Managing Recurrent Injuries: When to Seek Rehabilitation After Falls

Bruise

A year ago, I fell several times while skiing, but the pain disappeared after applying a medicated patch.
Six months ago, I slipped while canyoning and was in so much pain that I had to be taken to the emergency room, where an X-ray showed no fractures.
After resting for a few days, I felt better and underwent two weeks of rehabilitation.
On January 27, I went skiing in Japan again, and while falls are inevitable, I have recently been feeling like my old injury has recurred, with significant lower back and hip pain.
I have seen three doctors after my repeated injuries, and they all said there was nothing serious.
Should I consider going back to rehabilitation? Thank you!

Misia, 30~39 year old female. Ask Date: 2008/02/10

Dr. Chen Xianchang reply Rehabilitation

Hello, thank you for your inquiry.
Here are my responses and recommendations:
1.
Generally speaking, when it comes to injuries from falls, there are two main considerations: the first is inflammation at the site of impact, which may include periosteal reaction; the second is that the force from the impact can travel upward to the lumbar spine, potentially causing a herniated disc that compresses the sciatic nerve.
2.
For the first condition, deep tissue treatments such as shortwave therapy, ultrasound, or laser therapy are recommended.
For the second condition, lumbar traction should be considered, but it should be avoided during the acute phase to prevent exacerbating the pain.
Based on your symptoms, you should seek deep tissue treatment from a rehabilitation specialist.
Finally, I wish you peace and happiness!

Reply Date: 2008/02/10

More Info

Managing recurrent injuries, especially after falls, can be a complex issue that requires careful consideration of symptoms, previous injuries, and the overall impact on daily life. In your case, it sounds like you have experienced multiple falls and injuries over the past year, leading to recurring pain and discomfort. Given your history and the fact that you have already sought medical advice from multiple physicians, it is important to take a proactive approach to your rehabilitation.

Firstly, it is crucial to understand that even if X-rays do not show any fractures, soft tissue injuries, such as sprains, strains, or even minor tears in muscles or ligaments, can still cause significant pain and discomfort. These types of injuries may not always be visible on imaging studies, which can lead to a misinterpretation of the severity of your condition. Therefore, if you are experiencing persistent or worsening symptoms, it is advisable to seek further evaluation and possibly additional imaging, such as an MRI, which can provide a more detailed view of soft tissue structures.

Rehabilitation can be beneficial in several ways. It can help to strengthen the muscles around the affected areas, improve flexibility, and enhance overall function. In your case, where you are experiencing pain in the lower back and gluteal region, a targeted rehabilitation program focusing on core stability, pelvic alignment, and lower extremity strength may be particularly helpful. A physical therapist can design a personalized rehabilitation program that addresses your specific needs and helps to prevent future injuries.

Additionally, it is important to consider the psychological aspect of recurrent injuries. Fear of falling again can lead to decreased activity levels, which can further exacerbate physical issues. Engaging in rehabilitation not only helps with physical recovery but can also boost confidence in your ability to move safely and effectively.

In terms of when to seek rehabilitation, it is generally advisable to pursue physical therapy if you experience any of the following:
1. Persistent pain that does not improve with rest or over-the-counter medications.

2. Difficulty performing daily activities or returning to your previous level of function.

3. Symptoms that worsen over time or do not respond to conservative measures.

4. A history of multiple injuries in the same area, indicating a potential underlying issue that needs to be addressed.

Given your recent experiences and the recurrence of pain, it would be prudent to return to rehabilitation. A comprehensive assessment by a physical therapist can help identify any underlying issues and develop a tailored treatment plan. This plan may include exercises to improve strength and flexibility, manual therapy techniques to alleviate pain, and education on body mechanics to prevent future falls.

In conclusion, while it may be tempting to dismiss your symptoms as minor, the recurrence of pain after multiple falls suggests that further evaluation and rehabilitation are warranted. Seeking the assistance of a qualified physical therapist can provide you with the tools and strategies needed to manage your symptoms effectively and reduce the risk of future injuries. Remember, early intervention is key to successful recovery and maintaining an active lifestyle.

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