BATTLE WOUNDS

Everyone from the trained professional to the weekend warrior knows sports injuries. When injured, all athletes want to know, “How soon can I get back into lifting, running, swimming, etc.” The treatment and duration of recovery depends on how severe the injury is, how it happened, and what kind of shape (and I don’t mean whether or not you’re ripped to shreds) the athlete is in prior to the injury. Sport injures ranges from blisters and frostbite, sprains and strains, to head trauma, broken bones and blown out knees. To keep this article interesting and more in line with the serious athlete, as opposed to novices, or those who become injured while partaking in extreme activities, I’ll narrow the subject down to typical injuries encountered in the gym, on the track, or on the court. The injuries not being discussed in this article will be hernias, fractures, dislocations, and head traumas; if you have experienced one of those injuries the likelihood of needing more immediate medical attention is imperative and beyond the scope of this article.

WHY DO I KEEP GETTING HURT?

There are three things that make an athlete vulnerable to injury: one – they are too tired to perform the activity (Fatigued), two – they are not in shape to perform the activity (Lethargic), or three – they are not using their head and attempt to do more than they are capable of doing (Stupid). All injuries occur because the traumatized body part was incapable of withstanding the abuse of the environment i.e. the weight you’re trying to lift, the distance or terrain you’re trying to run through, or how hard you’re trying to hit, throw, or dunk the ball. Sprains, strains and tendonitis account for 90% of the injuries athletes encounter. Improper care or neglect allows injuries to expand into more chronic problems with the related joints whether it is the foot, knee, back, shoulder, elbow or neck. If you keep hurting yourself there is a likelihood that you never totally healed in the first place.

HOW TO DIFFERENTIATE BETWEEN COMMON INJURIES

So you’re hurting and you don’t know if you have a sprain, strain, tendonitis, a muscle cramp, or maybe the muscles are just stiff and sore Injuries can be classified as mild, moderate, or severe depending upon the degree of trauma. How each injury occurred must be taken into consideration before care can be administered. Therefore, the basic parameters that follow are guidelines on how to help you through the initial process of determining what’s wrong and what care may be needed.

Sprains

Sprains involve injury to the ligaments, the joint, and sometimes the bone of which ligaments are attached to, while strains are injuries to the muscle and tendon. Both injuries are usually present when serious trauma occurs. To determine the difference, a sprain usually occurs suddenly when one turns an ankle or knee when running or jumping. The injured area will hurt immediately and increase in pain when the extremity (shoulder, elbow, wrist, knee, or ankle) is taken through a complete range of motion. More severe pain is usually felt again at the end of the joint’s normal range of motion; the ligament will be tender and painful and may also be discolored (bruised, swollen and red).

Strains

The most common and generally overlooked injury is the strain. Many refer to it as a muscle pull or tear. The tear can occur in the muscle belly or at either end of the muscle where it attaches to the bone. Strains occur either suddenly or gradually following prolonged or extreme use through muscle contractions against resistance, such as excessive reps or extremely heavy weights. Depending upon how the injury happened and the seriousness of the trauma, pain can be sudden and extreme, or dull and achy and increase when the muscle is used. Extreme strains cause swelling and tenderness and even a balling up of the muscle that has been torn. The swelling can cause joint pain and a persistent annoying ache. With less traumatic injuries, many athletes won’t recall what originally happen that started the pain, and subsequently blow it off as insignificant. Ignoring the pain may prolong your recovery and complicate the injury every time you work out and demand full utilization of the compromised muscle and joint.

Tendonitis

Tendonitis develops when you neglect a muscle strain. The prolonged overuse produces chronic inflammation that will eventually cause an irreversible protective calcium layer in the joint causing arthritis or worse yet, a bone spur.

PAIN IS NOT THE PROBLEM IT’S ONLY THE SYMPTOM

The easiest, most dangerous, and certainly the dumbest thing an injured person can do, is take something that stops the pain and continue to play. Mind you, I’m not talking about a simple little bruise or tweak that goes away on its own, I’m talking about an injury that hurts when you use the muscle or joint and doesn’t go away within a couple of minutes. To cover up the pain and play on that injury, is only asking for bigger complications that are harder to heal later on. The pain meds, even the use of “over the counter medications” can cause serious complications to the liver and kidneys. A good example of this is Alonzo Mourning a professional basketball player, who for years suffered with the aches and pains associated with being a professional athlete. On October 28, 2002 he was placed on the inactive list because of a condition called “focal segmental glomerulosclerosis” (scaring and impaired kidney function). He developed this condition by taking high dosages of something anybody can get over the counter ASPIRIN. Aspirin along with Ibuprofen, Aleve, Naprox, Voltaren and Indocin are classified as non-steroidal anti-inflammatory drugs (NSAID). According to an article in The New England Journal of Medicine (June 16, 1999) the author estimates 16,500 deaths per year are due to complications associated with taking aspirin and aspirin-like products. The active ingredients accumulate, causing damage to your stomach, liver and kidneys, which can become life threatening. Is it worth the risk? I don’t think so.

