Pyramid Science

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Sunday, December 21, 2008

Injury Prevention

The medical profession has resource and expertise to objectively diagnose by X-ray, blood tests, bone scans and an innumerable array of other internal investigations. Self-diagnosis must be done cautiously as it can waste time or even cause serious harm. Injury is best left to the chartered physiotherapist. They will use various techniques to begin treatment like the reduction of pain and swelling to then guide through the recovery phase. Self-help must include an understanding of how injuries occur and how best to avoid them. Some sports carry a high risk of injury: combat sports, skiing, gymnastics. Two categories of injury are traumatic injury, which can occur suddenly and straightaway raise a problem. Maybe pain or swelling, bruise or open wound, but can be externally caused or caused by direct blow or direction change in a twist or fall (extrinsic). An intrinsic (internal) injury has no obvious cause.

Hamstring injury

Hamstrings. Overuse injuries are more subtle and the gradual onset and increasing pain are usually associated with a repeated activity. Tennis elbow, runners' shin. This is relatively easy to diagnose, but becomes difficult if severe or complicated by another more visible and immediate injury. This needs careful assessment since many inflammatory diseases can mimic such apparent injuries. Traumatic injuries can be avoided by using the correct equipment with a safe environment. A wet floor or waterlogged grass should involve cancellation or at least postponement of the activity. Referees are familiar with their rôle in keeping everything safe. Overuse injuries can be avoided by conditioning the body to the expected stress beforehand. Proper warm ups, not training every day and giving the body time to recover. Restart gradually if recovering from a injury is critical. Complete functional recovery must be made before engaging in full training stress. Proper warm downs, using the correct size equipment for strength capability. Shoes must fit and be replaced if damaged or worn.

Diet is very important to provide the correct fuel. Carbohydrate intake is for energy and protein is for growth. Do not exercise on a full stomach, but have several small meals daily of a balanced diet. Digestion requires a lot of blood and exercise diverts this away from digestion tasks. This is the cause of potential problems. Fluid intake is essential to avoid cramp, dehydration or exhaustion. Plenty of water and a moderate salt intake. Caution. Take extra salt either by professional instruction or experiment with electrolyte drinks. It is essential to drink adequate water before taking salt. If suffering from cramp, passive stretching is advisable, but with care. Application of ice can be beneficial to assist a muscle to relax. Repetetive night cramp may be indicative of circulatory problems and should be referred for medical opinion. If in doubt stop what you are doing. Illness, pain, fatigue and stiffness are general indicators of oncoming problems and to avoid any kind of injury, you must 'listen' to your body.

Rehabilitation Principles

There is never any point in trying to exercise through or 'run off' an injury. This will not work and any pain is a warning of an already sustained injury. Continuation can only make it worse. Diagnosis is the next stop and the recovery phase can only be begun in the knowledge that the injury is not aggravated. Work within the limits of pain.

Tendon and muscle injuries usually involve passive stretching to regain lost flexibility. Follow this with specific (re)strengthening exercises concentrating on the injured muscle group building to the final phase of functional exercise. Where muscle is co-ordinated with other muscles for a particular activity, stretching the injured muscles remains important for a while afterwards so to avoid stiffening and re-injury.

Warm up/warm down

Joint injuries usually consists of strenghtening exercises for muscles around a joint in order to regain stability. The exercises allow regaining mobility, leading to the final phase of functional dynamic exercises. Specific exercises must be done afterwards to protect injured joint. Stretching involves positioning muscles at their longest range, but within pain limits and holding the position for a count of ten without movement. Gradually increase the length. To increase joint mobility there is a need to stretch the surrounding muscle groups passively and to engage in some gentle bouncing movements (ballistic - extreme caution). This mobilises joint structures. Strengthening exercises only improve muscle power for load work. The frequency, loading and speed can all be modified as appropriate, but progression is the key word.

Start with little and often then build on quantity. Gentle stretching every hour or so. Several different exercises are the most beneficial for all round mobility with a slow increase in weight loading. Be guided by your own progress. Increase the loading as appropriate. Compose this treatment according to the available time and the type of injury. Most importantly work within pain limits or you risk making the injury worse. Cut back.

Alternative Exercises

Other regimens can be used to maintain fitness if there is an inability to do usual sport. Swimming is good for rehabilitation of many types of injury. Swimming as a main sport may avoid injury to begin with. Stop anything that causes pain. Resumption of sport must be started carefully and progressively, but always with caution. Much will be dependent on the specific injury, otherwise you could be set back further than you started through incorrect (or inadvisable) rehabilitation.

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