Why your injured muscle won’t heal & your rehab exercises don’t help
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Too often, injuries just don’t seems to get better. For a lot of people, the pain subsides for a while, then comes back with a vengeance like a bad movie sequel. The injured muscle in your back that just won’t heal no matter who you see. Your dodgy rotator cuff injury that still hurts even though you diligently perform your shoulder rehab exercises every day.
Does any of this sound like you? If so, then this is the article for you.
This article is aimed at people who have already sought help from a therapist. If you haven’t already found someone, please see here for tips on finding the right manual therapist for you. You may also want to check out this article for tips on getting the most from treatment.
If your rehab exercises aren’t helping…
Firstly, are you actually doing them?
The biggest complain I hear from therapists is that patients don’t do their exercises/stretches often enough (or when they are supposed to do them). At the risk of stating the obvious… if it’s not got better on it’s own by now… it not going too!
Like your mother said “Do what your told!”.
How long is too long?
It can take tens of thousands of repetitions performing a movement correctly before your body realises that it’s supposed to do it that way. Give it some time. If however, after a couple of months you have not felt any improvement at all, something is wrong. Read on…
Going ‘hell for leather’.
Sometimes you can do too much of a good thing. If you are battering your injured muscle to the point of exhaustion it won’t heal properly. Listen to your body and work within a pain free range of motion, unless told otherwise by your therapist.
CAN you do your rehab exercises correctly?
Do you actually have the mobility in your joints or flexibility in your muscles needed to perform your exercises correctly? There is no point performing shoulder extension exercises if you don’t physically have any extension available in your shoulder joint. All that will happen is that you will compensate by using other muscles and thus make your problem worse.
Ask your therapist to check you have the range of motion needed to perform the exercise properly. If you don’t, work on restoring your mobility first, then start the rehab exercises.
ARE you doing your rehab exercises correctly?
Even if you have the mobility/flexibility
you need, it doesn’t mean you are able to perform your rehab exercises correctly. Good technique and correct motor control are vital when it comes to all exercises and stretches.
Waving resistance bands and dumbbells around like a cheerleader with pom pons isn’t going to help your injured muscle heal. In all likelihood, performing an exercise incorrectly will just reinforce the faulty movement patterns that lead to your injury in the first place
By the same token, performing a stretch in a bad position or without bracing your core (see here), means you probably won’t stretch what you were aiming for.
- Check your exercise and stretching technique every time you see your therapist.
- Always make sure you are starting in the correct stable position and finishing there too.
- Check the movement is occurring in correct place and that you can feel it happening.
It’s not about strength, it’s about control. Only increase resistance levels if you can execute the movement with correct form. By the same token, you do need enough resistance for your body to take it seriously.
Are your rehab exercises & stretches crap?
Physical therapists, chiropractors and osteopath’s area of expertise is identifying and treating injuries, not necessarly teaching exercises. Like every profession, there are some who really know their stuff and some who try to get by using the basics.
If your therapist just hands you a generic sheet of exercises & stretches (like these) without showing you how to do them, alarm bells should ring.
If after several months your problem isn’t improving, it may be worth seeking the help of another therapist.
Other reasons your injured muscle won’t heal
Don’t use ice!
Controversial I know, I may write a more
thorough article on this soon. Yes, icing your injured muscle will reduce inflammation and temporarily numb pain. In my opinion, it won’t do anything to help your injury repair itself.
Icing will actually slow your healing down leading to the formation of more scar tissue. Your muscles will just tighten up and shut down. Your blood vessels will also contract which will reduce blood flow and slow down recovery.
If you have to do something to ease pain, try a hot water bottle. I have always found it tends to work better at alleviating pain anyway.
Stay hydrated!
Around 70% of the human body is water.
Without adequate fluid intake your body has no way of transporting waste products and rebuilding your injured muscle. You should always aim for 1ml of water for every calorie you ingest (more if its hot or you are exercising).
Therefore a daily base level should be around:
- 1.5+ litres for woman
- 2+ litres for men
Something else is wrong!
To often, we fixate on the injured muscle or structures around it and miss the bigger picture. Maybe your injured muscle won’t heal because you have a problem elsewhere.
“It is like a finger pointing away to the moon…. Don’t concentrate on the finger or you will miss all that heavenly glory” – Bruce Lee (Owner of a short leg)
The human body is like an incredibly
complex 3D house of cards. Twist, bend or remove one card and the whole structure is affected. Something as simple as a flattened arch in your foot can actually cause problems with your neck.
Does this sound far fetched? It’s more common than you think. I see people with problems like this on a daily basis!
Some of these postural deviations can be congenital (you were born with them) and may even be the real reason you got injured in the first place.
