When anyone suffers from an injury or is in pain it is completely natural to wonder what went wrong and how we can avoid it from happening again.
In most cases it boils down to a simple equation of load vs capacity. Every tissue in the body has a certain capacity. If we apply a load that is much greater than the tissues capacity, there is a higher risk of pain or injury. If we apply that load slowly over time and give time for that tissue to adapt to that load, we should be fine. This is because the capacity of those tissues will slowly increase, for example muscles will get stronger, bone density will increase, and tendons become more resilient. However, if we apply that load quicker than the tissues can adapt, we are more likely to get injured For example if you drop a brick on your foot, the load is much greater than the capacity and it is applied abruptly so there is no time for adaptation.
The more common scenario we see is someone starting a new activity quickly. Again, the load is greater than the capacity and although it is not as abrupt as trauma, it is still quicker than the body is able to adapt. So, the tissues start getting damaged and the capacity actually goes down.
In both these two situations the load is applied faster than the tissues can adapt.
On the other hand, sometimes we are smart, and we keep a workout routine or running load constant. All is well until stress, illness, poor nutrition, not enough sleep, or other factors may reduce the capacity by hindering our ability to recover from each workout. The capacity goes down.
This lowered capacity leaves us more vulnerable to injury, and in addition pain can also be influenced by our beliefs, expectations, past experiences and other things happening in our lives.
So, most injuries can be attributed to this load capacity relationship. Unfortunately, many people are told their pain is due to biomechanical abnormalities such as asymmetries in their anatomy or they move wrong. Examples are short leg, flat feet, gluteal muscles not activating, sacrum out of place or other things. These factors have been researched and the conclusions are that many don’t even exist.
For those that do exist, they may lead to higher stresses on certain tissues, but even then, they play a small role if any on pain and injury.
Fact remains, if you give the body enough time to adapt, injury and pain are unlikely, even if we are not built perfectly or move perfectly.
Watching the Paralympics, it can be noted that they are able to perform at extremely high levels with massive asymmetries and compensations as long as you give the body time to adapt to the loads.
We need to keep this in mind, when we look at the real causes of injuries. Don’t get down on yourself or getting over analytical on how you move. Think about, have you changed things to rapidly in your sports, running or daily life.
We also need to remember this if we get pain or injury. If we do get injured, then think of reducing the load with some rest. If time of rest (protection) is too long, then the tissue capacity will also become less and consequently less load is required to get injured again.
This makes it necessary to make a slow return to previous levels of activity.
In the long run applying some mechanical stress to the body is a good thing as long as respect is given to the time it takes for the body to adapt. Being sedentary, the body will adapt by reducing its capacity. Gradually and slowly increase an activity and the body will adapt by increasing its capacity. Do it too quickly and the body may get injured.
So, remember the CONCEPTS OF LOAD vs CAPACITY and TISSUE ADAPTATION. Failure of the tissues capacity to tolerate load will be the root cause of most pain and injury.
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