Understanding Cardiac Disease in Athletes: My Personal Story

As a physical therapist, I’m often asked, “How long will it take to heal?” or “When can I get back to running, tennis, or my sport?” It’s one of the most common questions, and my go-to answer is always, “It depends.” There’s no simple timeline, as recovery is influenced by a variety of factors. The healing process varies depending on the nature of the injury, the type of tissue involved, and the effort put into recovery. Let’s dive into what influences recovery times and how tissue heals.

Factors That Impact Healing Time

While there are general timelines for healing, how long an injury will take to recover depends on several key factors:

• Sleep and Nutrition: Proper rest and diet are essential for supporting tissue healing.
• Underlying Health Issues: Conditions like low energy availability, autoimmune disorders, or imbalances in lab values can slow recovery.
• Activity Modification: Following prescribed activity restrictions and avoiding re-injury is crucial for speeding up healing.

Once these factors are addressed, the healing process for the injured tissue generally follows a predictable path. While the recovery time can vary, certain tissues have a more reliable healing timeline.

Healing Times by Tissue Type

Different tissues—bones, muscles, tendons, ligaments, cartilage, and nerves—heal at different rates. The reason for this variation lies in blood flow. Tissues like bones and muscles have a good blood supply, enabling them to heal faster. Tendons and ligaments, on the other hand, have less blood flow, which makes their healing process slower.

Healing is generally broken down into three stages, each dictating how much load the injured area can handle and when it’s safe to return to physical activity.

Phases of Healing

1. Inflammatory Phase

The inflammatory phase begins immediately after an injury and can last from hours to days. During this phase, blood vessels dilate to increase blood flow to the injured area, which brings cells that help clean up the damaged tissue. You’ll often notice redness and warmth as a result. Swelling is also common, which can inhibit muscle function. The tissues are at their weakest during this phase, and it’s important to protect them from excessive strain. While inflammation is a necessary part of the healing process, it can be problematic if it lingers longer than expected—usually beyond a week.

2. Proliferation Phase

This phase focuses on tissue repair and can last anywhere from several days to several months. During this time, new cells, blood vessels, and the extracellular matrix begin to fill the injury site. Collagen—the building block of connective tissue—is laid down in a disorganized manner, providing a framework for new tissue. At this stage, the tissue can start to handle some load, but it’s still relatively weak. The collagen fibers need time to mature and align in a way that supports the healing tissue.

3. Remodeling Phase

The remodeling phase is where the real strengthening occurs. This phase can last from months to even years after the initial injury. As the tissue adapts to stress, the collagen fibers realign according to the forces they experience, which improves the tissue’s ability to handle load. For example, tendons will realign based on the lines of tension, and bone density will increase under weight-bearing conditions. During this phase, excess scar tissue is broken down, and the tissue begins to regain its strength and flexibility. Gradual, progressive loading is crucial during this phase to restore function and ensure full recovery.

The Role of Physical Therapy in Recovery

While the healing process can feel slow and frustrating, having a physical therapist guide you through proper rehabilitation and exercise progression is key to a successful recovery. A well-planned physical therapy program can help you return to your sport safely and prevent future injuries.

Understanding the stages of healing and the factors that influence recovery time can give you a better idea of what to expect. Patience and adherence to the recovery plan are essential, but with the right approach, you’ll be back to your activities stronger than before.

Thanks for reading!

As endurance athletes, it’s essential to keep our bodies in balance. Running, cycling, and swimming provide incredible fitness benefits, but they also come with their own set of challenges. To stay injury-free and perform at your best, it’s crucial to complement these activities with exercises that improve flexibility, strength, and balance. Yoga is one such practice that can enhance mobility, improve posture, and cultivate mental focus—key components for any endurance athlete.

If you’re looking to integrate yoga into your routine but can’t commit to full classes, here are five simple yet effective yoga poses that will boost your performance and recovery.

1. Downward Dog

Benefits: Opens up the shoulders, stretches the calves and lower legs, activates the core, and promotes thoracic extension.

Why It Helps: For swimmers and runners, maintaining thoracic extension and shoulder mobility is vital for proper form. This pose not only stretches tight calves and lower legs—common issues for endurance athletes—but also teaches you how to engage your core while breathing, which is crucial for long endurance efforts like running or cycling.

2. Chair Pose with Rotation

Benefits: Strengthens the legs, improves hip mobility, and stretches the shoulders, spine, and neck.

Why It Helps: This pose builds leg and glute strength, even without adding the rotation. The twisting action challenges your balance and helps open up the shoulders and mid-back, areas that often become tight from extended hours of endurance training. Additionally, focusing on your breath helps to further stretch the rib cage and spine, improving flexibility and posture.

3. Tree Pose

Benefits: Improves balance, hip mobility, and core stability while strengthening the feet and arches.

Why It Helps: As running is primarily a single-leg activity, it’s essential to have strong and stable balance on one leg. Tree pose helps train your glutes to stabilize your pelvis while maintaining control of your body. It also improves proprioception and strengthens your feet and arches, especially if performed barefoot, which benefits overall foot stability.

4. Cobra or Upward Dog

Benefits: Increases lumbar and thoracic spine extension, strengthens the core, and opens up the shoulder girdle.

Why It Helps: For athletes who spend a lot of time cycling (or sitting at a desk), the spine can become overly flexed. This pose counteracts that by promoting spinal extension and opening the front of the body. It strengthens the muscles of your back and core while stretching the shoulders, improving posture, and helping counterbalance the forward hunch created by long hours on the bike or in front of a computer.

5. Crescent Lunge

Benefits: Strengthens the legs, improves posture, and enhances core stability and shoulder flexibility.

Why It Helps: This dynamic lunge targets leg strength, hip stability, and spinal extension, all crucial for endurance athletes. Performing it barefoot can also engage the foot muscles to help stabilize the pelvis and legs. It’s a great way to strengthen the lower body while enhancing flexibility and posture, both of which are essential for endurance training and racing.

Integrating Yoga Into Your Routine

Yoga is more than just physical exercise; it offers mental benefits as well. The mindfulness and focus required in each pose can help calm the mind, reduce stress, and improve your mental discipline, all of which are essential for maintaining a steady pace during long races. By incorporating these poses into your weekly training routine, you can enhance your flexibility, balance, and mental focus, ultimately improving your performance, recovery, and race day success.