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- Caring for Injuires part 1
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Then something goes wrong, the world blurs sideways, flow spatters into chaos and suddenly you're looking up at what seems a strangely peaceful sky. Your intellect barges in on your subconscious neural party and asks what the hell is going on. "You've done enough harm," the brain tells the body. "Let me handle this."
What happens next is important. The brain has to know what to do, and the body has to go along with the plan—not just because you want the pain to stop but also because you want to repair whatever is damaged as soon as possible. To not deal with injuries actively is to risk not being able to do anything actively. "Most men who stop running permanently do so because of injuries," says Susan Kalish, executive director of the American Running and Fitness Association in Bethesda, Maryland.
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We'll remind you of the basics.
| Muscles are groups of fibers that
contract to cause movement. Muscles are attached to bones, other muscles or skin
(contracting muscles is what makes you smile) and are responsible for all bodily movements
and force. When abused, misused, overused or put to use without first being warmed up,
muscles can tear, go into spasms or do any number of painful things A lot of blood flows through muscles to supply them with sufficient oxygen and nutrients to do their jobs, and also to sweep away waste products. This blood flow helps muscles heal quickly—in minutes, hours, days, weeks—depending upon the extent of the strain they were under. . |
| Tendons are among the body's toughest materials. They are connective bands and cords that attach muscles to bones. Connective tissue doesn't have much give, isn't very rubbery, doesn't care to stretch. So, when overly stressed, tendons rip loose from bone, or they tear. |
| Ligaments—also made of tough
connective tissue—envelop joint sockets, lashing opposing bones together firmly. As
with tendons, ligaments can tear or separate from bone. Tendons and ligaments have weak blood supplies, so they take much longer to heal when badly injured—as long as six months in some cases. Severe tears might take surgery to fix. If you suffer a serious tendon or ligament injury, you must quit exercising the injured area. And you must be particularly careful when you resume exercising. And you can't even think about restarting early, if you want to rebound quickly. "Injured ligaments and tendons often are pain-free long before they are completely healed," says E. Davis Ryan, P.T., owner of Community Physical Therapists in Fort Lee, New Jersey, and co-author of The Lazy Person's Guide to Fitness. They need to be babied for at least six weeks, he says. |
All injuries are unique and deserve lots of individual attention, but they're also much the same. Because the body's response to insult is fairly consistent, the steps a wounded warrior should take are similar from one injury site to another, notes David Janda, M.D., director of the Institute for Preventative Sports Medicine in Ann Arbor, Michigan. Even when a doctor's attention is called for, you'll usually want to first try these forms of aid to get some immediate relief. Use the RICE stuff. It's a classic, familiar formula for reducing swelling and pain, this acronym for Rest, Ice, Compression and Elevation (RICE). What's less appreciated is that these four courses of action are grouped together because each takes a different approach to counteracting a single problem: the spilling of blood and fluids into the injured body part. This bloat-provoking leakage and the pressure it exerts—especially when it's in a joint—can severely limit mobility and curtail your return to active life long after the pain has subsided, says Allan M. Levy, M.D., team physician for the New York Giants, partner at the Sports Medicine Center in Fort Lee, New Jersey, and co-author of the Sports Injury Handbook. Keep swelling down, and you'll be back in action faster, with less pain and aggravation. According to Dr. Levy, the reason RICE works is that:
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Stretch for the future.
Stretching is a foundation of prevention and treatment alike, for similar reasons: Tight muscles curtail movement, effectively reduce strength and, significantly, leave themselves vulnerable to becoming injured again, says Dr. Levy. The problem here is that when you damage muscles, they react involuntarily by contracting, or shortening. It's a protective mechanism short-term, but long-term, muscles that aren't gradually lengthened again will heal in their shortened state. When you resume activity, these shortened muscles will more easily tear than when you first got injured—that is, unless you stretch. As a rule of thumb, you'll know you're ready to resume activity when you can stretch the injured muscle as far as you can the same, uninjured muscle on the other side of your body without pain, says Levy.Pop the right pill. You're in pain, you want relief, you open the medicine cabinet. What to choose? For injuries, the pain reliever of choice is ibuprofen, the main ingredient of familiar brands such as Advil, Nuprin and Motrin IB, says Dr. Janda. Ibuprofen is an anti-inflammatory, which means it reduces swelling and with it, pain. If you don't have any on hand, try aspirin, because it also has anti-inflammatory properties, suggests Dr. Janda. Aspirin interferes with blood clotting, however, so it shouldn't be taken in large doses during contact sports, Dr. Levy notes. The last choice is acetaminophen medications such as Tylenol, which kill pain, but do little to reduce inflammation. (They do, however, provoke less stomach irritation, if that's an issue for you.)
