Every day, for the rest of your life. Kidding. Sort of.
The Grand Canyon is a mile-deep gorge carved by the Colorado river approximately 5-6 million years ago. The river itself is a mere 200-500 feet wide while the Canyon, from rim to rim, can be up to 18 miles wide. If you look at the river today, it is difficult to imagine that simple running water created such a massive, gaping hole in what appears to be quite solid rock. A park ranger let me in on the secret ingredient that affords water its undefeated record over rock: time.
Injury occurs when a tissue has been stressed beyond its capacity. This can occur due to low levels of stress applied over a long time or high levels of stress applied over a short time.
As we move throughout our lives, the forces we exert on our environment and the forces that our environment exerts on us carve grooves in the structure of our bodies. The movements we make repeatedly and the postures that we sustain longest carve the deepest grooves. As a result of our habits, some structures adapt and increase their capacity while others receive sub-optimal stimulation and their capacity decreases. Understanding this concept helps us to appreciate the contribution that our patterns of daily life make to the process of injury.
Our bodies are smart. They find ways to accomplish what we need to, despite our lack of capacity. We continue to perform our activities of daily life despite poor endurance and insufficient range of motion. We do this because we have responsibilities to attend to and the lunar calendar only affords us 24 hours in a day. As a result, our bodies disperse stress to adjacent tissues that may or may not be prepared to handle the load. This strategy is typically referred to as “compensation.”
In order to counteract the grooves that our patterns of daily life carve, we need to provide an equal and opposite force. Performing a specific set of exercises 3-4 times a week for months or even years after the pain of injury has resolved provides such a force. This set of “corrective” exercises may evolve based on your needs and should be updated on a regular basis as such. It is important to consult your physical therapist early regarding how to appropriately respond to the ever-changing demands of your environment. Action is most effectively taken while the river is merely a trickle, and before it forms a canyon.