Sports Injuries Self Management
During my adolescence, I was a high-ranking, competitive athlete and served my mandatory Army draft in the Sports Club of the former Soviet Union Army. This Army Sports Club was the main camp to prepare Olympic national teams. Our coaches pushed us to the “limit”. A practice session would not stop until our heart rate would reach 210-220 beats per minute. For young and well-trained athletes this entails a great deal of hard work. We practiced six hours daily, three hours before noon and three hours each evening. There is substantial scientific data to conclude that overly intense workouts, like those often required by professional sports, contribute to health in rather harmful ways. In my case, in the Sports Club as well as at the national team level, this detrimental factor was offset by implementing mandatory rehabilitation from overtraining in the form of post event sports massage, neuromuscular reeducation training, post-isometric relaxation techniques, etc. These rehabilitative means minimized damage to the body, prevented sports-related injuries, and increased the longevity of athletes in professional sports.
Now, when I observe the work out routines of many sports enthusiasts in gyms it reminds me of the way we used to be forced to work out in the former Soviet Union Army Sports Clubs, with the only difference being not to receive the constant mandatory rehabilitation. Since I mentioned that sports enthusiasts work out as hard as competitive athletes, the following material is addressed to both groups.
When athletes work out so intensely and do not receive rehabilitating treatments for overtraining, sports enthusiasts expose themselves to side effects such as the muscular pathologies, the instability of joints and more.
Being an elite professional athlete in competitive sports in the NBA, NFL or Olympian teams, etc. has little to do with “sports” as in the original connotation of this word. It is a very rough, extremely tough, physically overloading and demanding, and emotionally traumatizing multi-billion dollar display of what is essentially a “show business” industry. To survive and succeed today, an athlete not only has to possess physiological potential but also volunteers to be pushed to both physical and emotional limits. Blaming coaches for overtraining is only partially correct. The bigger portion of the problem consists mainly of the protocols and policies of athletic organizations. Let’s also remember that in addition to a smart training protocol and hard work, God given (genetic) physiological potential plays a crucial role in whether one can succeed in professional sports. Those who are born with extremely high physiological potential can withstand greater overloads without succumbing to sickness. But there are many more individuals who cannot.
When an athlete lay ill in an ice bath, has lost his appetite, etc.; this is already a clinical expression of dangerous exhaustion. In most cases, this doesn’t happen overnight but is due to an accumulation of over-training/overload side effects over time. After vigorous work outs muscles will demonstrate a higher resting tone. This is the first over-training side effect that must be eliminated. Otherwise, a “snow ball” of negative effects in time will cause increasing illness for the athletes or even can cripple them, ending their career.
One sample of over-training side effects is called “Simple Delayed Onset Muscle Soreness.”
The “Simple Delayed Onset Muscle Soreness” is only one example of the massive side effects of over-training trend in the modern exercise “continuum”. These side effects cause multiple severe traumas to muscles, tendon and ligament tears, herniated discs, and the untimely, extensive development of osteoarthritis and much more.
The phenomenon of exercise stress induced side effects and subsequent sports related injuries are the result of two major factors:
Lack of proper pre-event warm up and constant rehabilitation from the side effects of exercise.
Inability or unwillingness of an athlete to undergo a full rehabilitation after a minor injury.
Proper pre-event warm up
Since my arrival in the United States sixteen years ago, I’ve been a member of physical rehabilitation departments in various medical groups. All those years I was amazed, witnessing the disproportional complications caused by sports injuries and the need for complicated reconstructive surgeries, including spinal surgeries.The term “disproportional” relates to comparative statistics between athletes and sports enthusiasts in the US vs. Eastern Europe, the part of the World where I spent the first twenty years of my career as a rehabilitator. Being a high ranking competitive athlete, and working with the Eastern European Olympic teams, I was very familiar with these statistics.
The incredibly high statistics reflecting US sports related injuries has, however, a simple explanation. I realized this phenomenon once I started to observe vigorous work out routines in sports clubs and athletic organizations. In their pre-event warm up routine the vast majority of athletes only jogged a little, stretched for 10-15 minutes and considered that these activities prepared them for vigorous exercise. Never did I see a hint of neuromuscular re-education and post-isometric relaxation techniques. It seems as if the United States athletes had no concept of these techniques, which are so necessary to achieve athletic longevity and prevent sports related injuries.
The improper and incomplete warm up does not prepare the body for the excessive loads that muscles, tendons, ligaments and joints routinely sustain during vigorous exercise and athletic activities. In most cases, eventually this leads to strain/sprain type injuries. These injuries result in tendon, muscle and ligaments tears and various other pathologies of muscles and/or joints. Therefore, the constant improper warm up procedures will lead to the devastating sports injury statistics here in the United States.
Stretching is a necessary portion of warm up programs; it contributes to the increase in range of motion. However, in the case of developing muscular pathology, stretching alone will cause instability of the region, which in turn leads to muscle, ligament and tendon tears at the time of forceful movement.
