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19
May
2014

Injury Prevention & Recovery

By dave 1

For those who exercise regularly and/or exercise at a high intensity, injuries are usually a rare but occasional occurrence.  Knowing how best to avoid injuries and how best to recover from them, is vital in ensuring we train at peak performance.

Your body is very smart, it will usually tell you a long time in advance that something is not right.  You will feel muscles, ligaments or tendons ache or tighten during or after exercise and it’s usually when we ignore these warning signs that serious injuries occur.  

Always listen to your body, it doesn’t speak English so pay attention to those aches, pains or feelings of discomfort and stop what you are doing.  You might lose a training session because of it but better to stop and assess what’s wrong than to continue and tear something then be out for months or more.

Injury Prevention

Flexibility

Having supple, flexible muscles is very important in helping prevent injuries from occurring. Stretching after training and never before, will help to ensure you have flexible muscles. To maintain flexibility hold a stretch for 30 seconds, to develop your flexibility you must hold stretches for 40 seconds or more.

No static stretching where you hold a stretch, should ever be done before warming up. Static stretching tears the muscles microscopically and should only be done at the end of all exercises to improve flexibility and aid recovery. If you static stretch and then train, you are then training with a microscopically torn muscle which increases the chance of injuring the muscle, ligament or tendon.

Core Strength

Having a strong core is vital to prevent injuries in almost all the body. I doubt there’s anyone in the industry who doesn’t shout this from the rooftops. Having a strong core, helps ensure there’s a good solid foundation to build the rest of the body around, helps keep muscles functioning in the way they were designed to, reduces imbalances in the body, improves posture, increases comfort while training and more importantly increases your performance and crucially your results.

Overtraining

Overtraining is working the same muscles in the same way repeatedly and not allowing for recovery. This leads to drops in performance, plateaus and eventually injury. People who train regularly are usually guilty of this. The recovery part of training where your muscles repair and grow, is as important in my experience as the training itself. Vary your workouts and never train the same muscles in the same way, 2 days in a row. You will lose performance and you will get injured. Most people who overtrain, do this because they have a bad diet and they try to out train it – which is impossible. Train smart or be stupid, overtrain and get injured.

Warming Up

Ensuring you warm up properly has a huge role to play in ensuring you avoid injuries. Cold muscles, ligaments and tendons have less blood flowing through them, making them colder, have slower responses and have less pliability, leaving them susceptible to strains or tears. You should think of your muscles like chewing gum. Try stretching a cold piece of chewing gum straight from the packet and it tears very easily. Warm it up in your mouth and it’s much more pliable and stretches much further.

I recommend to clients that they should warm up for at least 5 minutes but ideally 10 minutes. Starting at a very gentle pace and gradually increasing the intensity as the minutes go by. Their heart rate should be between 130 and 150 beats per minute at the end of their warm up. Ideally the warm up should mimic the exercise they are about to do. For example if you are going for a run, start warming up at a fast walk gradually increasing the speed to a jog as the minutes of your warm up pass. Likewise if you’re doing a spin class or going for a cycle, start off at a low resistance/gear and slow speed. Then gradually increase the resistance/gear and speed as the minutes pass.

When doing weights, I always recommend warming up with at least 5 minutes of cardio, followed by a warm up set, for the specific exercise you are about to do. The cross trainer is a great machine to warm up on, using both the upper body and lower body. When lifting weights, I recommend a warm up set of each exercise you are about to do. For women lift an easy weight for 15 to 20 repetitions. For men it would be an easy to medium weight at around 60% of your maximum weight, lifted for 10 to 12 repetitions.

Cooling Down

Similar to the warm up, cooling down correctly really helps with muscle recovery/repair and also with injury prevention. Always aim to include 3-5 minutes of cool down exercises at a light intensity at the end of your workout. This will also ensure your heart rate and breathing gradually returns towards normal.

Hydration

Being just 2-3% Dehydrated has been shown in many studies to cause the body to be 20% less efficient when exercising. That’s a very high percentage to lose just from being slightly dehydrated, so it is vital that you always pre-hydrate before exercising. Being thirsty is a sign that you are mildly dehydrated and is your bodies’ emergency response to tell you to drink water. For most people, your urine should only be mildly colored if you are hydrated enough. Being dehydrated also causes higher risk of cramp and muscle strain. For those that exercise regularly I would recommend that you aim to drink at the very least 2 litres of water every day and even more on days that you exercise, to replace fluid lost through sweating and through your breath. A small person might require less and likewise a larger person would require more.

