How Soon to Work with an Injury© 2007 Lawrence Gold 7/5/2007 10:55 AM
It's important to distinguish this way because painful conditions can often be addressed immediately: a lifting injury, muscle strain/spasm, pain during inhalation, herniated disc, many whiplash "injuries." Injuries -- sprain, muscle tear, surgical wound, ruptured disc -- are a different species and are best addressed after complete tissue healing has occurred. If pain neither gets worse nor improves after a couple of sessions, referral back to a physician and an MRI or other scan may be in order. Failure to improve is a "red flag"; with Hanna Somatic Education®, improvements should come quickly.
Both injuries and pain trigger Trauma Reflex. The function of Trauma Reflex is to protect an injured area from further injury or pain. When tissue damage is involved, pain reports the existence of the wound, and even if Trauma Reflex is dispelled, the pain of the wound re-triggers it. So, to do a Trauma Reflex lesson when there is soft tissue damage is, if not fruitless, of reduced value. If in doubt, proceed with care and do not inflict further pain; if pain gets worse, stop the lesson. You will have to do a Trauma Reflex lesson after healing has occurred.
On the other hand, when pain results not from tissue damage but from muscular soreness (fatigue), joint compression, or nerve entrapment (e.g., sciatica, thoracic outlet syndrome), a good Trauma Reflex lesson (usually preceded by a Landau Reaction lesson and followed by somatic education of relevant muscles/movement patterns) is sufficient to bring lasting relief from pain and satisfactory freedom of movement. Do a Trauma Reflex lesson when progressive joint damage is involved, as in the presence of crepitus (crunchy sounds) in the knee joint; tight muscles cause tight joints and freeing muscles frees joints, preventing further joint damage and setting the stage for healing. Just make sure that you teach freedom of both agonists and antagonists in balanced patterns of coordination (the value of somatic exercises).
Typical healing times for significant soft-tissue injuries and bone fractures is six to eight weeks. If an external wound is involved, as in surgery, no redness, indicating inflammation/increased blood flow, should remain.
By the way, people often confuse inflammation with pain, with words like, "inflamed muscles." Usually, that's muscular soreness from fatigue; "inflamed" implies tissue damage. In my view, people should be taught the difference, and we should know how to recognize the difference. "Inflammation" doesn't clear up when muscles relax; soreness does (may take 1-2 minutes).
Likewise, "ligamentous strain" or "stretched ligaments"; ligamentous injuries are rare, and most often are actually muscular contractions. Ligaments are designed to permit the full range of movement that muscles are capable of inducing, and so are protected by the stretch (myotatic) reflex. I think that people attribute difficult to treat injuries or instability to ligament damage because ligaments are "really, really deep" and so, by that thinking, anything that's hard to treat must be ligamentous. Well, maybe, but more often, it's just painfully habituated muscular contractions and disturbances of coordination.
So, in brief: with soft-tissue or suspected skeletal injuries, wait until after healing; with pain without soft-tissue or skeletal injury, proceed immediately.