The first picture we see the muscle in its normal resting tone. The physical manifestations of the normal resting tone are: the absence of discomfort, tension or restriction of motion, and the absence of having the urge to massage these particular muscles. The second picture we see a muscle with a raised resting tone. As you can see, the same muscle is shortened and thickened. In this instance, the person may experience a little discomfort. At the same time we can expect that the muscle will demonstrate some degree of insufficiency during stabilization and movement.
This raised resting tone of muscle can result from physical or emotional overload. Irritation of spinal nerves can also initiate the reflective higher tone. This insignificant raised muscle tone level must be addressed. Otherwise, the muscles will gradually accumulate tension, to the point when microcirculation will be disturbed, and the pain analyzing system will be activated. Consequently, the person will start experiencing pain and limitation in range of movement, along with many other dysfunctional attributes.
Here, we can say that this particular muscle will demonstrate insufficiency in movement and in stabilization of the region, which in turn contributes significantly to the instability of the joint.
In addition to the muscle’s instability, if this painful stage of muscular abnormalities is not addressed in a timely manner, the muscle can develop a hyper tonic condition along with the pathological changes within it.
Usually, the raised resting tone of muscles should be addressed by receiving massages or by a regularly scheduled, constant warm up routine.
The third picture shows a difficult muscular pathology. As we know, muscle mass is composed of muscular fibers. In this situation, partial fibers of the same muscle accumulate much more tension than other parts of the same muscle, which makes this portion of the muscle shorter than the rest of the fibers of the same muscle. Any attempt that will cause the muscles to participate in movement or stabilization will also cause the over-tensed portion of the muscle to disproportionally overwork. Now, massage alone or regular stretching will not help. If this difficult pathology will not be adequately addressed, it is very possible that a person will suffer a significant muscular tear. The constant overwork of this part of the muscle will gradually lead to partial microscopic muscle fiber tears. One day the most insignificant movement can cause a massive partial or complete tear. In this condition stretching, may aggravate the abnormality.
At the time of maximum stretching, Golgi organs, located in the tendon, fire electrical impulses that cause muscular relaxation. With this pathological change in the muscle the impulse will bring relaxation to the unstressed part of the muscle and will not affect the pathologically changed portion.
The cure comes in the form of post-isometric relaxation techniques. In order to explain what post- isometric techniques are we first have to discuss the three types of muscular actions. The muscular actions are divided in isotonic, isometric and isokinetic.
Isotonic action is when muscles contract without extra load, gradually shortening and transmitting the power to sustain the movement.
Isometric action is when muscles attempt to contract, but because their action is countered with equal force in the opposite direction, they cannot produce any movement. As a result all of the muscle mass is forced to stretch in order to fight this resistance. At the time of isotonic movement, the shorter, over tensed part of the muscle will work, but the loose part of the muscle will not. This regime will significantly overload the pathologically changed part of the muscle.
In order to eliminate pathological changes within muscles we must apply isometric action and post-isometric relaxation techniques. Isometric action will stretch the pathologically shortened part of the muscle just as it will stretch the rest of the muscle. After the pathological part of the muscle is stretched for thirty seconds all the muscle fibers will be stretched equally. At this time we need to apply post-isometric stretching techniques. This causes Golgi organs to fire impulses, thus making the entire muscle equally relaxed.
No one, including experts in all rehabilitative fields, is a hundred percent certain that muscles don’t begin pathological development within one of its sections. Therefore it’s important to devote the first ten minutes of warming up to self post-isometric relaxation exercises.
The other important factor that can be a serious pre-condition for significant sports related injuries of the spinal column and joint region traumas is Bio-Mechanical Disturbances. Bio-Mechanical Disturbances is a broad term describing any functional anomaly or dysfunction of the skeletal muscular system. Static biomechanical disturbance refers to a muscle misbalance and compensatory movement especially in the neck region. In this case biomechanics of the entire skeletal muscular system and especially of the spinal column is affected. In simple terms, static disturbance can be explained with the following example. If a 200lb person is weighed on two scales located equidistant from the central line of his body, then the existence of static disturbance will tilt the scales in different ways. It could be 90lb and 110lb or even 80lb and 120lb. The difference could be pretty sizable.
This difference signifies that the part of the body that weighs more is providing compensatory support for disengaged muscles on the other side of the body. If, under these conditions, an unexpected forcible movement occurs then the side of the body that is already subjected to additional load has a much greater chance of sustaining injuries such as tears, herniated discs, etc.
The largest percentage of biomechanical disturbance is of the neck. Since the neck and head is the body’s equilibrator, much tension accumulates in the neck and upper back area. Thus, in most cases, the bio mechanics of the neck is a little disturbed. Therefore, having this fact in mind, the warm up is always starts with the neck.
In DVD #7 I have developed an educational program where I teach a proper pre-event warm up that will allow an athlete and/or sports enthusiast to prepare their muscles and joints for extensive loads of athletic competition and vigorous exercise. The proper warm up is a compound procedure including neuromuscular re-education techniques, post isometric relaxation and a set of special exercises that are as much physical as they are mental. In essence, these procedures address raised muscle tone, preventing the escalation of raised muscle tone into dangerous muscular pathology and offers the proper warm up order, starting from neck and upper back, etc, that provides maximum protection possible for subsequent extraneous loads of athletic competition. At the same time, incorporation of these procedures in a routine warm up will contribute to the elimination of exercise stress side-effects.