Muscle Knots/Trigger Points

Muscle fibers when under regular repetitive use, get tangled into knots or trigger points. Personally I find releasing these knots incredibly beneficial with not only reducing the frequency of injuries, but also with injury recovery. Physiotherapists, Physical Therapists and Massage Therapists all treat these Trigger Points, with various techniques. However there are several types of equipment that you can purchase and use yourself, that can be very beneficial. Such as: Massage sticks, foam rollers and spikey massage balls etc… Foam rollers for me are the best and most effective tools and can be bought very cheaply. If you train regularly foam rolling should be part of your weekly routine.

Injury Recovery

N.B.  Always seek professional medical advice straight away, if you’re ever injured in any way.  A delay in treatment can substantially increase the seriousness of the injury and dramatically increase your recovery time.

R.I.C.E.

R.I.C.E. stands for Rest, Ice, Compression and Elevation.  These are 4 simple techniques that when applied correctly can greatly improve your recovery from minor strains to soft tissue and also aids discomfort.  Everyone knows you’re supposed to ice an injury but most forget or don’t bother.  I cannot stress enough how much I recommend RICE, even on old ongoing injuries.

Rest

As soon as you can, you should rest the area as much as possible.  Without rest the now weakened area could continue to strain, increasing the inflammation, pain and possibly lead to further injury.  In general you should rest until you are able to use the injured area without much loss of functionality or much pain.

Ice

Ice is fantastic at quickly reducing the swelling that occurs to soft tissue when injured.  Swelling is a necessary and inevitable part of your bodies healing process, however too much swelling can be destructive.  Personally I find using Ice the single biggest factor with healing any soft tissue injuries, new or old and can’t recommend it enough.  The method I use is 15 minutes on, 40 minutes off to allow the skin temperature to return to normal, as often as you can.  To prevent frostbite, wrap the ice in a thin towel.  Frozen peas etc… work just as well and sometimes better, as they can be molded around the injured area.  Once thawed out though, they can’t be eaten.

Four Stages of Icing:

1.     Cold.

2.     Burning or Prickling sensation.

3.     Aching, sometimes this hurts more than the original injury.

4.     Numbness.  This is the most important stage, once numb you can remove the ice.  Generally takes 10-15 minutes to reach this stage when wrapped in a thin towel.

Compression

Again aimed at reducing swelling and supporting the injured area.  Apply a compressed bandage but not too tight, ensuring you don’t cut blood supply/circulation to the area.

Elevation

Again aimed at reducing swelling, it will also help waste product removal from your bodies healing process, away from area.

Joint Supports

Personally I find joint supports very effective, but they have a short window of use.  The injury should be almost back to full functionality before being applied and are a good aid to help the joint fully recover.  However if used for too long, the joint can become used to the extra support and won’t fully recover.

Hot & Cold Sprays

Personally I’ve never noticed much benefit from Cold or Hot sprays.  Their main use would be for very minor bumps, knocks or “dead legs” and simply numb the nerves in the area, reducing the pain and reducing swelling a little.  In my experience, they don’t penetrate deep enough or for long enough to be of any real benefit.

Heat

Heat is generally used for chronic pain injuries that are slow to develop and have no inflammation or swelling.  For example stiff, nagging, sore joint pain is usually treated with heat.  For those that exercise regularly applying heat to a pre existing chronic pain injury before exercising, may help to increase the elasticity in the joint and to stimulate blood flow.  Moist heat seems to work best in my experience, so use a wet hot towel for example and never leave on for more than 20 minutes.  Once again where injuries persist, always seek medical advice.

Ultrasound

Ultrasound therapy uses high frequency sound waves and is said to help ease painful joints and muscles.  There is mixed evidence to support this however and personally I haven’t noticed any benefits when using ultrasound to treat my knee and elbow injuries over the years.

Acupuncture

Acupuncture involves the use of sharp, thin needles that are inserted into the body at very specific points.  The therapy is believed to alter the body’s energy flow and is used widely to treat a wide variety of illnesses and other health conditions.  Personally I have seen some benefits when using acupuncture to help recover from injuries.  However I believe it compliments standard treatments and should never replace them.

Dry Needling

Dry needling involves the use of sharp, thin needles inserted into Trigger points in muscles.  Again there is mixed evidence as to the effectiveness of dry needling, but personally I have seen some benefits when being treated in this way to help recover from injuries.  However I believe it compliments standard treatments and should never replace them.

