Non-Surgical Treatment



Stage One: Tissue Healing


Healing is a biological process that the body initiates immediately after tissue injury.

Healing is achieved in two steps;

    1. Restoring the injured tissues to the right position and close enough to one another so the body can build a “bridge” of repair tissue.   If tissues cannot be restored to their normal alignment then surgery may be required (i.e. fractured bone).
    2. Protecting the site of injury until the repair tissue is strong enough to withstand load again.  Slings, casts, braces, splints are common examples of devices designed to protect repair tissue until it heals sufficiently. If the injured tissues cannot be stabilized well enough through a brace or cast, surgery may be required to anchor the tissues in place (internal fixation such as screws, pins, etc.)

Even though the healing process begins immediately it can take months for the repair tissue to mature sufficiently to withstand load again.

The length of time it will take a given injury to fully heal depends on the following variables that a surgeon, physician or physiotherapist can discuss with you.

    1. The name(s) of the injured tissue/tissues (ie. bone, cartilage, muscle, tendon, nerve)
    2. The degree of blood flow in the  injured tissue(s) (ie. low to high)
    3. The type of injury/injuries (ie. fracture, sprain, strain, tear)
    4. The severity of the injury/injuries (ie. mild, moderate, severe).

The healing process can also be delayed in patients who smoke as well as patients with diabetes, rheumatoid arthritis, cardiovascular or arterial diseases.

Your surgeon or physiotherapist are the most qualified healthcare professionals to inform you when sufficient healing has occurred in order to safely initiate activity or exercise.

Mistake #1: Doing too much too soon

The absence of pain does not mean your injury has healed.

Just because you may have less pain at the site of your injury does not mean it’s safe to exercise.

Unfortunately, if you initiate activity or exercises too early it can cause permanent damage, delay healing and lead to chronic pain and disability.  There may not be a solution if you do too much too soon..

Before starting any form of exercise after an injury, ask your physiotherapist if it is safe to do so.


Stage Two:  Rehab Exercise


Restoring function is achieved through safe, appropriate, and progressive rehabilitative exercise.

Rehabilitation exercises are selected to progressively improve joint mobility and muscular strength without disrupting the repair tissue.  The preservation of healing repair tissue is absolutely critical.

Only after the repair tissue has healed sufficiently is it safe to initiate exercise.

Your surgeon or physiotherapist are the most qualified healthcare professionals to inform you when sufficient healing has occurred in order to safely initiate activity or exercise.

The key to success is doing the RIGHT exercises at the RIGHT dose at the RIGHT time.

Unlike personal trainers, physiotherapists are recognized as experts by physicians and surgeons in designing safe and appropriate rehab exercise programs.

Because of the potential for permanent damage caused by inappropriate or premature activity, physiotherapists and surgeons are very strict in individualizing rehab protocols that set out a clear schedule of what a patient should and shouldn’t do at each stage of tissue healing (ie. early rehab, middle rehab, late rehab).

Mistake #2  Doing too little too late.

Just because you still have pain at the site of injury does not mean that it isn’t healing and that you shouldn’t move.

In this situation, delayed movement or exercise can result in permanent joint stiffness, severe muscle weakness,  chronic pain and disability.

To prevent complications, it is critical to follow up with your physiotherapist and / or surgeon as ordered and to follow their recommendations on restoring your range of motion and muscular strength.

Never miss an appointment with your physiotherapist or surgeon.

How to return to activity as safely and as quickly as possible.


  1. See a physician or physiotherapist for an accurate diagnosis as soon as possible after your injury.
  2. Ask your physiotherapist for a written rehabilitation protocol for your injury, surgical procedure or condition.
  3. Your physiotherapist may make modifications to your protocol based on how well you are doing.
  4. Do not attempt new exercises or return to activities or sports without permission from your physiotherapist.   To avoid re-injury, ask your physiotherapist first before doing new exercises.
  5. To avoid permanent stiffness and tightness, follow up with your physiotherapist as they recommend.
  6. Get medical clearance from your physiotherapist, surgeon or physician before returning to work or full sports.