Exercise & Injury

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Dealing with workout-related injuries. The wise trainer will take protective measures to avoid injury, so that pleasure rather than pain is derived from your exertions.

by PHIL JOFFE

Care should be taken to start any form of workout with a thorough warm-up, by mobilising joints and slowly raising the core temperature of your muscles. Protect your feet with a good pair of activity-specific shoes; remember, ‘time wounds all heels’ and your exercise footwear is your best protector against a multitude of foot complications. Begin at a low level of intensity and gradually increase effort, never exceeding 85% of maximal heart rate. Posture and good technique should be maintained throughout a workout to exclude imbalance injuries. Be sensitive to your environment and climate. If it is hot and humid, lower the intensity of your workload and keep well-hydrated with water. If it is cold, introduce a longer warm-up, as tears and strains are more likely in cold body tissue.

The majority of minor injuries suffered arise from the impact nature of many cardiovascular activities, or because of the repetitive stress experienced by overusing a particular body part. Avoid this error by introducing variation into your programme and do not overwork any one muscle group.

Serious injuries require medical attention as soon as possible. Minor injuries you can handle yourself, also as soon as possible, using the well-tried PRICE procedure: Protection. Rest. Ice. Compression and Elevation. These are the steps to follow in the treatment of bruises, strains and sprains. The latter occur when ligaments surrounding a joint are twisted, stretched or damaged. A strain occurs when muscles or tendons are pulled or over-stretched, and a bruise appears when internal bleeding follows the tearing of skin tissue.

First, one should protect the body from further harm by stopping the activity that caused it. Second, the body should be allowed to rest without attempts to work through the pain. Third, crushed ice or cubes of ice (even a packet of frozen food in an emergency) in a plastic bag, or rolled in a towel, should be applied to the damaged area for up to thirty minutes, depending on how sensitive your skin is, and this treatment can be repeated regularly for anything up to seventy-two hours after the event. The ice will numb the damaged part, locally constricting the blood vessels, thus reducing any bleeding into the area. Ice helps relieve pain and reduces the bruising and swelling of injured tissues, but to avoid ice burns, do not apply directly to the skin.

After ice has been applied, compression should follow. Bandage, but not too tightly, the area affected and this will lend support, prevent additional bleeding and reduce stress and swelling. Elevation of the damaged limb is useful in assisting gravity in the return of blood to the heart; venous return is often reduced in injury as blood pools in the damaged area. Always give an injury enough time to heal, but if pain persists, see a doctor.

What follows are only some of the injuries which may be sustained during exercise because of overuse or poor body mechanics:

Shin splints – Refers to aching pains felt down the front of the shins, the pain being localised on the inside of the tibia bone of the shin. There are a number of causes of this general condition, including stress fractures of the fibula bone, inflammation of the membranes covering the bone, or swelling of the muscles within the muscle-sheath because of excessive bouncing, jumping or jogging on the toes and ball of the foot on a hard surface. The condition is promoted by not wearing supportive shoes and by excessive pronation of the ankle joints. Stretching the calf muscles thoroughly and strengthening the front shin muscles helps prevent this disorder, as does decreasing high-impact activities (running, etc.).

Stress fractures – These are fine fractures found either in the tibia or fibula of the lower leg, or in the small bones of the feet, and may be caused by over-repetitive moves, similar to those mentioned before. These hairline fractures are sensitively painful to the touch and often difficult to see on an X-ray. Only rest will help heal this problem, and you should train around the injured area or swim or cycle where possible to help rehabilitation.

Stitch – The side-stitch is often experienced by beginners and is usually caused by a spasm in the diaphragm. This is a result of improper breathing and insufficient oxygen because of the rapid contractions during exercise. To prevent stitches, train at a more gradual pace, breathe carefully (exhale on effort), and if you experience the discomfort of a stitch, stop exercising, breathe deeply and slowly, and the stitch should pass.

Cramps – Common in unfit trainers, cramps are caused by a number of conditions. Stomach cramps often follow exercising too soon after a heavy meal, when the blood supply needed in the working muscles is diverted from the digestive system. Fatigue can cause a muscle to cramp, as will dehydration, cold, over-stretching of unfit muscles, and certain chemical imbalances. A balanced diet containing all the essential nutrients, a fully hydrated system while training, and a full warm-up and cool-down programme will help prevent cramps.

There are a number of exercises that are considered to be contra-indicated exercises, more likely to injure than to stimulate pain-free growth. Speed often lowers the quality of movement, whereas a slower, more sustained contraction of muscle, using the full range of movement across a joint, will provide safer and more effective development of fitness. Locking of joints which support body weight (especially knees) can interfere with balance, coordination and control, and hyper- extending the spine can be dangerous. Controlled, moderately paced, fully executed exercises, with movements within the parameters of the natural movements of the joints and muscles are the safest and most likely to succeed in producing a stronger and better-toned body.
With increased awareness of the capabilities of your body, you should be able to develop performance and derive the satisfaction that grows from exercising energetically and safely.

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