Why 6 Weeks to Return to Sport?

In a word, scar tissue formation.

Interestingly, the way the body deals with an injury is by forming scar tissue. We repair, and we do so with remarkable alacrity. The process of the scar both becoming stable and tolerant of tensile stress is pre-determined. Assuming everything goes well, there are very specific time lines.

• Between 0 and 4 days, there is no prepair per se', just bleeding
• Between 4 days and 15 days the construction of the "scaffolding of repair" takes place. This scaffolding is not tolerant of tension, but it gradually picks up strength
• By day 21, the scar achieves 15 percent of its final tensile strength. This is good because at three weeks loading is important to help organize the scar and make it as strong as possible - more of this later.
  
• By day 42, six weeks, the scar achieves about 40% of its final integrity, and there is much that one can do on a scar like that has achieved this level of tolerance without irritating the injury.
• And by day 90, the scar achieves 90# of its final integrity.
  

The process that the scar undergoes, building of a scar from the initial injury, is significantly impacted by the introduction of tension. The reason for this is that the cells that build scar, fibroblasts, have a pole like the earth has a pole, and with intermittent tension, the cells align themselves parallel to the lines of stress, and the scar tissue fibers they lay down are also placed parrallell to the lines of stress. This leads to a stronger and healthier scar that is tolerant of stress as those fibers bond with adjacent fibers.

Why Use a Stick

The Stick is a wonderful tool that we use here in the clinic almost every day and on almost every patient. we actually sell them here, but you can also buy them at their website too.

We use The Stick two ways:
- To smooth out dense connective tissue thickenings and
- to treat "trigger points" in the muscle.

Trigger points were first identified by Janet Travell, MD, President Kennedy's physician. These are microscopic areas of inflammation in the muscle tissue that lead to local muscle fiber contraction. Trigger points are palpable, painful and they interfere with normal muscle function. The Stick is used to treat these trigger points in a "seek and destroy" fashion. Yes its painful! The key is to find the trigger point, press hard and maintain the pressure as long as you can to let the trigger point resolve. You should find an immediate increase in flexibility of the muscle. Allow a day or two to pass before you do it again.

The other way we use The Stick is to "brush" the dense connective tissue. we do this by rolling gently, but deep enough to affect change in the way the tissue feels. It is not so much a trigger point level of pressure, but rather the rolling can be a before or an after exercise activity. My athletic patients who use the stick find this to be a very worthwhile process.

My theory is that the benefit of The Stick accrues because local dense connective tissue trauma produces local dense connective tissue scarring. That local scarring produces a local thickening of the tissue, that in turn interferes with normal function, ie elasticity, of the tissue. Using The Stick over time leads to a softening of those local scars, and allows the normalization of the elastic properties of the dense connective tissues. In turn, muscles can cantract and develop tension normally, and the overall function of the part improves perceptibly.

There you have it.

Again, if you would like a Stick, we carry a couple of them for sale.