Does anybody know if Dr. Muschaweck's procedure can be done without anti-inflammatories?
Or what type of anti-inflammatories she prescribes? Or for how long they are to be taken?
The healing process after a tendon tear can be roughly divided into three phases: inflammation, repair, and remodeling. By understanding what happens in each of these stages, you will be better prepared to give your students advice on what to do and when to do it.
When a student first tears a tendon, many of the tiny blood vessels (capillaries) that feed it are destroyed. During the first 72 hours after injury (the inflammation phase), the body’s main job is to stop bleeding, clear away damaged tissue, prevent infection and lay the ground work for later repair. Stressing the area with stretching or strengthening exercises during this time will only further tear the tendon and its capillaries, undoing much of the work the body has done and making the injury more severe.
If the inflammation phase is allowed to run its course without disturbance, the body will enter the repair phase, which lasts six weeks or so. It begins this phase by setting up a delicate molecular and cellular matrix that serves as the framework for reconstructing capillaries and connective tissue. It then starts the initial stages of filling in this matrix.
A healthy tendon is made of collagen fibers arranged in an orderly way, making it strong and somewhat flexible in the direction of pull applied to it. However, at the beginning of the repair phase, the body lays down new collagen fibers haphazardly. This is a crucial time. If the student systematically applies very mild force along the lines of the healing tendon (by practicing extremely gentle strengthening and stretching asanas), the collagen matrix will become aligned in an appropriate way. The body will then lay down new fibers of the right type and connect them to one another in the optimal orientation to produce a strong, slightly flexible tendon. If, instead, the student does not apply any stress to the tendon after the body lays down the initial collagen fibers, the body will continue to lay down new fibers haphazardly, and connect them randomly. The result will be a weak, thick, inflexible scar.
Another potential problem might arise if the student stresses the healing tendon too much by practicing asanas that demand more than just a little stretch or contraction of the hamstrings. If that occurs, the matrix will break down, the tendon may tear more, and the student will be thrown back to square one of the healing process (inflammation), quite possibly with a more severe injury than the original one.
No Days Off is a call for consistency, moderation and patience: the full-time, year-round commitment to the process. Two athletes put the 2019 No Days Off Collection, featuring winter performance apparel made from Australian Merino wool, through its paces over a cold-weather training camp in Craftsbury, Vermont. Film directed by Emily Maye and produced with support from The Woolmark Company.