Everybody remember when your coach would tell you to “walk off” a sprain? Seemed heartless at the time, but I swear half the time it worked! Couple steps in and I could run a bit, and then a few more practice cuts and I could move just like normal! But that can’t be right, can it? Can you really just walk off a leg injury?
Well, like everything else in medicine, the answer is a big “it depends.” It has a lot to do with the neuroscience behind pain and inflammation than it does any real magic though. After any application of force that our body perceives as “too much” we will begin to exhibit signs of injury, and the body’s first priority is to protect that potential injury. If you leave it go too long you may see large amounts of inflammation, you will definitely feel pain, and you may even begin to lose range and strength. Interestingly, all of these things are actually protective mechanisms of the body. If there is tissue damage, I want all of that swelling in the area because it will bring fresh nutrients and cells to allow for rebuilding of any damaged tissue. Pain and limited motion actually would keep me from aggravating the injury further, because with pain I don’t want to move it much, and the extra limitations prevent me from putting excessive strain through a possible injury.
What gets interesting is the part that this happens with any perceived injury, which means we can get this entire limitation, pain, and inflammatory cycle without the presence of actual tissue damage! It’s a perfectly normal protective response to have these sent to any potential injury, and the only way for the body to determine if the injury is “real” or not is to start experimenting only with gentle movement. If it discovers that this gentle movement is not dangerous, it will gradually allow you to perform more movement with less restriction until you’re back to full.
This is all we are doing when we try to “walk it off” really. We are purposefully trying to see if our body can tolerate a little bit of weight, and then if we discover it can, we can go further and further until we find a limitation (or don’t in some cases). Essentially, we are slowly testing whether the possible injury is real, and if the body discovers that there is no tissue damage, it will allow you to perform normally again. If, on the other hand, it discovers it cannot do these things even at a gradual level, it will keep you shut down for a bit, but we’d rather prefer it did!
With that said, any potential injury should be taken seriously, and just like we are describing that pain can exist without tissue damage, tissue damage can exist without the presence of pain, so any time there is an acute trauma that causes these limitations, as a general rule I would rather have it screened by a good athletic trainer or medical practitioner to see what’s going on rather than just trying to walk it off. But, this is why when you tried it, sometimes it actually worked!