Fitness articles

Injury & Recovery

28/01/2011by in

Injury & RECOVERY

Over the past 20 years the country has seen an explosive growth of public interest in mass participation, be that within sport or the joining of a health club. However “Sport for All” has inevitably led to “Sports Injuries For All”.

The information provided in this article is meant as a general guide to injuries, which could be faced by a sports person or a regular gym goer. It is also very important that should you injury yourself in a sporting context or within the gym then do seek medical advice from a recognised professional as soon as possible.

Muscle Injury

Muscles are groups of fibres that contract to cause movement. Muscles are attached to bones, other muscles or skin and are responsible for all bodily movements and force. When abused, misused, overused or put to use without being warmed up, muscles can tear. A lot of blood flows through muscles to supply them with sufficient oxygen and nutrients to enable them to do their jobs and also to sweep away waste products. The blood flow helps muscles heal quickly, in minutes, hours, days, weeks – depending upon the extent of the injury.

Muscles provide the power for the body’s movements. They are firmly attached to bone and transmit the pull of their contraction over one or more joints through noncontractile tendons inserted into bones. Muscles contract in response to spinal reflexes or in a response to detailed control from the brain. Muscles need a rich blood supply and both strength and capillary vascularity are improved by training.

Muscles may be damaged by direct blows, which may cause bruising and some disruption of fibres, or by self induced tears.

Muscle Tears / Strains: Can be classified as mild, moderate or severe.

A severe strain involves a complete rupture of the muscle or tendon. Mild and moderate strains, that is, pulls of muscular tissue, are much more common than complete ruptures.

Muscular tears may occur deep (central) within the muscle or towards the edge (peripheral) of the muscle. At first it is not possible to differentiate between a peripheral or central tear, however after a day or two, the two types can be distinguished. 

A central tear is usually more painful, loss of function is more evident and bruising is unlikely, whereas a peripheral tear bruising normally appears.

Treatment

Central tears may take about three times as long to return to full training as peripheral tears, which can drain and heal more quickly. Good management should permit recovery in about 3 weeks for the average central tear or 1-2 weeks for the peripheral tear.

The first principle of recovery is R.I.C.E.D, starting with:

Rest: The aim of first aid is to stop bleeding and minimize tissue damage.

Ice cools the tissues and diminishes the bleeding, however always place ice within a towel when applying. If ice is not available then a packet of frozen peas are just as good. Ice may be applied for 15-20mins every 2-3hours depending on the severity of the injury.

Compression is produced by firmly bandaging the affected part, so as to constrict the tissues sufficiently to stop further bleeding, but not enough to stop circulation.

Elevation is raising the affected part so as to allow free drainage by gravity of tissue congestion.

Diagnosis: Consult a sports medicine specialist as soon as possible after the injury.

Remember that early treatment speeds recovery and a quick return to activity.

Rehabilitation

After the first 23hrs the principle of muscle rehabilitation is clear. The aim is to stretch the muscle back to its full range of movement, passively and then actively. Passive treatment like heat and massage cannot of itself mend tissues – only exercise restores muscles. In the long term if you avoid injuring muscles, you’ll likely avoid damaging tougher parts of the body as well, such as bones, tendons and ligaments.

Tendon Injury

Tendons are among the body’s toughest materials. They are the connective bands and cords that attach muscles to bone. They have a sparse blood supply and metabolism but due to compactly aligned collagen fibres, have a high tensile strength. Tendons have limited elasticity and loss of this with age predisposes to injury. They have weak blood supplies, so they take much longer to heal when badly injured. The body’s two largest tendons are the Achilles and the Patellar (knee).

Tendinitis consists of a slight pain on movement and tenderness on being touched. This is a common response to unaccustomed or excessive exertion and usually settles within a day or two with rest. Total Rupture of tendons is unusual, however partial rupture of a major tendon is quite common.

Treatment

Rest is nearly always the treatment of choice for tendon injuries as further movement can increase tissue damage.

Bone, Joint and Ligament Injury

Fractures

Fractures come in a variety of forms, simple, greenstick, comminuated, compound and stress. Fractures are X-rayed to establish extent of the break and then treated by manipulative reduction to correct alignment and immobilization, usually for several weeks, in a plaster cast. Fractures take from 4-6 weeks up to several months to heal.

Stress fractures are the characteristic occupational hazards of the sporting bone. Stereotyped movements put very localised stresses on a bone, which finally cracks. At the same time the tiny crack starts to heal itself. The usual treatment required is simply 3-6 weeks avoidance of the repetitive sports movement. Symptoms usually subside within about 10 days when there is an obvious temptation to resume sport. This usually brings the symptoms right back.

Joint Injury

Sprains are stretching injuries caused to the joint structures. The joint capsule, lining and adjacent ligaments can all be damaged. A synovial effusion causes pain and swelling due to tension caused in the joint by excess synovial fluid secreted by the lining.

Ligaments
Like tendons are made of tough connective tissue, which envelop joint sockets, lashing opposing bones together firmly. As with tendons ligaments can tear or separate from bone.

Ligament Sprain
The principle function of ligaments is to maintain a joint’s integrity while it is moving. Acute sprains of ligaments are graded as follows.

Grade 1: Minor tearing of ligament fibres resulting in local tenderness, slight swelling, and dysfunction, no joint instability.

Grade 2: Partial tear of the ligament resulting in local tenderness, swelling, moderate disability and mild to moderate joint instability.

Grade 3: Complete tear or rupture of the ligament causing strong tenderness, swelling and bruising with severe joint instability.

Becoming Injury-Resistant

Progress Gradually: Pushing your body harder than its ready to be pushed results in damage, whether its tiny tears that make your muscles sore, or larger traumas like lower back spasms.

Warm Up: Without question, inadequate warm-up is a major cause of injury. Muscle fibers are like elastic bands: When they are cold, they are stiff and liable to tear. Warm muscles up, and they are not only more pliable but they also contract faster and in effect become stronger.

Use Safety Gear: Using the right equipment, be that headgear, trainers, clothing, scrunchies to keep the hair out of your eyes all help to reduce the risk of injury.

Learn the Right Moves: Educate yourself to train wisely by reading books or magazines. Get the assistance of a more seasoned trainer to give you guidelines and assistance.

References
Sports Injuries, Diagnosis and Management; Christopher Norris
The Fitness Leaders Handbook; Kangaroo Press
ACE Personal Trainer Manual
The Men’s Health Guide To Peak Conditioning; Rodale Press