Sports injury recovery

Injured tissue heals in a predictable sequence. First comes an inflammatory phase, where the body clears the damage and lays down the initial repair. Then a repair phase, where new tissue is built. Finally a remodelling phase, where that tissue is reorganised and strengthened according to the demands placed on it. The last phase is the longest and it is the one most people rush.

That final phase is where things usually go wrong. The tissue that forms early in healing is not as strong or as well organised as the tissue it replaced. It becomes capable only when it is progressively loaded, which is a process measured in weeks and months rather than days. Where someone returns to full training as soon as the pain has gone, the tissue has not finished adapting, and the injury recurs. This is why so many people describe the same injury coming back two or three times.

Alongside the injured part, the rest of the body adapts too. Muscles around the area tighten to protect it, which is useful for a while and unhelpful afterwards. Other muscles take over work they were not doing before. Movement patterns change, and they tend to stay changed even once the tissue has healed. A shoulder injury can leave you with a tight upper back months later. A knee injury changes how you walk, which shows up in the hip and the lower back.

There is also the part that is not physical. Recovering from an injury takes a toll on confidence, and the fear of doing damage again keeps people from loading tissue that is ready to be loaded. That hesitation is genuine and it is extremely common. Where someone is stuck, it is often as much about rebuilding trust in the body as it is about the tissue itself.

What this all means is that recovery is a process with stages, and each stage asks something different. Understanding which stage you are in changes what helps, and it is the first thing we will work out with you.

Recovering from a significant injury usually involves more than one person, and it is worth being clear about who does what. We are not physiotherapists and we do not diagnose. Where a rehabilitation programme has been set, our job is to support it rather than replace it or contradict it.

In practice the division is straightforward. The diagnosis and the rehabilitation plan belong with your GP, a physiotherapist or a consultant. The strengthening and loading programme belongs with you, and with whoever is supervising it. The soft tissue work is ours, and it fits around those rather than competing with them. Where you already have a physiotherapist, we are happy to work alongside them and to follow whatever approach they have set.

If you come to us and we think you need a diagnosis you do not have, we will say so and suggest you get one before we start. That is not a way of turning you away. It is the fastest route to getting better, and treating an undiagnosed injury is the sort of thing that wastes months.

This is also where the practice's background matters. Richard Clarke has provided pitch-side support across many seasons of professional rugby and football, which means working with injured athletes at the moment it happens and through the months that follow. He has an honours degree in sport and exercise science and research on sports massage published in two international medical journals. That background shapes how injuries are managed here, and it is set out in full on his page.

The assessment starts with what happened and where you are now. We will ask what the injury is and how it was diagnosed, when it happened, what you have been able to do since, and what your current plan is. We will also ask what you are aiming at, because the answer is different for someone returning to a Sunday five-a-side and someone training for a marathon. The target shapes the timescale and the work.

From there we will look at how the area moves and how you use it, including the compensations you may have developed without noticing. Most people arrive aware of the injury and unaware of everything that has changed around it, which is usually where a good part of the treatment lies.

The treatment itself depends entirely on the stage. Early on it is gentle and focused on the surrounding muscles rather than the injured tissue. Through the middle it is broader, covering the areas that are taking extra load. Later on it is firmer and directed at any restriction that would load the healed area unevenly when you return to training.

You will also get an honest view on timescales. Recovery estimates are genuinely uncertain, and anyone who gives you a precise date is guessing. What we can do is describe the stages, tell you what progress at each one looks like, and be clear about what would mean it is not going to plan. Where something is not improving as it should, that is a reason to go back to whoever diagnosed it rather than to keep treating.

This page is reviewed by senior therapist Richard Clarke, whose background includes pitch-side work across many seasons of professional rugby and football. The treatment used is deep tissue massage, with the pressure adapted to the stage of recovery. Where the area is fresh or still guarded, relaxing massage is used instead so that nothing is provoked. If you have not been to the practice before, our page on your first visit explains what happens when you arrive.