice burn.
Leave for 5 mins and remove if it gets painfully cold (after three days-this can be left for up to 20 minutes).
Repeat every 2 hours for acute or severe injuries or 3-4 times daily for less serious injuries or complaints.
The skin will look pink when removing the ice, but this is normal.
Do not apply ice if you have any loss of sensation or numbness in the area, extreme sensitivity to cold, poor circulation in your hands or feet, Raynaud’s disease or broken skin.
Some people find a compression bandage or support helpful in the early stages of a soft-tissue injury. This is optional, not essential, and should not be used if you are also elevating the area. More recent tools such as compression boots are a good option for reducing swelling and speeding up the healing process by enhancing blood flow.
Then after three days…
This is a technical way of saying keep the area moving as much as possible and within your comfort zone. You can still do this by using a brace or splint to support the area.
During this period, the injured area will still feel quite sore, weak, swollen and difficult to move.
This is when small, controlled movements can help the healing tissues form in the right direction and pattern to ensure the newly healed area becomes flexible and strong like the original tissue was.
Frequent movements in all directions the area will move into will help. This should not be against any weight or pressure, just gentle repeated movements every few hours.
Over the next few weeks, your symptoms should improve quite rapidly. If your pain persists beyond this time or you have any concerns or questions, contact your physio for further assessment and treatment.
When should I seek additional help?
Most minor acute soft-tissue injuries will heal well on their own if you treat them correctly, but sometimes you may need additional support to rehabilitate the area fully.
If you have seen no improvement to your injury within 3-4 weeks despite following the recommended guidelines, you should speak to your physiotherapist or G.P.
How long do take micro tears take to heal
This will depend on the micro tears and soft tissues involved and the severity of the injury. Soft tissue injury recovery time is also influenced by acute conditions and age, medical conditions, and nutritional state. The time frames mentioned above are not for specific injuries. Hopefully, we have provided a starting point for understanding the timeline of micro tear healing.