Another thing, if the pain you’re feeling today is a result of something that happened two, three or more months ago don’t you think your body should have healed it by now and if not why not? So what do you do?

WHAT DO I DO WHEN I INJURE MYSELF?

First, stop whining! Second, if you aren’t getting better, schedule an examination with a trained professional who has your best interest in mind. It may not be your HMO doctor or the local doc-in-a-box. You want someone who is better equipped in sports injuries and understands how to handle the cause of your pain instead of giving you something that just covers it up. The following recommendations are conservative and appropriate for mild to moderate injuries.

The application of ICE on Sprains Strains and Tendonitis is the best thing you can do in the acute stage for the reduction of pain and swelling. Ice helps slow the degree of inflammation by decreasing the blood flow and minimizing bleeding into the tissues that cause swelling and pain.

If you’ve sprained your ankle, knee, wrist, elbow or shoulder you’ll want to use the following procedure referred to as RICE: Rest, Ice, Compression, and Elevation. When you blow out an ankle, knee or shoulder, you’ll know that you’ve done something and will want to stop doing any activities that cause pain. So, REST. While resting you’ll want to stop the pain and slow down the inflammation. The quicker you slow down the inflammation the quicker the recovery so that is why you ICE it. COMPRESSION keeps the swelling down and prevents movement. Gently wrap the area as quickly as possible with an “ace bandage” or tape. Then kick back, and ELEVATE your leg, foot, elbow, or wrist. Within the next couple days when inflammation is not an issue you can start to use heat. DON’T USE HEAT FOR AT LEAST 48 TO 72 HOURS. Ice is always the preferred modality over heat initially. If you decide to use heat, use it in conjunction with ice. Apply ice for twenty minutes followed by ten minutes of heat, followed by another twenty minutes of ice. Around the third or fourth day, begin to stretch the area that was injured and within a week or two, be ready to gradually start working out, using ice after the work out. Always start working out gradually and cautiously, and within four to six weeks you should feel more capable and tolerant to a normal work out.

Now, you know what to do with the acute stage of your injury in order to get back to the gym, or court within four to six weeks, but, what does one do when the injury is not getting any better? Ask yourself, “am I just a wimp, or is this something that really needs professional attention?” The likelihood of being a pansy is very common, so the first thing you should do before giving up training is to determine how long and how bad you’ve been injured. On a scale of 1 to 10, one being good and ten being bad, how bad is it? Let’s say you injured yourself four to six weeks ago, and you have been pretty good about keeping the ice on, stretching the muscles, and minimizing the activity to the injured area during your workout schedule. The pain level is a 2 when hanging out and a 6 to 8 when working out. That’s a good indication you were more injured than you originally thought. Your body is having difficulty adapting and has compensated by recruiting another muscle group or system to help pull the load. A major part of the problem, is finding someone who can help. Most M.D’s won’t know what to do. Therefore they will send you to physical therapy. The P.T. will help by making sure you are stretching properly, and strengthening the muscle groups that help support the injured area, they will also make sure you are ergonomically lifting, running, cycling, or swinging the racket. If you were looking for an alternative approach I would recommend a chiropractor with Applied Kinesiology training. Chiropractors understand what allows the body to function more normally, how the body heals and how the physical and nutritional needs of a patient need to be addressed for a more complete and thorough healing.

AN OUNCE OF PREVENTION IS WORTH A POUND OF CURE

Once rehabilitated, your health coach should sit down with you and clue you in on what to do to prevent injuries from reoccurring. Each person will need specific instructions based upon their sport and injury; However, there are four things you want to make absolutely sure you’re doing on a regular basis to help prevent injury:

One, WARM UP: Anybody who has been working out for any length of time knows your chances of injury increase with a lack of preparation. There never seems to be enough time to get the type of workout you want and still stretch properly, do your cardio, and cool down. Solution make the time, or the injury will give you more down time than you ever thought you had available.

Two, BE CONSISTANT WITH WORKING OUT: Make your workouts a part of your daily routine. The person who is going to get into more trouble with injuries is the one that works out hard one or two days a week, and doesn’t work out again for another week or two. If you aren’t in the gym or on the court, make sure you are stretching or doing your cardio daily. The more consistent you are, the more you’ll know your strengths and weakness and less likely to injury yourself.

Three, EAT NUTRITIOUS FOOD and DRINK PLENTY OF WATER: Entire magazines are written on this subject. If you aren’t drinking at least 1/3 of your body weight in ounces of pure water, you are dehydrating and just asking for trouble. The foods you eat are the materials needed to construct the instrument you’re taking into the gym or onto the court to use.

Four, GET A HEALTH COACH. Every professional has a coach to help them perform better. Find yourself a HEALTH coach – a chiropractor, physical therapist, or trainer who is not just interested in making you feel better, but seriously interested and knowledgeable in enhancing your performance by allowing you to function and perform at your optimum potential.