Well, shit happens. Injuries happen. Being banged up is just part of the game. Dave Tate has a great post/article about the differences between being hurt, injured, and just plain fucked up. Right now I'm just hurt. It limits me from doing some things completely, causes me to second guess other things, and inhibits other synergist muscle groups from doing their job as well.

I suffered a small triceps tendon tear to the distal attachment at the elbow. There was swelling and some edema from the bursa being inflamed. There was no loss of range of motion, and strength remained to some degree. This is how I knew it was just a grade 1 tear and wouldn't need any assistance via docs.

Below is the outline of Phase 1: Acute phase 24-72hrs

1. Immediately post injury I limited as much excessive elbow movement as possible but did not immobilize it.  There was zero direct elbow extension and allowed the healing and inflammation process to begin for the first 24-72 hours.  I used slight compression on and off to push lymph though, as well as passive assisted elbow flexion and extension via my other arm at day 3.  No added modalities were used at this time in order to not increase inflammation and possibly cause further damage. I did as mentioned above, use some assisted compression on and off to assist the body in moving the fluid.

  • rest and limit movement but do not immobilize completely unless you can further damage the tissue with additional movement
  • do not add any modalities that may cause further inflammation like, heat, IASTM, deep tissue etc.
  • begin passive assisted range of motion as soon as possible up to barrier of pain.
  • If in pain use ice to relieve pain, but stay away from NSAIDS
  • compression over ice if it is pain free

Phase 2: Acute phase 3 days to 1 week.

At this point I had full range of motion but some pain and stiffness pretty consistently throughout the day. I had the majority of pain in full flexion and full extension which told me the tendon is the issue not so much the muscle or musculotendinous junction. The healing process was happening quicker than I expected so I began to introduce modalities to help lay down good scar tissue as well as keep the muscle from any atrophy. Atrophy can happen as quick as 6 days. I knew the tissues were healing via the constant itching and raised temperature of the area.

At this point I started introducing passive assisted range of motion exercises as well as active range of motion exercise in multiple planes of motion. This was progressed quickly to very light tension with an elitefts micro-mini orange band. Once full active range of motion was accomplished with minimal pain we then progressed into phase 3

  • Introduce active and or passive or assisted range of motion exercise
  • introduce low level modalities like easy effleurage, e-stem, compression and mobilization if your ROM allows it
  • look for full active range of motion in multiple planes of motion related to the injured muscle
  • heat can and should be used prior to self therapy care

Phase 3: Loading and tissue restructuring phase 1 week plus+

As soon as resistance, manual or other can be tolerated through a full range of motion  with little pain you want to add in modalities that will help lay down the scar tissue. This can range from massage, effleurage, IASTM, cupping, ART etc. It is better to be less aggressive than more in the early stages. I was able to perform my own light IASTM to the triceps tendon and forearm attachment. E-stem frequency and intensity was increased to 3-4 times per day with heat and ROM. I literally carried a heat pack and my stem machine wherever I was and most places have a  microwave nearby. I literally heated up my pad in the microwave at a 7-eleven. Constant isometric contractions at end range extension were done during the day, well over 100+

    • Introduce resistance as soon as possible no matter how little. Must be in a full range though. DO NOT add resistance through a partial range of motion.
    • Start using modalities to help keep scar tissue and remodeling tissue in good form.
    • Static isometric exercises should be used throughout the day as much as possible. You may even feel fatigued from this, that's ok
    • Use all ranges of motion of the muscle being rehabbed. Even as a secondary or synergist muscle you need to take that into account.

Things to remember....

This is all based on the severity of an individuals injury, current and past injuries, training state, recovery state, training age and movement age. These phases are subject to my recovery capabilities. I am of course more aggressive with myself then I am with patients. First, seek medical advice and always consult a doctor if need be. The information presented above is not meant to treat, cure, or prevent  injuries and should be read for educational purposes only.

Stay tuned for PART II

Exercises prescription, loading, programming and more!