The word ‘Relapse’ to a health care professional is not a very nice one to hear, it means that for some reason, the client has re-injured themselves in the same place either during or after recovery. Michael Owen is a classic example of a person that had a lot of injury relapses, in this England striker’s case it was his Hamstring. We hate to see it happen as understandably it can be very disheartening for the client as they are often doing really well when the injury occurs.
In some cases however, the occasional relapse is expected.
Some injuries are very prone to relapses. The most well-known of these injuries that is prone to this is a ‘disc bulge’ or ‘slipped disc’ as it is commonly known. Disc bulges usually occur over a long period as the discs between the vertebra slowly fail as they are loaded incorrectly (usually by sitting poorly for prolonged periods of time). Once the tissue that causes an injury has failed, the tissue is then susceptible to re-fail, especially during the healing phase. Probably the most common reason for a relapse is due to a client falling back in to bad habits, the original cause of the injury.
We are creatures of habit, from the moment we wake up, to the routine we have when we go to sleep, we are dictated by our habits.
Once a bad habit is identified, and is thought likely to have led to the injury, we ask the patient to avoid or correct the habit. As your body heals, you become more comfortable and mobile. Unfortunately though this means that the bad old habit can sometimes return (usually subconsciously), often leading to re-injury. The habit can be movement based or even due to something you enjoy (such as a hot bath).
To help avoid these injuries recurring, it is best to ensure good habits for the injury are retained and bad habits avoided. However, this alone is not enough, rehabilitation exercises are also required to strengthen the area of injury once it is healed. Until the area is correctly supported it will be more prone to relapses
Research shows that any joint that has been injured becomes prone to re-injury again, this is because the muscles and tissues around the joint have become weak and are not feeding back information about themselves to the brain as effectively as they were before (known as proprioception). Rehab exercises are the final stage of treatment, rehab is the proverbial ‘fork in the road’ between a client that is content being pain-free, stops following advice and does not want to do rehab exercises, leading to a good chance of the injury relapsing. Versus a client that engages with rehab, continues to follows advice and has a much lower chance of their injury relapsing. As we say in clinic “When the pain is gone, it does not mean that your body’s function has improved”. Which rehab exercises to perform depends on many factors which a manual therapy professional should be able to help you with.
Thankfully we don’t see that many relapses in our clinic as we tend emphasise these points from the beginning during our Report of Findings. Though being aware of these factors is important for you to understand that there are some injuries with which a lot of care must be taken when avoiding bad habits.
Note: some habits can be resumed once the injury has subsided, such as hot baths. ;-)