Coping with Injury:
What You Need To Know

Injuries fall into one of several categories including; sprains, strains, subluxation, luxation, stress fractures and fractures. A sprain is an injury to a ligament, the soft-tissue structure that attaches 2 bones together. Sprains can range from mild, where the ligament is partially torn, to severe or a complete disruption where the ligament is ruptured and torn. A strain constitutes a tearing of the muscle-tendon fibers. Strains range from partial tears to a complete rupture. Muscle strains occur at the site where stress is most concentrated. These sites are part of the tissue where the muscle turns into tendon and is referred to as the myotendinous junction. This is also where the tendon inserts into the bone. Subluxation is a partial dislocation of a joint, the bones usually pop back into place on their own, but not without causing soft tissue damage. Luxation is a full dislocation and occurs when bones that come together to form a joint become separated. This involves stretching the joint capsule and ligaments. A stress or fatigue fracture, is a small crack that develops in a bone as a result of repeated stress. Finally, a fracture is a break in a bone.

To avoid injury means avoiding training errors. Start with a proper warm up routine ensuring sufficient blood flow throughout muscles and joints, increase exercise loads slowly and maintain proper form throughout and allow for sufficient recovery time between workouts. Once injury has occurred it triggers the body’s inflammatory response. Athletes and exercise enthusiasts often fall into a vicious cycle known as overuse syndrome. Overuse syndrome is the buildup of swelling and inflammation that leads to pain and decreased blood flow. Pain causes muscles to tighten, leading to a further reduction in blood flow, which in turn leads to even more inflammation.

The inflammatory response interferes with the body’s natural healing process as fresh blood flow is required to heal. Fresh blood brings in oxygen and nutrients needed to build healthy tissue and carries away waste products and excess fluids that have built up in the area.

External factors that increase blood flow also help decrease inflammation and facilitate healing. Heat, cold therapy, massage, ultrasound, radial shockwave therapy and even moderate exercise may be of value.

Injuries often occur either at the beginning of a workout or game, when muscles are tight and cold; or at the end of a workout and game, when they are fatigued and weary. Warming up and retiring before complete exhaustion reduces the risk of injury. For example, the majority of ski injuries occur late in the day after the lower extremities and body is fatigued.

Warming up prepares the body for increased activity allowing blood vessels to expand and the heart rate to increase slowly. Synovial fluid fills spaces between bones cushioning the impact of activity. Additionally, warming up raises tissue temperature; the increase in temperature results in an increase in pliability further decreasing the risk for injury.

Although injuries are unique, there are general patterns, causes and treatments. Each injury occurs through the prism of each individual makeup and circumstance. Regardless, there are some broad guidelines to follow for minor injuries and pain.

When something feels acutely or chronically painful as a result of activity, stop the activity immediately. Pain is the result of inflammation, a tear or rupture and signals damage to the tissue. Further pressure and or movement will compound the injury, even if it’s minor.

Inflammation is the main enemy in the hours following an injury. The more swelling the more the affected tissue will be remain injured and the longer it will take to get back to activity and full strength.

To minimize inflammation, begin a regimen of RICE immediately. R is for rest and I is for ice. Icing or cold therapy constricts blood vessels which serves a dual purpose, it minimizes pain and helps reduce inflammation. Treat the injured site for 20 minutes and reapply daily 3 to 4 times during the first 48 hours following an injury. Do not apply heat during the first 48 hours and don’t massage fresh injuries. Both actions increase the flow of fluids that contribute to inflammation. Heat and ice are both extremely helpful in speeding healing, but are used in very different ways. Cold therapy increases blood flow by initially slowing it down and constricting blood vessels. This indicates to the brain that the injury site is cold so the brain sends more blood to warm it up. Heat, however, increases blood flow by dilating or opening up blood vessels. Heat can be applied after 72 hours following acute injury. If heat is used earlier, it is likely to increase swelling and inflammation. After 3 days, both heat and ice can be used, alternating treatment therapies can simulate the effect of flushing stale inflammatory fluids from the area and driving in nutrient rich fluids.

Non-steroidal anti-inflammatory drugs or NSAIDs are sold over-the-counter OTC or through prescription. NSAIDs can aid the healing process by working on 2 levels. First, as analgesics, they decrease pain. Second, they retard inflammation by temporarily preventing the body from producing platelets. Thus nutrient rich blood can flow more easily through the injured area. Anti-inflammatory medications typically require daily usage after an injury to ensure the proper amount of drugs remain in the system to treat the injury site. Daily usage and longterm overuse of NSAIDs can lead to internal organ problems, including both kidney and liver failure so monitoring intake is extremely important. Topical herbal analgesic compounds applied directly to the epidermis have shown to deliver the same effects and potency as traditional OTC anti-inflammatory tablets. By bypassing the stomach and entering the body through the skin some all natural topical preparations have exhibited high efficacy, decreasing pain and inflammation and even resolving the injury completely.