While I have been checking the bruise and looking for swelling in my knee, last night was the first time I really noticed the muscles in my legs, or lack thereof.
I knew that being inactive for 3 weeks would make me weaker but the pain has been much more in the forefront of my mind than any potential atrophy. When I’m stood up it’s all pretty much in the usual place and in my funky leggings I hadn’t noticed much change, but as I was moisturising I realised my calf was kind of… hanging off me. There was no visible difference when I tensed and it’s so jiggly, kind of like a bingo wing!
Research (source) shows that when you immobilise a leg in a brace or cast it’s reasonable to expect around a 12% reduction in cross sectional area of the quad in 4 weeks and around 20% loss of strength in 2 weeks. I had no idea that it would disappear so quickly! Now I realise that my rehab is not really about my knee at all, but about getting my leg and it’s muscles working properly again.
Japan is a bit old school when it comes to injuries, they don’t really have physios, so I’m really glad I went to one despite the Doctor not mentioning it at all, although it seems I should have gone earlier. She said that sometimes she works with people within a couple of days of getting an injury like mine, so that they don’t get the atrophy in the first place.
Before I can really work on strength though I need to regain my full range of motion. In my second physio session today I managed to to a full rotation on the static bike which is so much more movement than just a few days ago!
On the plus side, I discovered that muscle atrophy due to lack of use doesn’t result in the reduction in the number of fibres (unlike ageing) but it reduces the amount of protein that is synthesised there, so they get smaller. Resistance exercise is apparently the most effective way of regaining atrophied muscles, with a single session resulting in increased protein synthesis in as little as 2 hours and lasting for 24-48 hours after the session, so fingers crossed it won’t take me too long!
The fibre distribution also changes from slow to fast twitch muscles (source). So I don’t need to create the muscles again from scratch, I just need to get them engaged and then remind them what I use them for.
All in all I’m feeling a little more positive about the rehab process. At first I was really scared that I had such a massive mountain to climb to get back on my board, but now 3 weeks is looking a little more attainable.
Have you had experience of losing strength because of an injury? Let me know in the comments 🙂