Training in your mind: A new approach to injury rehabilitation

If you have an injury that’s serious enough to immobilise an arm or a leg, you’re best to lay off the exercise for a while, right?

Not necessarily.

New research is investigating how the brain may be able to strengthen and maintain muscles where movement is restricted, by using a process known as cross-transfer. Basically, if an injured person trains on just the uninjured side, their brain may be able to mimic the movements of matched muscle groups on the opposite side of the body.

Dr Ashlee Hendy, a researcher at the Institute for Physical Activity and Nutrition (IPAN) and a lecturer in strength and conditioning sciences at Deakin, is currently conducting research into limb immobilisation. The results could shape future rehabilitation practices and be game-changing for not only injured athletes, but people with general injuries or injuries requiring rehabilitation such as those after a knee replacement.

‘People often think that if you’re injured then you shouldn’t exercise at all but that’s definitely not the case; you just need to know how to adapt your program,’ Dr Hendy explains.

Dr Hendy says the study is an important step in immobilisation research and acknowledges IPAN colleague Dr Severine Lamon for her collaboration on the study.

How can you train an injured arm or leg without moving it?

Previous studies have suggested that using the neural phenomenon of cross-transfer, your brain can transfer the effects of training and strengthening of the muscles in your right arm, for example, to your left immobile arm. Dr Hendy says her study is the first of its kind investigating the impacts of immobilisation in legs.

‘While there will still be an imbalance between the strength of the free limb and the immobilised limb, we are aiming to determine whether this approach can help reduce strength loss, which would be a huge win for anybody with a leg injury.’

The three-week study will involve participants with one leg immobilised through a leg brace and crutches receiving tri-weekly training sessions for the free limb. Dr Hendy hopes her research will help inform practices to assist rehabilitation and recovery in athletes and people with chronic conditions.

‘When you are at peak performance, you want solutions that help prevent or treat injury in the best way possible. I had an ACL (Anterior Cruciate Ligament) reconstruction at 20 years old, and if I had known about the cross-transfer effect then I may have recovered a lot quicker.’

        “People often think that if you’re injured then you shouldn’t exercise at all but that’s definitely not the case; you just        need to know how to adapt your program.”
      Dr Ashlee Hendy, Institute for Physical Activity and Nutrition (IPAN), Deakin University

What could the future of injury rehabilitation look like?

Dr Hendy believes her study will help change current rehabilitation practices by providing a more holistic approach. ‘While every person and every injury is unique, current rehab practices focus only on treating the injured side. If this study is successful, we can move towards trialling the program in people who are recovering from surgery, and in time, we hope that the standard rehabilitation approach will involve programs with a broader focus, targeting both limbs rather than just focusing on the injured side,’ she says.

As the research evidence builds, Dr Hendy and her team plan to share their findings with doctors and physiotherapists so they can improve their injury rehabilitation programs. ‘In the future, I think this will become a standard approach for physiotherapists,’ she says.

‘This is not just good news for athletes, but anyone with a limb injury. Speeding up recovery times means everyday people who sustain injuries can return to work sooner, the elderly can regain mobility after falls, and recovery from surgery will be faster,’ Dr Hendy concludes.