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Early Mobilization for Injury Recovery

Slow and steady... so start now!

The first question people usually have when they get an injury is:

“How long before I can play again?!”

Exactly when you’ll be able to go 100% again is a difficult question to answer.

But it turns out you can start moving a lot sooner than people once thought. In fact, the sooner you start some movement, the better an injury will heal!

How does this work and how can you do it?


I just got injured! What’s the first thing I should do?

Before you start moving and stretching a new injury, wait!

The first thing you should do is stop and perform the good old PRICE method:

  • P – Protect
  • R – Rest
  • I – Ice
  • C – Compression
  • E – Elevation

Which you can read more about here. This is important for treating a brand new injury as it helps with excessive inflammation 1 and attempts to prevent bleeding into surrounding muscle tissue 2. This should prevent further muscle damage.

This could last up to a week.

Why? You need to allow enough healing so the injury can take some stress without disrupting the newly regenerating tissue 2. It’s like picking a scab! You’re just slowing it down!

Don’t rush. You can’t exercise an injury away. Exercise is for rehabilitation: restoring function. As we’ve discussed before, nothing can truly speed up your body’s natural healing process. Read: What affects Healing? for more on that.

If you are not sure how bad of an injury it is, go see a professional. see disclaimer


Early mobilization.

So after that first week (or less if you are lucky) of a swollen and painful muscle that you can barely move, what’s next?

Mobilize. “To make mobile or capable of movement.” 3

Research has been showing us that muscle injuries (strains) actually heal better when you start moving earlier. A 2008 study using rats demonstrated that, after being given muscle injuries (poor little fellas), mobilizing the injuries with light exercise earlier provided significantly better muscle healing, as well as less scar tissue formation, than mobilizing the injuries later 4.

Most guidelines for injury rehab agree 2, 5, the earlier you can get an injury moving after an injury, the better the healing will be. So as soon as you can, start moving!

It’s not just muscle strains either. A 2006 study showed that people who had hip fracture surgery got to go home a lot sooner and needed a lot less ‘high-level’ care if they started moving earlier after their operations 6.


How?

After the first days (maybe a week), start doing some very gentle movement exercises with the injured body part. We call this ‘active ranging’ of the joint.

Example:  if you sprained your ankle, you can slowly start with pumping your foot back and forth like pressing on a gas peddle. Also try moving side to side. When that feels okay, move on to making circles and figure-eights. Eventually, you can sit there and draw the whole alphabet, which passes time and offers a lot of variety.

Up and down, back and forth, nice and boring.

It might look like stretching, but be careful. It’s not that “I wanna be more flexible” type of stretching. Instead, it’s more like that “I just got up from sitting for a long time and I’m feeling stiff” type of stretching. No forcing it!

You need to take it slow: move carefully, and don’t push past the point where it starts to hurt. Pain is usually suggested as a good guideline: get to the edge of where pain starts, maybe even going past a little, but then come back and repeat.

Remember that pain can be a funny thing and not always the best indicator of how bad something is. But during the first week, it usually matches the injury well. Read more about pain here.

Repeat these simple movements for about a minute each, and multiple times (three to five) a day. As long as it’s not aggravating the injury and making it hurt more, keep going.

After a few more days, approaching a week after the injury, you should start trying to put some weight on the injury. Again, use the same pain guidelines as above. Gentle exercises with some resistance is useful here. But still, no stretching! Just go through the available pain free range of motion with a little resistance, provided either by your other hand, or some very light weights.

Example: continuing with our sprained ankle example, by now you would be trying to bear your weight on your foot. Without causing too much pain, it’s you are trying to get rid of your limp. Walk on that baby… put some weight on it. Enjoy it. If your injury was bad enough that you needed crutches, you would simply be trying to stand on your own two feet. Again, the pain guidelines described above are still useful here.

This progressive approach is similar to a type of pain treatment: Graded Exposure. Therefore, this slow and steady movement will probably make things hurt less as well as improve tissue healing.


So how much longer?!

It all depends on how your recovery goes, and how bad of an injury it was.

Obviously the most important thing at first is rest. (Read: Rest for Injuries). If you keep aggravating it you are probably setting yourself up for a long healing time, poor recovery, and lingering pain. Take it easy! Yes, it sucks, but it’s short term pain for long term gain. Remember: rest doesn’t mean sitting on the couch, it means resting the injury itself. You can and should do other things. (Read: what to do while you are injured!)

If you fully tore your ACL, chances are you will need to rest for a long time. Early mobilization may not be the best idea either. A 2009 study showed that for severe sprains recovery is better when the sprain is immobilized in a cast at first, as if it were fractured 7. If your injury seems severe, best to go to a professional, and not read how to fix yourself on the internet!

But for the mild strains, sprains, and pains, (that are pretty much guaranteed to happen if you are active) it’s probably safe to start early mobilization, and recovery is much shorter.

For some very rough guidelines on how long it takes to heal, check out these articles:

But how long it will take you to go ‘full-out’ again isn’t the point of this article.

The point of this article is: start moving soon.


Early movement = better recovery.

In summary, almost every injury ever heals better when you start moving it as soon as you can. So if you have a new injury, get moving!

  • Yes, you have to rest at first. But try to stay active without using the injured part.
  • Start like a snail: barely moving. But start as soon as a few days after the injury.
  • Try to work around the edge of where it starts to hurt, but not farther than that.
  • Gradually increase the range of motion, complexity, and intensity of the exercise.
  • Hang in there! It takes time, but it will get better. We humans are remarkable healers.

After these first few stages of recovery, you can start some sport-specific agility drills, strengthening exercises, and stretches (if necessary) to build back your physical abilities. This is what rehabilitation really is, and it can be started during your recovery.

Read: ‘Active Recovery‘ for info on the next steps for rehabilitating most injuries.

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Good luck!

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