Why Proper Injury Management is Important

I recently treated a young dancer who hurt her leg at school.  The story of how she hurt her leg and her subsequent recovery is a perfect example as to why safety recognition and proper injury management is key. 

Now her mechanism of injury is somewhat amusing but totally preventable.  While at school she slipped on a pencil and awkwardly caught her balance.  She was unable to extend her leg fully and was walking around on her tippy toes when I saw her.  She complained of pain in her upper calf.  She had no swelling or deformity.  Her hamstring and calf were in spasm which was causing her pain.  I sent her home with instructions to RICE (rest, ice, compress & elevate).  This is where the story turns ugly.  She went to school the next day feeling better, that was until she was not allowed to ice during recesses and lunch.  When her mother arrived home, her ankle was swollen, bruised and sore.  She was in so much pain, you could not touch her leg without her crying.  Click here to see her ankle.  After one day of ice, elevation and rest the swelling had gone down and by day five full range of motion had returned and she is back to dance.

  

Her injury was totally preventable, making sure that things are not left on the floor and encouraging kids to be aware of their surroundings.  However, kids will be kids and that can't always happen.  What could have happened is the proper management post injury.  As was seen by her recovery once the RICE principle was initiated, if this had been done the day after injury then the swelling, pain and bruising would not have been so severe. 

Basic injury management principles are just that basic and simple.  The RICE principle has been around for many years and does not require much advanced knowledge of injury management.  Correct management obviously creates a more ideal situation for healing, which is in the best interest for everyone.  A similar situation is a friend of mine who hurt her knee during soccer.  Her husband told her to heat it that night.  These two situations show the importance of more education on basic injury management.  

As health professionals we may feel that everyone knows how to deal with acute injuries, but everyday athletes both young and old are getting improper advice which in turn prolongs their injury and taking them away from being active and achieving success. 

For more information on injury prevention and management follow us on Twitter @EliteInjuryMgmt and check out our website www.eliteinjury.com 

So You Made a Resolution

How many of us have made to lose weight by exercising more.  A great way to better yourself and improve your health.  We are half way through January and are starting to reach the point where people are faltering with that resolution.

One of the keys to maintaining a lifestyle change such as working out is to ease into it.  Not only will it easier to have this change be a lasting one, it will be more beneficial to the body.  When you push yourself too fast to soon you put yourself at risk of injury and not maintaining your exercise program which can lead to fluctuating weight.  We are going to focus on the injuries that can occur by doing to much to soon.

There is an increased risk of musculoskeletal injury when taking on a new exercise program to quickly.  Moderation is a key when starting out or changing your exercise program.  The exertion that you are putting on your body is more than it is used to which can lead to injury.  Typical injuries that you may experience when starting out with an exercise program are muscle soreness, muscle strains and depending on your choice of exercise you may see ligament sprains.

Muscle soreness is typical with physical exercise and typically is called DOMS - delayed onset muscle soreness.  DOMS is normal with workouts, and occurs one to two days after exercise.  If the pain is severe or lasts for longer than two days, you have progressed from normal muscle soreness to muscle damage.  If the pain is so severe that you our unable to complete daily tasks such as walking or lasts longer than the normal two days, you need to make a change to your program.  This also applies to any time you make a change to your work out.  For treatment of DOMS the best way to reduce pain is to continue with moderate exercise.  Stretching, cryotherapy and massage therapy have not shown to be beneficial in the reduction of pain from DOMS.  One of the best ways to deal with DOMS is to alternate your work out, by giving the muscle groups a day or two of rest before training them again, you allow the body to heal/repair from the prior work out.

Muscle strains occur when the muscle is taken beyond its normal capacity be it load capacity or range of motion.  These typically occur when using too much weight or performing a move that requires flexibility that you have not gained.  If you have taken up strength training, yoga or classes such as Zumba, you may be more prone to a muscle strain if you do not pay attention to your body.  Slow and easy is the best rule of thumb when starting a strength program. When doing exercises that involve flexibility or doing a movement that goes beyond your norm, pain is your guide.  If the movement hurts, stop.  Find a way to modify the movement, but continue to work on building towards completing the movement properly.

A ligament sprain can occur during weight lifting, running, or during activities such as Zumba, dance, soccer or even yoga.  You typically will not see them if you are cycling, running on a treadmill, rowing or using an elliptical machine.

As part of a complete exercise program, you need to have a flexibility and propioception portion.  A full body stretching program will help alleviate any muscle imbalances caused by improper posture.  Propioception is knowing where you body is in space.  By working on balance and proper positioning you reduce the chance of injury. Think of a volleyball player coming down from a block, if as they land their ankle starts to roll, an athlete with propioception training body will notice this and activate the muscles to avoid the injury.

Setting the goal and resolution of losing weight is an admiral one that will only be of full benefit if you are able to continue with it and avoid injury.

Performance Athletes and Injuries

All athletes at some time or another will need to compete or perform in front of a crowd.  For some athletes however, they are always in the spot light.  Performance athletes such as dancers, gymnasts, and figure skaters have the added pressure of always being critiqued on how they perform.

For many performance athletes both male and female the pressure to look good as well as perform at their best pushes them to extremes that other athletes don't try to achieve.  As with many athletes the fear of losing a position is great with all performance athletes.  This fear be it real or imagined can drive athletes to try and do anything to keep their position.

When dancers, gymnasts, figure skaters and cheerleaders become injured the notion of rest and recovery is a foreign concept to them.  They will hide injuries from their coaches and parents, not wanting them to know as their coach or parent may take them out of sport for the duration of their injury.  Performance athletes are prone to over use of pain medications due to this, which now causes more health issues on top of the initial injury.  However, some coaches and instructors expect their athletes to push through all injuries no matter how detrimental it will be to them both short and long term.  In some clubs and studios it is expected that athletes will train and compete through pain and that personal sacrifice and risk taking are expected and shows how dedicated you are to your sport, teacher and studio.  These athletes also tend to feel large amounts of guilt if they do become injured as they feel they are letting their coach, parent, team or troupe down.

A change of culture needs to occur in these sports.  Somehow all of us from coaches, parents, athletes, officials and health care providers need to encourage performance athletes to properly manage their injuries.  They need to know that their place in their team or troupe is secure and that their long term health is important.  Educating athletes and coaches to see beyond the next performance is part of this change.  No matter the sport proper injury prevention and management coming from all aspects of the athletes life is important.  The more education that coaches, athletes and parents have the safer the athletes will be in the present and future.