True leg length discrepancies, tibial torsion, femoral retroversion, scoliosis, a hammer toe, the list is endless and well out side the scope of this article. What’s my advice?
Ask questions!
Your therapist spends a limited amount of time with you and it’s impossible for them to pick up on everything. Just ask them ‘Could I have a problem elsewhere in my body that is stopping my injury healing?”. Just planting that seed in your therapists head may lead to the real solution to your problem.
You’re still damaging it!
This is without a doubt, the most overlooked reason that injuries occur, re-occur and don’t get better. The chances are, something you are doing every single day is preventing your injured muscle from healing.
Long periods of time spent in unnatural static positions causes muscular dysfunction. Muscles on one side of a joint will lengthen and the muscles on the opposing side will shorten. The real problem is that they lengthen and shorten in an unloaded state (they are not having to work). Our muscles simply adapt to this static position and eventually learn that this is normal. Muscle tissue actually changes on a cellular level and often neurologically shuts down.
This article will go on for ever if I get started on this so I am going to cut to the chase. Think about the positions you sleep and sit in every day. Think about the way you stand and the movements you perform as a part of your everyday life. Are you spending long periods of time sitting in a position that damages your injured hip.
If you spend hours every day in a bad postural position, no amount of exercise or stretching is going to fix you. You need to identify your bad habits, correct them and then re-educate your body.
Again, talk to your therapist. Ask if a bad habit could be slowing down your healing.
If you think this article could be useful to someone you know, please help spread the word and share it.
Total hip replacement Jan 3, hip then dislocated 2 weeks later. I laid on floor for 4 hrs because I didn’t have my phone. Dr then tried to put it back without me being relaxed. I’ve been going to PT, SINCE MARCH, and still having problems! I am scheduled for an mri… Any thoughts on how to get this to heal?
I’ve had multiple back muscle injuries from falling snowboarding and falling off an ATV. Whip last and muscle spasms. I also am hyper mobile. Muscle memory is horrible. 20 years later I sought treatment for stabbing lower back pain when I would lean forward/reach down. Osteopath first visit told me he didn’t even understand how I was up and walking! I have been seeing him for a couple years. A lot of stuff to undo. My pelvis was rotating unevenly and one hip showed higher than the other, causing the lower back stabbing pains and spasms. After adjusting and releasing me from head to toe, he found a 4MM difference in leg lengths! FOUR! This has been the main root of all of my problems for a very long time. Structurally different btw. I have been wearing a 4MM insert in my left shoe and see him every 4 weeks. Hips and pelvis are ok, but now we’re battling upwards (diaphragm/rib muscles, neck:shoulders). It’s a work in progress but he told me I was a trainwreck when I walked in a few years ago and slowly but surely he is correcting years of damage and muscle memory. Highly recommend seeing an osteopath!!!
I was picking up a 40 lb bag of dog food and when I turned to put it in the cart I had a muscle so bad it took me to my knees. Thats was in 2008. Its now 2021 and I still have problems. It can still drop me to my knees at times. I’ve had therapy 3x and massages done on it but it won’t heal. I don’t sleep because turning over in bed or any fast movement makes a muscle spasm shoot across my back and it takes my breath. My husband don’t sleep because of the noise I make. I’ve been on many muscle relaxers but none help. I don’t know what to do.
I pulled a muscle under my right arm putting a countertop in my kitchen with my husband. It has been about a month, there is no bruising on the skin just hurts when I press on the bone. I can tell its getting better but its a very slow process. Anything I can do to help ease the pain.
Has it gotten better yet?
Hi I pulled my muscle in the top of my stomache a few months ago getting out of the bath it was very painful to start with but it comes and goes and is worse with exercise any tips please
I pulled a muscle in my stomach also in October and I cannot get it to heal for good .. it has gotten better and at times seem to have healed for a couple weeks but then boom right back again square one.. I thought it might be my gallbladder but all tests are showing that’s normal. Not sure what to do and at this point it is affecting my day to day and even causing anxiety to the point I’m making myself sick. Any suggestions???
Costochondritis?
No
I hope you figure out how to fix it 🙁 I pulled back muscles 5 months ago and they won’t heal all the way. I’ve never had anxiety until now. Its killing me.
Having the same , had an inpact injury under right ribs back in January. Wouldn’t heal. Doctor sent me for galbladder tests , liver tests , xrays, blood tests all good. Finally saw physio specialist 4 months ago. Told torn muscle and cartlidge. But because of my job , twisting all day with weights will take months to heal or 6/8 weeks off. Did get slightly better , but still in pain most days . So starting new physio treatment soon. To be honest messes with your head & effects you everyday.
