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30 m a s s a g e & b o d y wo r k m ay/ j u n e 2 0 2 3 By Til Luchau KEY POINTS • Inflammation, pain, rest, and habit-modification are intrinsic parts of injury recovery. • It is easy to underestimate the personal impact of the switch from "alleviator" to "afflicted" when we're dealing with our own injuries and physical challenges. Knee Journal A Personal Log of an Injury's Progress THE SOMATIC EDGE I hurt my knee skiing yesterday. Shoving my ski instead of carving it through a steep turn, I lurched and felt a searing pop on the inside of my knee. Weight- bearing felt OK, but any tibial abduction or external rotation made me nauseous with pain. Today, almost any knee movement hurts. Suddenly, instead of being the alleviator, I'm the afflicted. What a switch! I am reeling a bit from the change in perspective. Rather than heading out first thing for my daily walk or run, I'm in bed, pondering my immobility. I have all the usual early-morning restlessness that gets me out into the snowy predawn fields around my house. But now, with most movement painful, I'm left with just the restlessness. As a daily mover, I've wondered what I would do if I couldn't run or walk. I've imagined I'd get more creative with upper-body activity. Easy to say . . . at this moment, waking up on the first day after getting injured, I'm seeing all the barriers and limitations more than I'm seeing the possibilities. Fascia fibroblast choreography in injury repair. Diagrams (top): Fibroblasts swarming and migrating (red to blue) toward the surface in injured tissues, forming tissue mats in the early phases of connective tissue injury healing. Micrographs (bottom): Fascial fibroblasts swarming during scarring. A: Fibroblast swarms. B to C: Consolidation over time. Collated from Jiang et al., 2020, and reproduced under a Creative Commons Attribution 4.0 International License (creativecommons.org/ licenses/by-nc-nd/4.0/). In my 20s, I spent a couple of months in a brace after injuring the same knee in a motorcycle wreck. The forced immobilization made me sit with things I wasn't taking time for in a way that was ultimately really great. I wonder what's ahead this time? DAY 3 With my routines disrupted, I lie in bed updating my knowledge about medial collateral ligament (MCL) injuries. It is a well-connected and multilayered structure, with its named portions including the deep MCL, the superficial MCL, and the posterior oblique ligament (POL). The POL is the main structure I probably injured, based on what I feel, the twisting mechanism of injury, and my lack of a posterior cruciate ligament (ruptured playing wallyball 15 years ago) that normally would help resist the external tibial rotation that produced that loud pop on the ski slope. Commonly injured, the MCL and POL either: (a) usually repair themselves, even when torn (say the rehab-physio sources, which I like hearing), or (b) need early 1 TECHNIQUE