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And then there are injuries. Broken bones, ligament tears, repetitive stress injuries that threaten to sideline you long enough to degrade your overall fitness level, not to mention your mental state, says Dr. Levy.
The strategy for dealing with small and big injuries is the same. You use the same first-aid method in the moments after the injury: RICE. Applied quickly, RICE greatly lessens the damage and recovery time required in most cases, says Dr. Levy.
You also use the same recuperation strategy: Do everything you can to let the injury heal as quickly as possible, then do everything you can to get the injured part back to where it was, or even better, in terms of flexibility and strength, says Dr. Janda.
Other truisms exist for injuries, no matter where they occur: For example, a pulled muscle needs to be worked—stretched—as it heals; torn ligaments or tendons need to be left alone, advises Dr. Janda.
The final truism is that while each injury should be treated uniquely, the same dozen or so happen over and over and over. "Most of the injuries I see are in just a handful of areas," says Dr. Janda. We bet you know right where they are. Here are some specific healing techniques for those places that typically take the most punishment.
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Training six days a week, Pearl knows that injuries are inevitable. And he knows how to use weight training to speed rehabilitation from injuries. Below are two programs: one for injured muscles, one for injured tendons or ligaments. Muscle injuries take less time to heal than injuries of connective tissues. Plan accordingly.
Of course, begin with lighter than usual weights, lifted a few days a week. Select a weight in the light to medium range for your training level. This program, he says, causes injured muscles to flush with fresh blood, rebuild tissue and clear away wastes. The intention in this training program, he says, is to rebuild strength first, then endurance.
For serious weight lifters, move up to six sets—the first three sets at ten, eight and six reps, the next three at eight, six and four. After a month, you can work back into your regular program. |
As with the muscle program, only begin working with weights when the swelling has subsided and you can go through the full range of motion without pain. This is a six-week program, three days a week, of a well-rounded program like our Core Routine.
At the end of the program, return to your regular routine. A couple more general pointers from a weight-lifting pro who not once, but four times, ruled the body-building universe: * Always warm up, get the blood circulating, raise the body temperature, work through range of motion before tackling the heavy weights. * Always start small. Begin with a light weight and add resistance with each set. The world champions do. They don't head for the big weights on their first set. |
Wrists are particularly prone to overuse injuries and repetitive-motion injuries, says Dr. Levy, as well as sprains and even fractures from sticking your hand out to break an unexpected fall. |
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Sprains are the most common wrist injury, says Dr. Levy. He x-rays all but the mildest wrist sprains because a sprained ligament sometimes pulls loose a bit of bone, causing a fracture. A fractured wrist needs to be encased in a cast. A sprained wrist usually heals well in a soft splint.
Primary treatment of a sprained wrist is the standard RICE prescription. A wrist-support splint available in drugstores helps immobilize it during the rest phase. Then, as it heals, begin building strength and flexibility with these range-of-motion exercises. Dr. Levy recommends taking an anti-inflammatory medication through the first ten days of physical therapy. Among the exercises he advises:
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Tennis elbow doesn't sound like a wrist injury, does it? But actually it is an inflammation of muscles in the forearm—the muscles involved in moving the wrist—and an inflammation of the tendon tying the muscles to the elbow, says Dr. Levy. When you have a serious case of tennis elbow, you can't open a jar, turn a faucet, lift a cup of coffee, clench anything or squeeze with your hand without hot pain shooting up the inside of your arm or radiating around your wrist and elbow.
Baseball pitchers get something similar to tennis elbow from snapping the ball. But in this case, it's on the inside of the elbow. (Sometimes they get much more serious pitcher's elbow—a bone injury—which requires arthroscopic surgery and takes up to a year to heal.) Golfers get tennis elbow, too, but on their nondominant side. A right-handed golfer will find his left side affected.
The treatment for tennis elbow is exactly the same as that used for a wrist sprain, which is described above.
| When to see a doctor: As Dr. Levy notes, even a minor wrist sprain should be looked at, given the possibility of it developing into something worse. If you have any pain that is recurring in your wrists, you could have a repetitive stress injury. Given the delicacy of the joint and the importance of your hands to all existence as you know it, when it comes to wrists, don't play tough—get to a doctor if you suspect anything is wrong | Next Page |
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