I strained both my trap muscles almost 7 wks ago, inflammation just won’t go a way. Any tips?
IF YOU TRULY WANT TO GET BETTER THEN YOU MUST READ ALL OF THIS, THIS IS VALUABLE INFORMATION
My pec muscle was strained really bad as a result from lifting above my head. This article did have a really good point though. About the bad habits, I noticed awhile ago I slept on my side and it actually applies pressure on my muscle when I do that, so i’ve been trying to sleep on my back more and even then i’ll wake up on my side, I can’t control that unless I tie myself down, not my best interest. But if it gets the job done then you need to do it! If you’re injured in any way, you MUST stop your bad habits. Only you really know your bad habits.
All my bad habits with a pulled muscle:
– Flexing the muscle to check if it still hurts, btw, if you’re doing this you NEED to stop!
– Bad posture.
– Lifting, even light stuff sometimes.
– Stretching, good at first then it started hurting it, and no I didn’t excessively stretch.
– Certain body movements like twisting, getting up after picking something up, a number of things.
– I could go on and on with things but the IMPORTANT part is that you STOP doing your bad habits.
I have had this injury over a year, pain still the same. I kid you not when I say… You can be doing so good, your muscle is getting better but then the absolute moment you do a bad habit, it restarts the pain process completely! You have to be consistent if you really want your pain to get better.
One more thing, trust me it’s worth it!
Don’t believe what the internet says all the time, for example… if someone on the internet says ice is doing so good for them but when you try it a few times and it’s not helping, then don’t do it! Everyone’s body is similar but not the same by any means. Certain things are going to help people and some things not. It’s trial and error, find what is right for you, and one more thing I swear…
NEVER EVER EVER NEVER EVER go back to your bad habits just because you don’t feel like your pain is getting better, it will make your pain process last soooo much longer, ok that’s it wish you well
Did you get any better? Dealing with the same thing as of now it’s been 3 months with no improvement just been getting worse because of bad habits got to the point where the nerve has gotten irritated pain has definitely Multiplied scared to even move the arm anymore
No
I would also like to know if you healed your oec muscle. I’ve had a chronic pectoral/shoulder issue for a year now & not sure what to do. Thank you for sharing your tips & advice. Unfortunately these muscles are extremely hard to not use.
Setting-up a home fitness center is one of my ambitions, and I appreciate this web site article. Thank you for sharing this.
Funny stuff. I’ve tried for years to get my muscles to heal and nothing works. The only thing that does help is ice. Stretching makes my injuries worse. Exercising with light weights makes the injuries worse. I’ve even tried progressive exercises; light or no weights for a week, add a pound each week, but keep the reps low, yet every attempt at this has ended in failure. I’ve spend close to 15k in the last ten years trying to get these injuries better. I’ve finally given up. Want a list of my injuries for you entertainment? Here goes.
2001 tore pec muscle on pec cable flies. 2001, strained buttox kicking field goals. 2008, tore right calf, strained left calf. 2009, strained both arches of my feet from walking ten miles barefoot. 2009, broke ribs in boxing match, the stomach muscle connected to that rib never healed. I can’t sing or talk too much without it hurting. I can’t do any ab work whatsoever. 2010, car wreck whip lash. To this day i cannot type, write, or use my left arm without experiencing pain in my neck muscles. 2011, injured thumb from playing the guitar. 2014, injured lower back. 2013, pulled and strained right ham string. 2014, pulled outside leg muscle on left side.
These injuries won’t heal. So I want you to feel sorry for me. Do it. i will feel better if you get on here and post that you now feel sorry for me and that it’s not my fault, and that I’m like a little puppy who just got pushed out of the fold. I know you want to feel sorry for me….I know it….I just do…..
Ok Clay.. I do feel sorry for ya!
I broke my hip Dec,20 2018, they cut my thigh to go in and put a bar in, from get go it just didn’t heal right. Now the mussel feels like it’s hanging to one side, hurts all the tine, the dr that was taking care of me didn’t seem very concerned. What kind of a doctor can help me?
I feel sorry for you . That’s alot to deal with. I have lower leg sprain. Its been 2 months already. I think its going to be a long road to recovery. I hear you, feel better!!
Use heat, heat and more heat. Just do it.
Gosh! that must be hard to deal with. I got a grade 1 tear in my trapezius and partial tear of both ECRB tendons and now awaiting hip MRI results. Pretty sure I tore something doing squat jumps. It seems like it is much better to get a fracture than a muscle tear. Fractures seem to heal better.