This sequence is an absolute must for athletes who have sustained an injury before and now are recovering from this injury.
Necessity of full rehabilitation after a minor injury.
Many talented athletes injure themselves to the point that injuries not only end their sports careers, but lead to a lifetime of painful symptoms and repeated reconstructive surgeries. The major cause of such extensive injuries is incompletely treated minor injuries.The incompletely treated original injury brings about a much more severe re-injury. To fully understand its devastating effect, I teach the necessity of full rehabilitation from even minor injuries. In my Self Treatment from Sports Injuries DVDs, I pay special attention to the fact that inhibition of pain does not mean a person can immediately be involved in vigorous competitive sports. In most cases, after having a minor trauma, a gym enthusiast receives an anti-inflammatory injection that inhibits pain and he returns to his normal vigorous routine. He is not aware of the fact that the absence of pain does not signify that the traumatized region has regained power. As a result, this region becomes a “time bomb. Sooner, rather than later, the person receives a much more severe re-injury; such as a partial or total tear of muscles, tendons, ligaments, a disproportional to age development of osteoarthritis and more. In many of these cases, a sacrifice of a little time for the sake of a complete rehabilitation will prevent serious complications.
In order to rehabilitate the injured region properly a person should undergo 15 to 20 comprehensive treatments including medical massage protocols, ice and hot stone therapy, trigger point therapy and, not less importantly, rehabilitative exercises including post-isometric relaxation and neuromuscular re-education.
In our modern fast paced life and in our present economic situation, most people experience time or financial constraints to be able to undergo 15 to 20 visits to a rehabilitation facility, thus producing these devastating statistics of sports related injuries and other back and limb disorders.
These traumas can and must be prevented. That’s why the idea of self treatment is so appealing, so timely, and its implementation is so critical. This is the main reason why my development team and I worked on the implementation of these ideas into the seven volume Sports Injuries Self Treatment DVDs.
For those who sustained a sprain/strain injury and were properly diagnosed, but who do not have the time or money to complete the entire course of treatment in a rehabilitation facility, this program addresses sports related injuries of the neck and upper back, shoulder, lower back, elbow and wrist, leg injuries including hamstring and quadriceps muscles, knee, shin splints and ankle.
The offered protocols are designed to increase sports longevity, prevention of sports related injuries and enhance athletic performances.
These DVDs are not a Hollywood production designed to entertain the public. It is a serious guide for injury treatment and prevention as well as a health awareness course that can help millions of people to rehabilitate themselves from injuries and to prevent possible re-injuries. This, literally, makes our nation much healthier and saves billions of dollars in medical costs.
It is possible to help yourself only by following the practical steps I proposed in this program. In order to achieve sustained results it is very important to follow the steps exactly as I present them and for the exact duration or number of repetitions that I propose.
I require this strict protocol following, not because modifications and personal initiative is not possible. In fact, by understanding what I ask of you in my program, each of you will be able to come up with your own style of performing these techniques. However, in order to develop a style of your own, you will need to be familiar with basic knowledge concerning the nature of injuries, muscular and joint traumas and the necessity for full rehabilitation from the original minor injuries. Also, it is important to understand how neuromuscular re-education and post isometric relaxation helps in the rehabilitation of these injuries. In order to bring this understanding to every person, each DVD contains a theoretical lecture that explains all the above concepts followed by a thorough actual demonstration.
I also would like to note that from the perspective of injury as well as from the perspective of treatment, sports injuries are no different from injuries caused by automobile accidents, traumas at the work place or injuries caused at any other place and time. Therefore, the use of rehabilitative methods introduced in my Self Treatment DVD Series could be applied in variety of circumstances in all areas of everyday experience that could bring about injuries. Everyone can benefit from the knowledge contained in this series of DVDs.
While living in the United States I have always noted that people have a tendency to try “NEW” things. What I am explain is that during these past sixteen years, which is my period of observation in the US, there have been many “NEW” books, various companies and organizations offering to the general public a variety of new pieces of exercise equipment, new exercise programs, new supplements, new “quick gain” gadgets and many other “NEW” fad type developments. I think the expectation of “NEW” comes from different industries such as the automobile industry, computer companies, and video games, for example. This contributes to forming a public expectation of something “NEW” and better consistently entering the health and exercise market. The exercise and health industries are in constant competition for market share and forced to “keep up.” However, the human body and mind certainly is not a car, a computer or a video game. In order to come to the conclusion that a “NEW” product is safe and effective, it has to clinically prove itself over time. As I live and watch, most of them have not accomplished this.
In a similar vein, many promising theories have died out, principally because they were not proven clinically to be safe and effective. The DVD series that I offer as a home program may also be very new to most of the American public. Yet, this methodology has more than forty years of massive utilization with various levels of athletic clubs, including the former Eastern European Olympian teams. Throughout its history, this methodology has absolutely proven itself clinically to be very safe and effective and will definitely deliver sustained results.