Let's face it, if you are an athlete, injury is inevitable. It's not a matter of if, but when, especially in the more grueling endurance and contact sports. There is no magic way to avoid injury, plain and simple. However there are many ways you can help yourself avoid many of the more "preventable" injuries. Such as repetitive strain injuries, strains and sprains, and joint dysfunctions. True some people are just "injury prone" due to structural or postural idiosyncrasies, but they to can help reduce maybe the severity, or frequency, by following these steps. By no means am I revealing anything new to many of you, but hey, we learn through repetition ya? So here are your 5 reminders of how to play safe and avoid injury.
Remember those sit and reach tests in gym class? That was to check the flexibility of your back and hamstrings, and somehow that was supposed to show how flexible you are...like one plane of movement tells us anything. Flexibility is a widely recognized factor in tissue health. "The more flexible you are the less likely you are to injure." They say. Tell that to dancers and gymnasts! While it is true that there is no major correlation between flexibility and injury prevention, it certainly makes sense the reasons we do it. Ridged muscles and ligaments don't elongate well, thus create an increased risk of tearing, otherwise known as a strain or sprain respectively. The trick is knowing if you are inflexible due to a shortened muscle, or an elongated muscle. Sometimes a muscle can be what we call hyper-tonic or ridged and short. Other times the muscle can feel tight because it is already over stretched or elongated. Think of a rubber band already pulled tight, ready to snap. This is where it is important to know which is which, because an already elongated muscle, will not respond well to repeated elongation. Those muscles will actually respond better to strengthening versus stretching. This is where a knowledgeable massage therapist, PT, or personal trainer can help you. We would be able to look at your posture, do some assessments and tell you what is short and what is elongated. Then we can do what we do to improve upon that.
2.Proper warm-up and cool-down:
All to often I hear about people stretching during a warm-up or getting right into their car after a run. Sure we have a time limit, we have to go to the bank, get groceries, and meet Franny at the restaurant by 8. But your body will thank you, and you will get much more out of those exercises if you warm-up and cool-down properly. To warm-up you want to move! Static stretching should be avoided as most studies have shown that static stretching done before activity actually reduces performance and does not help in reducing injury. If anything it may actually promote injury to stretch cold muscles. Instead do a "dynamic" warm-up. This is a combination of movements designed to promote increasing of your heart-rate, warming of the tissue, and range of motion exercises. This can be done in 5-10 minutes and you should be breathing heavier, and a starting to sweat. It is, after all, a WARM-up. Consult the wonderousness of this Youtube sourced video!
A proper cool-down is NOT walking to your car. A proper cool-down involves gradually letting your heart rate normalize by slowing your pace or walking, if you are doing cardio. Now this is where static stretching fits into the picture. If you jump into the sitting and stretching too soon you may incur a blood pressure imbalance. Your heart is still pumping at 160 bpm, however you are no longer assisting in the venous return by flexing your muscles in a rhythmic manner, causing blood to "pool" in your extremities. To suddenly stop moving you risk passing out or unnecessary fluid build-up. Once you have reached a heart rate of 120 bpm or less do some stretching for all your major muscle groups. Hold each stretch for at least the count of 10-20. Your muscles are nice and warm and pliable now, you will get much better stretching gains post workout. Holding it for a longer period of time will also help your nervous system remember the new tissue length.
3. Proper form and posture:
This bit is so important. Many people, much smarter than myself, have spent hours, and years even, to study and discover the proper technique to perform just about any athletic or work related action. Your body was built a certain way, you have muscles that attach at certain spots on certain bones, and they have a certain kind of leverage that is most efficient in a certain position. This is why teaching kids at a young age how to properly tackle an opponent is so crucial. This is also why we pay so much extra to see a good personal trainer or coach to show us how to do these things. I can tell you that a high percentage of work and play related injuries occur because of bad form and posture. This is also a topic that is constantly evolving. Remember in the old days of running you were probably told to strike with your heel roll to your forefoot and push off while you run. Well thanks to innovations in science, namely pressure plates on treadmills and slow motion HD cameras. We now know that it is far more efficient to run on our forefoot and create forward momentum through hip flexion and body angle. Say whaaaaat?! I offer a free running gait analysis with your first massage for this very reason. Most people have terrible running form and we certainly see a lot of them walk through our doors for Plantar Fasciitis, knee, hip, ITB, or back pain. Ask about our 9 week back to proper running form. Gazelle sports in Kalamazoo also has a free Good form running clinic I often recommend.
4. Proper Equipment:
Is your sporting equipment worn out, outdated, or simply the cheap option? Well you are asking for trouble my friend. Shoes, Helmets, Pads, cups, goggles, and such of all shapes, sizes, and brands. Now is not the time to be a cheap skate. In this world of sporting equipment, all to often, you get what you pay for. For example, football helmets. We all know that concussions are a major concern in this sport (Though concussions happen in almost all sports with football, lacrosse, hockey, wrestling, cheerleading, and soccer leading the pack). Football helmets are actually rated by a scale to test how concussion prone you would be if wearing this helmet called a STAR rating. This number is created after extensive testing, the lower the number the better the helmet. A good helmet would be about a .300, which roughly means you have a 30% chance per season of concussion. Some helmets on the market are actually rated over a 1.0. Which essentially means you are guaranteed a concussion during this season! Why would you buy that helmet? Bottom line is, do your homework, make sure it fits, and replace it before it fails.
5. Take care of your soft tissue:
What is the best way to care for your soft tissue you ask? Why, massage and a good strength training program is. Even if you are an endurance athlete, you NEED to strength train. Quite frequently runners knee is due to weak hip abductors not doing their job. You may hear health professionals throw the word "imbalance" around from time to time. We are usually referring to the fact that in a certain area of your body, the muscles that work opposing to each other are not of equal strength. This happens most often in the core muscles. A majority of people are very strong in the back and hip flexors, but weak in the abdominals and hip extensors. This leads to a postural inefficiency known as lower cross syndrome. The tell tail sign of this is over curvature of the lumbar spine. This type of "imbalance" can lead to groin, hamstring, and back injuries if not corrected. Cue the massage therapist, PT, or personal trainer to the rescue. Get some massages done on the Back and hip flexors, do some exercises for the abdominals and hip extensors, your posture should start to get better with repetition. Now you are on your way to being less injury prone. Another way massage can help is helping to break up old scar tissue from previous injuries. Scar tissue tends to be a bit like wet spaghetti, once its stuck in a wad, you need to carefully break it apart so you don't rip the strands. Scar tissue that has healed improperly is much more likely to re-injure, versus those that have been properly treated. Any good sports massage therapist should know how to properly treat an injury. Finally, make massage and strength training a regular part of your training program. Dr. Jordan D. Metzl, a frequent writer for Men's Health, and author of the book "The Athlete's Book of Home Remedies" says "I'm a huge believer in having a massage twice a month and even more often when you are training hard. This goes for athletes of all types. A good massage is one more way to help keep your muscles supple and less prone to injury."
These are just a few ways you can make yourself less prone to injury. I'm sure I will think of others, as I currently am thinking of at least 5 more, so look for a future blog to have more ideas. Stay healthy.
Nicholas Garman, LMT NSCA-CPT