Those comments are all well and good but what am I supposed to do with my shoulder injury (was a muscle strain) have spent thousands trialling all manner of treatments. Have achieved about 93% recovery but cannot get it that last 7%. Try all sorts of stretching, tried exercising but if i do it flares up again. Best is dry needling, but still cannot get it any better now. All I do know is all the so called ‘experts’ such as shoulder surgeon, multiple physios all bar one and a few doctors knew less than I did about my shoulder and argued that I had a joint degeneration problem. I kept arguing it was muscular, which it was later proven to be the case, but unfortunately had been in spasm nearly 12 months then.
Hi Bruce, I’ve got a rare neurological disorder which affects my muscles and movement. It’s called dystonia and although it might not be what you’ve got, I just thought I’d mention it so that you could look into it to see if it could be what you’re suffering with. It a complicated condition but the main symptoms are spasms, stiff muscles, and involuntary contractions – which obviously all can cause pain and it’s hard to relax the muscle. I’ve had it for 7 years, but it took me 5 years to get a diagnosis, and even now the doctors and specialists still don’t really know anything about it. It can be triggered by accidents and injuries, or stress, because it’s rare though there’s not much people know about it which makes it hard to treat – if physio and splints don’t work then the first thing they usually try is Botox injected into the area to real the muscles/spasms.
Anyway sorry to bore you with the long reply but I think it could be worth looking into.
Good luck and I really hope you finally find someone who knows how to ease your problem
I listened until you said, “don’t use ice.” I had major improvement in an injury during six weeks of PT that included using ice. The second round of PT was with a different therapist who used heat and the injury worsened to the point he had to cut back my exercises to almost nothing and started using …. ::Drumroll:: … ice on me.
Sara’s explanation bellow is actually pretty close. I used to use ice on my own injuries and on clients for years and all it seemed to do was temporarily reduce pain. A few hours later, the pain would return and the injury would usually feel worse. When I stopped using ice and switched to using movement and other treatments, clients seemed to recover quicker. To be honest, I rarely use heat either.
The advice above is based on my own research and experience with clients. It’s based on what I have found has worked over the years both on clients and myself.
Obviously, its your body though, if you feel ice helps you, go for it. I would say however, its very difficult to prove the effectiveness on a treatment based on one injury. There are just too many variables. If your first therapist hadn’t used ice at all, would you have recovered quicker?
I recently heard that coaches in high level cycling have stopped recommending ice baths after races. After a race the cyclists would jump in a bus, go to their hotel and jump in an ice bath. This approach seemed to increase the rate of injury. When they switched to getting athletes to cycle back to their hotels instead of riding in a bus the levels of injuries decreased significantly.
Here are a couple of things you may want to consider.
To my knowledge, there has never been any serious study that has shown the effectiveness of ice in injury recovery. Isn’t this surprising since treatment with ice has been around for years? Surely someone would have proved it works?
The body’s natural response to a trauma is inflammation. The body does this initially to prevent further injury. This response is also used to get junk out of the area and to flood the area with the stuff it needs to heal. Why is this response wrong? Our bodies have evolved over thousands of years. Why would it still use this response if it didn’t help?
As mentioned, ice will temporarily reduce pain and inflammation. In my opinion though, it slows recovery.
I will write something on this when I get time. Thank you for your comment.
Below my belly button to the right orphan therapist was looking at me to the left maybe 6 inches I have pain in my lower abdominal muscles that won’t go away it’s been 5 months right now what would be the best way to get this to heal I just started doing sit ups but I’m doing them in a rocking fashion where it’s helping me what should I do I want to start working out again however I want to heal any and all advice and medical advice would be appreciated. Thank you and Happy New Year
Nice info, but after reading “do not use ice”, I had to take what you said with a grain of salt. Every chiropractor and physical therapist I’ve met (and been under) has told me to use ice for my injuries, and my current chiro–35 years in the practice–makes sure to use ice for back injuries when doing adjustments.
Charles, you have to understand the mechanism in place that makes ice seem to work. Ice will decrease inflammation. However, do you understand how and why it decreases inflammation? It decreases inflammation by constriction. That is the OPPOSITE of what a muscle needs to heal! Inflammation is needed for healing. So you need to eliminate chronic inflammation and allow acute inflammation. Your muscles need HEAT to heal. You know why? Heat increases blood flow. Your muscle/tendons CANNOT heal without blood flow. However, shoulder tendons don’t get a lot of blood flow. Ice restricts the blood flow even more. That is why the author of this article is saying to heat your muscle/tendon instead of ice it to heal it. Research it Charles and then you will see what the author is talking about.
I can lie down it’s the ONLY relaxation I am able to expeience relaxation for my abs .bracing my abs, sounds as if it is a counter-intuitive action
nice post! i was trying to find a first aid cure for my back pain as it wasn’t going away and i stumbled into your post. very helpful.