Muscle blog series: Part 2: Muscle Injury
What is muscle injury?
Injury can be acute, which can be
either direct or indirect:
Direct injuries are from an
external force at the point of contact, e.g. a player receiving a bruise within
a muscle after being struck during a game.
Indirect injuries usually involve
the athlete themselves damaging the soft tissues in the body through internal
or external forces. An example of this can be a hamstring strain while
sprinting in the 100 metres or even a hamstring strain when lifting a weight.
Chronic injury: Long standing and not healing quickly or well.
Repetitive Strain: Overuse injury that is sustained from repetitive
stress, incorrect technique or equipment, or too much training, which causes
cumulative strain to the structure that builds up to an injury state.
Static Strain: a one off load that
overloads the muscle and it tears
Postural Strain: This is an overuse
injury that is sustained from continuous stress from a certain position/posture,
which causes cumulative strain to the structure that builds up to an injury
state.
Abnormal Pathology: This is more
medically related. For example, connective tissue disorders or even cancer.
What occurs when you injure muscle?
Bleeding, Inflammation, Repair
and Remodelling.
Bleeding lasts for up to 24 hours
at most in most muscle injuries
Inflammation starts within hours
of the injury and is most prominent up until 72 hours. It does continue but
gradually less and less as time passes.
The repair stage is a long phase
and starts around 24 hours and continues for several weeks.
Remodelling starts around a few
weeks in but continues for months. This is all about creating a high quality
scar tissue, which is as close to the tissue that it has replaced.
What are the implications of injuring muscle tissue?
When you injure muscle, pain
occurs and a period of immobilisation can occur due to this pain. However this
is very detrimental to muscle as on average muscle strength decreases by 2-6%
in the first 8 days of immobilisation, but some muscle waste even faster than
this! (Muller,1970)
Muscle is a relatively quick
healing structure with an average healing time of between 2 – 6 weeks.
More unusual issues can develop
such as Myositis Ossificans: This is bone growth within muscle tissue and it
has been reported in 9% to 20% of all cases of quad contusions, which is an
impact to a muscle squashing the muscle against the underlying bone, causing
damage and bruising. An example of this would be getting kicked in the thigh.
What is the risk of injuring muscle?
This depends on what activity you
are doing and your general conditioning. Things like strength, power, endurance, proprioception,
core stability, flexibility and your ability to recover will influence your
injury risk, but one big reason for injury is having previously been injured.
One study suggests that you are 33% more likely to have a hamstring tear/strain
if you have previously had one!
What should I do if I have injured a muscle?
This depends on when in the
healing process the injury is at. But if we take it from day 1:
First 48 – 72 hours: PRICEM:
P: Protect the injury from too
much strain
R: Rest the injury from any
aggravating activities
I: Ice the injury for 15 – 20 minutes
every 2 hours in a damp tea towel
C: Compress the injury with
something like tubi grip
E: Elevate the injury
M: Carefully keep the injury moving
to stop things from stiffening up and to encourage recovery and minimise
wasting.
After this initial period light
stretches and strengthening can be progressively started and need to be built
up as the injury allows.
Exercises correcting movement
dysfunction can reduce the time to return to full activity (Mason et al 2012)
Electrical stimulation of the
quads supports the regeneration process & results in a provable stronger
reduction of the atrophy (wasting) (Mucha 2004)
The recovery rate of muscle is 50%
greater with therapeutic ultrasound (Dyson et al 1999)
Hamstring injuries are common in
athletes and frequently result in long delays in return to sport (Mason et al
2012)
So what can help me to prevent or minimise my risk of muscle injury?
This depends on the demands of
your activities. If you require your muscles to work through a certain range of
movement then you need length in the tissues that is adequate for that exact activity.
This is vital so that the muscle doesn't become over stretched and tear. If
your sport requires certain attributes of strength or endurance then these will
also need to be trained to the appropriate levels.
Greater symptoms of muscle damage
were found in subjects with greater stiffness (Malachy et al 1999)
Warm- up is essential to slowly
bring the muscles up to operating temperature, which gradually increases the
load and gets the muscle pliable, making it harder to tear. The warm-up needs
to be:
Specific to sport
No static stretches:
Static stretching impairs sprint
performance in collegiate athletes (Winchester et al 2008)
Include dynamic stretching:
Dynamic stretching during
warm-ups as opposed to static or no stretching is probably most effective for
high speed performance sports such as football ( Little and Williams 2006)
Increase respiratory and heart
rate slowly
At least 10 minutes (first 3
steady to avoid lactate build up)
Other issues can be equipment
based. For example not wearing the correct trainers for your sport or foot
posture type. Over training is also a problem as every time you work your
muscles you develop microscopic trauma, which takes time to recover, so if you
don’t allow enough recovery then you risk injury. A good trick here is to mix
up your training so that you recover through rotation. For example one day you
could train strength and another you could train core stability. Recovery can
be improved with massage, ice and even electrotherapy.
Training should be progressive
and not be built up too quickly as this too can lead to developing injury. You
should take your time and start slowly, plan in advance if you are training for
a specific event and the week before you should taper.
Sleep is also vital as a lot of
recovery happens at this time and what you eat is very crucial as the fuel and
nutrients are what your body uses to heal and recover.
You sometimes need to examine the
movements to see if there are any dysfunctions and if any are found then exercises
correcting the movement dysfunctions can reduce the risk of re-injury of
hamstring strains. (Mason et al 2012).
Excellent info! This article is gainful for all athletes. They can solve their injury problem and prevent the future injury by following these instructions.back and neck pain bergen county
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