The Health Clinic

Sports injury advice (New Item)

No.

CONDITION

 DATE SUBMITTED
1.

Plantar Fasciitis or plantar fascia strain - Symptoms and treatment advice - Written by Brian Porter

 December 2005
2.

Achilles Tendon Injuries - Symptoms and treatment advice- Written by Brian Porter

December 2006
3.

Exercise Physiology The Science of Performance - A link from Martin Bates

 17th January 2006
4. HEALTH & FITNESS ITEMS FROM THE DECEMBER MAGAZINE  19th December 2007
5. MAGAZINE ARTICLES FOR SPRING 2008  New Item 23rd April 2008

ADDITIONAL ADVICE

1.  Stretching

The main purpose of stretching is to promote flexibility and thereby reduce the risk of injury. The more stretching we do the better our flexibility. Note that flexibility takes time to improve. Do not expect to see major improvements overnight!

 CONTRA INDICATIONS TO STRETCHING:

Ø      Pain

Ø      Medication for pain

Ø      Injury

 PRINCIPLES OF STRETCHING:

  1. Should be a part of daily routine for all athletes.
  2. Stretch before and after each workout. Warm up before stretching at the start of the workout and warm down before stretching at the end of the workout.
  3. Relax as you stretch.
  4. Wear comfortable clothing.
  5. Stretch to the edge of discomfort but not beyond.
  6. Do not hold your breath during the stretch.
  7. Isolate the muscle to stretch.
  8. Move into the stretch slowly and hold for 30 seconds. Feel the tension slowly decrease as the stretch is held.
  9. Move out of the stretch slowly.
  10. Perform at most, 4 repetitions of each stretch.
  11. Practice proper techniques. There is no benefit in taking shortcuts.

Click here for more stretching exercises. 

2.  Injury Treatment Advice

The quicker an injury is treated the greater the chance of a speedy full recovery. Treatment should start immediately where possible and certainly within 24 hours.

Fast action limits damage. Think R I C E D (Rest, Ice, Compression, Elevation, Diagnosis)

REST.

This will prevent further damage to the injured part The injury should be supported using splints, bandages or plaster cast. Rest completely for 48 hours after injury and do not put weight on the injured part. Crutches can be used to aid mobility of people with injured legs. A sling should be applied to support an injured arm. Rest also forms an important part of training and should be incorporated into any training schedule. This can be in the form of complete rest from exercise or active rest, (exercising muscle groups other than those in your main activity. For example, a runner may swim on his rest day. This form of exercise can also help those recovering from injury to maintain muscle tone and aerobic capacity.

ICE.

Ice should be applied over the injured area as soon as possible after injury to reduce the metabolic rate and oxygen requirements of the cells in the surrounding area. These cells would otherwise die, causing secondary injury. The cold also reduces the internal bleeding and swelling.

Care must be taken when applying ice. The ice should not be placed in direct contact with the skin but covered by a cloth to prevent cold burns. If the area is being massaged with ice, oil should be applied to the skin. In the initial stages of injury (usually the first 48 to 72 hours), ice should be applied every 2- 3 hours, reducing to 3 times a day as healing progresses and swelling subsides.

Ice should be applied for at least 10-15 minutes, increasing to 30 minutes, unless the skin is sensitive and the area feels uncomfortable, in which case, remove the ice for a minute, then re-apply. The skin should turn colour: pink for pale skin, darker for dark skin.

Heat should never be used in the acute stages of injury as it increases metabolic rate, increases the blood flow and causes swelling. Heat may be used after healing has taken place and bruising has turned yellow. Massage can be introduced at this stage to further promote healing and remove scar tissue.

There are various ways to apply ice:

  1. Stroke oiled skin with an ice cube, keeping the ice moving over the area slowly.

  2. Ice cubes can be shattered and placed in a towel, which is wrapped around the injury, over a tea towel.

  3. Freezer packs or frozen food such as peas can be used These should be wrapped in a towel. They are very effective as they mould to the shape of the limb and can be re-frozen for future use.

  4. Ankle or wrist injuries can be immersed in iced water in a bucket. The part is immersed and held for as long as is tolerable, removed for a few minutes then re-immersed.

Maintain compression to the area whilst ice is applied. Do not enclose the whole of a joint to prevent super-cooling of the blood in the joint.

COMPRESSION.

This means applying pressure to the affected area, which helps to limit the bleeding into the tissues. Elasticated tubular or crepe bandage may be used. Additional pressure can be applied if a layer of cotton wool is applied to the area before bandaging. Non-elasticated bandages are not used as the strapping needs to stretch to allow for swelling.

Bandages must not be too tight as it will restrict circulation. If swelling increases the pressure increases and causes further damage. The swelling and colour of skin beyond the strapping should be checked. White/grey skin and blue nails indicate the strapping is too tight and needs to be released.

ELEVATION.

The injured part should be supported in elevation whenever possible. Gravity will then assist the drainage of any fluid away from the area. This helps to reduce the pressure and pain within and around the tissues.

DIAGNOSIS.

Accurate diagnosis is crucial for maximum recovery. Medical advice should be sought as quickly as possible if there is any doubt about the injury and is essential for the following:

Head injuries. Headache, nausea, vomiting, dizziness, following head injuries. Pains in the neck or symptoms down the arms such as tingling or numbness. Pains in the back and down the legs, or numbness. Breathing difficulties or chest pains. Fracture, or suspected fracture. Dislocation of a joint, or severe injury to a joint or ligament. Profuse bleeding and deep or large wounds. Severe muscle and tendon injuries. Abdominal or groin pain. Eye injuries.

3.  THE EFFECTS AND BENEFITS OF SPORTS MASSAGE

1.  General Circulation.

All the cells in the body need a good supply of blood, which has all the ingredients needed for their growth, repair and nutrition. Cells also need to get rid of waste materials such as lactic acid, and debris from tissue damage or inflammation.

Massage has a pumping effect, which stimulates the circulation of blood and so increases the supply of new blood to the tissue and increases the rate at which waste is removed from the tissue, thus speeding up the recovery from training, competition or injury. As well as being beneficial to the muscles being massaged, the general circulatory stimulation can help improve the health or recovery of most other systems of the body.

2.  Scar Tissue. 

When damage occurs to tissues, some bleeding will take place and will develop into scar issue, which is a vital part of the healing process. However, very often too much bleeding occurs which can lead to excessive amounts of scar tissue forming.

Massage techniques are used to prevent excessive scar tissue from forming. Where scar tissue has formed, massage is used to break it down into smaller particles, which can be removed by the blood circulation system.

3.  Adhesions and fibrous tissue. 

Scar tissue, which is left, will form adhesions and fibrous tissue. In the early stages, scar tissue is sticky and can stick muscle fibres together. For a muscle to work properly, these fibres need to slide across each other, but when stuck together they cannot do this and the affected area will not stretch or contract, reducing the efficiency of the muscle.

Friction massage is used to break down the adhesions by literally tearing the adhesive bonds apart. Once separated, the fibres are able to function properly again. Although this can be painful at the time of treatment, it does not damage the muscles. When a large fibrous knot has formed there may be little or no blood circulation in it so natural healing cannot take place. When the knot is loosened by massage, blood flows into the area, which stimulates healing and continues the breakdown process. Often a large knot will reduce by 10 per cent at the end of a massage, but when massaged 4 or 5 days later it may well have reduced by a further 20 to 30 per cent as a result of the increased blood flow.

4.   Tissue Flexibility. 

Massage is able to stretch specific localised areas of muscle tissue, though it must be remembered that this is not a substitute for the warming up and stretching which all sports people should carry out regularly.

HOMEPAGE