Tips to Help Prevent and Recover from Some Common Injuries

Shoulders

It is important to have strong equally balanced Rotator cuff muscles.  I have very basic exercises that I give to all my clients that are fantastic at both strengthening and balancing out the muscles in and around the shoulder and neck.  Ensuring the muscles in the shoulder, chest, upper back and neck have good flexibility will also help prevent and recover from injury.

Knees

Again it is important to have strong equally balanced Quads, Hamstrings and Gluteal muscles in the leg.  Having strong Quads and Glutes are the most important muscles to work on, to strengthen and support the knee joint, especially when recovering from injury.  Id estimate almost all the clients I see have very weak glutes. If your knee clicks or grinds when in motion it is usually a sign of muscle imbalance which can usually be rectified when identified correctly.  Flexibility also plays a huge role in injury prevention in the knee.  In my experience for those that exercise regularly, especially if the exercise involves impact, having a tight IT Band (muscle on the outside of the leg) will eventually lead to injury.  It is therefore vital that you focus on stretching out this muscle.

Hamstrings

A torn hamstring can be a painful, persistent and recurring injury, that if not treated properly can be hard to fully recover from and could eventually lead to a full detachment.  Having flexible, strong, equally balanced hamstrings and warming up properly are all key to avoiding tearing the hamstring.  It is common for people to only focus building the larger of the muscles in the hamstring (bicep femoris) and neglect the surrounding muscles, so it is vital you ensure you strengthen all the muscles in the hamstring.  Bridges on Swiss balls or BOSU balls are best for this.  Following the R.I.C.E. technique, building balanced strength and improving flexibility, will help to ensure you fully recover from the injury.

Ankles

Having strong ankles is extremely important for those that play sports, train with exercises that use impact or even just for those that wear high heels.  Simply standing on 1 foot for 90 seconds will help to build up the muscles around the ankle.  Advancing to do it with eyes closed will really build strength.  For clients that play sports or compete at a higher level, I always work on strengthening the ankle using a BOSU ball, but this should not be done without supervision.

Shin Splints

Shin splints describes a variety of generalized pain that occurs around the front of the lower leg/shin.  Shin splints are usually caused by repetitive trauma to the muscles or bones in the lower leg, such as excessive running on hard surfaces and/or using worn or incorrect footwear.  Sometimes if left untreated can lead to micro fractures in the bone.  Muscle imbalances in the leg, poor flexibility, incorrect footwear, poor running technique and increasing running distance too quick, can all lead to shin splints.  Shin Splints require a lot of rest and identifying then resolving the problem that caused them.  They can be stubborn to recover from as resting your legs for a long period is very hard to do.

Mild Lower Back Pain/Stiffness or Discomfort

General lower back pain or stiffness is usually caused by having some or all of these:  poor posture, a weak core, tight muscles or over training the muscles in the core.  If you have chronic recurring pain you should always seek a medical professional.  Correcting your posture, strengthening your core and improving flexibility are all simple yet effective ways to resolve this.  There are several simple exercises I use that quickly build up the core and improve flexibility.  Pilates is ideal for this, but just because you train at an advanced level does not mean you can do an advanced Pilates class.  Start with beginners, then progress.

Glutes

Tight and weak glutes can really impair speed and reaction times and can eventually lead to hip and/or knee problems.  Tight glutes can also lead into lower back discomfort.  Again improving your strength, flexibility and removing any trigger points will all help.

Tennis elbow

Describes a variety of generalised inflammation, pain or soreness that occurs to the general area, on the outside of the arm around the elbow.  This injury is common in people that play Tennis or other racket sports and is usually caused in the backhand stroke.  Constant keyboard use or poor posture using a keyboard is also a common cause.  Following the R.I.C.E. technique at the first sign of the injury will really help.  Improving the flexibility in your forearm, tricep and bicep and also removing any trigger points will also be of great benefit.  You should also work on forearm grip strength (when recovered) and improving your posture when typing or stroke technique.

Golfers Elbow

Describes a variety of generalised inflammation, pain or soreness that occurs to the general area, on the inside of the arm around the elbow.  This injury is common in people that play Boxing, Golf, Hurling, Baseball or any other racket sport which hits hard or larger sized balls.  Striking the ground is also a common cause of the injury.  Following the R.I.C.E. technique at the first sign of the injury will really help.  Improving the flexibility in your forearm, tricep and bicep and also removing any trigger points will also be of great benefit.  You should also work on forearm grip strength (when recovered) and improving your swinging technique.

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author: dave