Injuries

13.03.2015

As I am writing this I have a slight tear in my calf muscle. Very annoying and frustrating as this means that I will have to take it easy this week, which is difficult as I have fitness sessions to instruct!!! My Sports Therapist Chris Tillbrook has given me specific instructions of what I can/can’t do. While I am very good at giving these instructions to other people I am terrible when it comes to doing as I’m told!! (Sorry Chris!)

What is a sports injury?

Muscle tears or strains are usually caused by suddenly stretching a muscle beyond its level of elasticity and can be very painful! Sprains are damage to ligaments and tendons surrounding joints

Muscle strains are graded one – three with three being the worse.

Grade one strains

These are mild strains, only affecting a small amount of the muscle fibers. The healing process is approximately two-three weeks

Grade two strains

There is more extensive damage and more muscle fibres are involved but the muscle isn’t fully ruptured. The healing process is usually three to six weeks

Grade three strains

There is a complete rupture of the muscle. This will require surgery to repair the damage. If the injured person is a sports person they can be out of action for 12 weeks

When should you get medical treatment?

If you experience severe pain, swelling or numbness

If it’s an old injury and feels worse than before

If the joint doesn’t feel stable or normal

How should injuries be treated?

As you will have learned as good students on First Aid courses we need RICE in our lives. Well, I’ll have a ‘P’ please Bob (only a few of a certain age will get that attempt at wittiness!) and make it PRICE

P- Protection. Protect the injury from further damage…

R- Rest. Stop as soon as you feel something go wrong. I was half way through a studio class when I felt it go ping. Not good timing when I’ve got 40 people well into their training session. Luckily it wasn’t a bad strain and I just took the level down to low intensity, I once tore a muscle which made me fall to the floor. My class thought it part of the routine  and they all took to the floor with me!

If you try and be a hero/ignore it you are very likely to make the injury worse as you will be more vulnerable in the first few hours. Grade one and very easily become grade two or even a full rupture, you’ve been warned!

I-Ice. The best thing in your first aid kit is a bag of frozen peas (obviously keep these in the freezer not the first aid bag!!) Apply ice to the injured area (not directly on to the skin) 10-15 minutes at a time; let the area return to normal body temperature before icing again, usually after an hour is good. This will help with the pain, reduce bleeding within the muscle tissue and stop the injury from swelling. Don’t use heat for the first three days as this can cause swelling to get worse.

C- Compression.  Use a bandage or elastic support to reduce swelling. Most people know about icing an injury but don’t bother with compression. This is equally as important to protect the area form further injury.

E – Elevation. If your leg is injured support it with a pillow and try and raise it higher than your heart.

One day later…

You will probably feel more pain and if there is bruising it will look quite horrific (good for a bit of sympathy and regular cups of tea). Keep applying the RICE principle for 48-72 hours after the injury happened.

Three – seven days later…

Injuries start to heal after about 72 hours. The pain should be starting to feel better, swelling has gone down and the bruising starts to fade. You can now alternate ice with heat. Heat helps the blood to circulate carrying oxygen and nutrients to help with the healing process. You can now take off the compression bandage and gently exercise the area. Slightly stretch but don’t go past the point of pain. As soon as you feel the slightest discomfort stop.

You’ll find that your range of motion will increase gradually, don’t be tempted to hurry this up or you’ll be back to square one.  Being immobile is bad for injuries that are a few days old as this can cause stiffness. Start gently moving the injured part or walking with a normal gait as soon as possible.

Foam rollers

Foam rollers are great for rehabilitation following an injury or for prevention.

Muscles are surrounded by a soft connective tissue called fascia. This tissue can influence flexibility and joint range of movement. Research shows that using a foam roller is a form of “Self Myofascial Release” and that it makes the fascia more flexible and breaks down scar tissue and adhesions.

How long should you use it for?

Research suggests between 1-5 minutes on a particular muscle group.

How many times a week?

Usually two to three times a week works well for people. Foam rolling can be added as part of a warm up.

It is worth remembering that chronic persistent tightness can mean a weakness elsewhere so the continued need to keep foaming a particular area may indicate muscle imbalances that need working on.

What’s the best way to use a foam roller?

What injuries can foam rolling help?

It has been shown to improve flexibility and can be beneficial for the following injuries;

Plantar fasciitis                 Gastrocnemius and Soleus (calf muscles) Plantar Fascia itself – using a pedi roller or cold can rolling along the floor, the length of the sole

Patellofemoral Pain (runners knee)       Quadriceps ITB and TFL (Tensor Fasciae Latae – muscle on the outside of the thigh – roughly where your pocket is) Hamstrings Calf muscles

Illiotibial band syndrome ITBS ITB itself – be cautious when using the foam roller directly over the tender area, work into this gradually. It’s often best to work above the area first. TFL Quadriceps

Medial Tibial Stress Syndrome “Shin Splints”    Calf muscles

Achilles Tendinopathy  Calf muscles

You may have noticed a few areas come up regularly so a programme of rolling calf, quads, ITB and hamstrings will cover most things and could be used for injury prevention as well as treatment.

One of the key findings of a recent study was that the roller increased flexibility without reducing muscle performance. Other studies have reported similar findings. As a result foam rolling is recommended as a part of a warm to improve flexibility.

Avoiding injury

Warm up

It’s really important to warm the muscles up before you start exercising. Not only are you preparing your cardio – vascular system you will also be protecting your muscles and joints. Your body temperature will increase which will warm the muscles, cold muscles are easily injured. Where two bones meet we have cartilage, for example the knee. This acts as a shock absorber to protect the joint.  During a warm up blood goes to the cartilage and helps plump it up to increase the protection. We also release synovial fluid which lubricates joints and helps them glide easily.

Dynamic stretches are a great was to prepare the muscles, ligaments and tendons for the activity you are about to perform. Gentle movements which mimic the activity will warm the muscles and help prevent tears.

Cool down

Equally as important is a cool down and stretch. Gently decreasing the intensity of an exercise session rather than coming to an abrupt stop will help to slowly decrease your heart rate and the amount of blood delivered around the system. Stopping suddenly will mean that your heart is still in exercise mode and will pump the blood it thinks is still needed to the muscle groups. We don’t have a pump in the legs to return the blood to the heart; it relies on muscle contractions and valves in the veins to make its way back. If you stop quickly the blood pools in the lower limbs which can make you pass out.

I really recommend that you do post exercise stretching as the active muscle shortens and to avoid injury or muscle soreness it helps to gently stretch them back to their pre-exercise length. I see many people leave studio sessions before the cool down or hop off the treadmill and straight out the gym door.

I know what you’re thinking, I’ve given you all this advice yet I have an injury so what’s the point?! Inevitably, even if you do everything correctly but you do a lot of exercise you run the risk of injury. The lesson that a sports person has to learn is that if you’re injured rest, otherwise it could get worse.

A word of warning; if you have an injury and have to use crutches to get around, it is not advisable to get drunk … you know who you a

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