Rethinking Sports Injury Rehabilitation—the Best Way to Get Better

Anyone who has spent more than a few minute with trial lawyer Doug Landau knows that he is constantly on the move. This triathlete lawyer has long used “active recovery” after competitions, as well as other modalities, to speed up the healing process. Injured athletes are realizing that staying active is a crucial part of the rehabilitation process. Staying active can mean both physically and mentally.

One of the ways that lawyer Landau recovers from injury, and/or a hard competition, is to run in the water with his aqua jogger flotation belt. In addition, long rides on a recumbent bicycle set on an easy level enable him to keep the blood moving, without impact or danger of further re-injury. After he had undergone double hernia surgery several years ago, in order to maintain fitness without risk of undoing the successful surgical procedure he underwent at Reston Hospital Center, Landau walked every day until cleared to return to running, and eventually weight lifting.

The key for athletes and active individuals is to ask what they can do, as well as what they should not do.

Asking treating doctors, physical therapists and other healthcare providers for strategies to accelerate the healing process through active lifestyle choices may help an injured patient recover more quickly and help keep their sanity! Keeping as active as possible during rehab is now routine for sidelined athletes at all levels of fitness.

Doug and Melissa Landau after a race
Melissa & Doug Landau understand that regular participation in athletic competition sometimes get interrupted by injury. Active rehabilitation can aid competitive and recreational athletes in recovering more quickly AND keeping their sanity! The Landaus are shown here after finishing the Tropical half marathon in San Juan, Puerto Rico during their recent vacation to the warm, welcoming island.

When personal injury attorney Doug Landau was studying physical therapy 40 years ago, he was told to rest when he acquired stress fractures and shin splits from training with the Boston University track team. In fact, rest, ice, painkillers and taping were the preferred course of treatment. However, this caused athletes to lose strength, aerobic capacity and flexibility. Plus, Landau observed that many members of the track team not only lost physiological fitness, but also suffered psychologically. Top level and recreational athletes, used to a regular dose of endorphins, were cut off cold turkey. In addition, a number of collegiate athletes gain significant weight during this period of inactivity, which may make it even harder to come back from an injury. This could be because they’ve lost some coordination, and now have more weight on damaged joints, bones and connective tissues. Several of lawyer Landau’s close friends seem to be stuck in a vicious cycle of chronic injury, because of the strong desire to be competitive coupled with the lengthy periods of total inactivity.

While rest is still a good call for sleep deprived athletes, and muscle repair and growth occur during the sleep cycle, the “cold turkey” approach is falling into this disfavor. The standard of care currently seems to be to keep athletes as active as possible, without aggravating their underlying injuries, or putting them at greater risk for re-injury. Identifying and correcting the bio-mechanical, nutritional and other issues that may be leading to muscle imbalance, training mistakes or physical weaknesses are important points of focus as well.

While the PT mnemonic “PRICE” is still a good idea, there is more to an athlete’s recovery than:


These five tactics do not address the underlying issues that may have caused or contributed to the injury or disabling condition.

Landau, like many athletes, therefore engages in low impact activities such as recumbent or upright cycling, aqua jogging, swimming, rowing and elliptical machines in aid to recovery and maintaining fitness. These activities help with blood circulation and getting healing nutrients to the injured muscles and connective tissues. They help repromote cell growth and repair while also maintaining aerobic fitness, vascular gains, and the high level of metabolism required for participation in most endurance events.

Science establishes that exercise removes cellular debris that accumulates from damaged tissues and accelerates the flow synovial fluid, which is incredibly important to join lubrication. Landau likes to say that running in the water helps to get “the gunk out.” The bones, tendons and ligaments can be healthy, but if the lubricating elements are missing, sports participation becomes painful and no longer enjoyable. Furthermore, when muscles are not being used regularly, you are going to lose their elasticity.

Further supporting the move towards more active rehabilitation and recovery after injury is the fact that aerobic exercise helps release human growth factor hormones. These hormones promote healing in the tendons and connective tissues. Landau points out that this is important because tendons and ligaments have a very poor blood supply, as you can see by their white coloration, as opposed to the red, blood-infused muscles.

The psychological and emotional boost from regular workouts can be just as essential to a full, successful physical or structural recovery. Evidence tends to suggest that exercise can help with stress, boost moods and help prevent and treat depression. Without regular activity, athletes’ level of stress and the stress hormone cortisol can become chronically elevated. This can lead to tissue breakdown, and hinder the healing process. Furthermore, cortisol can lead to fatigue, depression, headaches, colds and flus, as well as digestive problems. If an athlete has a regular schedule, then a cessation of activity can also lead to impaired sleep, which is critical for the body’s tissues to recover, heal and grow. Even if an athlete cannot participate in his/her primary sport, other activities can keep their minds and bodies sharp, and help accelerate the healing process.

One of the cruel truths lawyer Landau has learned over his decades of athletic competition is that it is much easier to lose fitness than it is to gain it. While a day or two will not usually lead to huge losses in aerobic fitness or strength, de-conditioning can happen very quickly. Plus, he has found that as he gets older, staying active becomes more important as hard won gains in fitness can disappear more quickly.

If you or someone you know was injured while exercising and/or participating in a sport, due to no fault of your own, please give us a call (703-796-9555) or email us at Abrams Landau, Ltd.