I would guess one of the most common questions we get asked in the medical field is “when will this get better”? We unfortunately usually must meet this with a very annoying answer: it depends. This might seem like a brush off, or the answer of someone ignorant to your diagnosis. But the reality is far more simple: there is no perfect way to know the answer to that question. Healing takes time. What I would like to do today is take a look at some of the factors that go into resolving a relatively straightforward diagnosis: tissue sprain.
First Things First
Local tissue blood perfusion has a huge impact on tissue healing as appropriate nutrients and cells need to be brought to the area. Unfortunately, no human body supplies blood in the same way to the same place. Various factors like your own circulatory health, your immune system function, your genetic makeup, and your physical activity level affect this relatively straightforward factor. This means that within your own body there may be a great degree of variability.
There’s also more!!
2) Ability to load/unload. Healing tissue requires a delicate balance of enough load to stimulate our cells to heal efficiently and lay down new tissue in the right direction, and not so much that it causes further injury. Unfortunately, your job, daily responsibilities, and lifestyle may frankly prevent you from effectively limiting the latter. And providing enough can sometimes be affected by our own nervous system’s pain response. This combination of difficulties can make prediction of change extremely challenging.
3) The effect of your comorbidities can also change your healing rate. Certain disease processes like diabetes and COPD, or the presence of various autoimmune disorders can affect our healing. However, no two cases of these issues present the same. Also, the degree to which they affect you can vary a massive amount depending on how long you have had the condition, how severely it has progressed, and how many conditions you have.
4) Your prior activity level can greatly change healing rates as well. Tissues that have acclimated to micro-injury like muscles exercised within recent weeks tend to heal more quickly that those in sedentary individuals who have not acclimated to chronic loading and rebuilding, and the body’s previous adaptations to training and loading can allow for faster carryover of exercised for trained individuals vs untrained. This means that those regularly already doing the types of activities that are used in a PT program should progress faster than those who did not.
And these factors are not a complete list! Chronic medication use, history of joint injections, severity of tissue damage, and more are all part of the complex equation that we cannot accurately quantify to give predictions for recovery! So unfortunately, the best we can usually give is average, which are average because some people recover much quick, and much slower. It is impossible to know almost anything with absolute certainty about future events like this, and unfortunately healing is no different!