“Hey, get your finger out of there!” It sounds a little weird at first, but I’d estimate saying this phrase at least once daily. The scenario usually begins as a runner describes their injury. I ask where it hurts and they begin point, transitioning to a poke, and before I know it, they’re inches deep, digging with the tips of their fingers. The evaluation continues as the runner makes a point to bounce on the site, much like bashing the keys of a piano, or they become aggravated with the difficulty of locating the “exact spot.”
I think I’m right in assuming the same thing is occurring at home. I mean, the writing is on the wall… or skin? A desire to locate the exact source of pain can often result in bruising that resembles the perfect outline of a fingertip. But at what point to we transition from poking to prolonging our injuries? A look into tissue mechanics and injury healing can help you better understand my concerns with you mashing away with your fingers.
“But It Feels Good”
Poking around with the fingers at painful sites has been around for a long time. Deep pressure massage techniques are used to help release trigger points, or balls of knotted tissue, while also decreasing localized pain. A good push from your finger has been shown to decrease sensitivity at a given site, ultimately decreasing your pain; however, at the end of the day, you’re not looking to desensitize an area, but to heal.
Injured tissue is weak and degraded. It lacks the ability to absorb shock, contract, or stretch. Typically, most runners poke at muscle injuries (shin splints come to mind). When injured, muscles become tensile intolerant, or lack the ability to either shorten or lengthen. At a microscopic level, the contractile elements that produce movement tear. The injury can be fairly harmless, like after a hard workout, or more serious, resulting in a partial or full tear of the muscle. The key here is that there’s damage.
Damage doesn’t equate to scar tissue, so don’t combine the two. Tissue damage evokes an inflammatory response, while the failure for that tissue to fully recover may result in scar tissue formation.
Healing tissue will go through three phases: inflammation, proliferation, and remodeling. The entirety of the process can take months (yes months). The inflammation stage should be short lived, measuring four to six days. The goal here to let the injury run its course, which will set you up for full tissue healing later. Digging for gold at an injury site could likely prolong the inflammatory response and ultimately delay your return to running.
The Proliferation Phase
The second phase of healing results in scar tissue development. Hold the horses! That doesn’t give you a permit to start digging. Scar tissue development is normal and required for tissue to return to normal strength. Being knuckle deep during this stage can result in a continue cycle of scar tissue development. The body lays it down and you break it up. Now hit the repeat button.
Scar tissue will remodel back to normal tissue. You just need to let it.
The Remodeling Stage
The scar tissue laid two in the proliferation phase will begin to adapt to stresses you place upon it—and that doesn’t mean with your fingers. Scar tissue from stage two lays down haphazardly, resulting in decreased tensile strength. As you begin to use your muscle again the fiber alignment begins to mirror that of normal tissue. It also begins to restore to normal tensile strength.
The best method for transitioning scar tissue to normal tissue is activity, not rubbing, not kneading, and certainly not poking.
So remember, the next time you think that you need to “work it out” a bit, strap some oven mitts on your hands and leave it alone. Allow your body to transition through the normal healing cycle with appropriate timed rest and exercise.