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Injuries During Exercise

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Here we look at some of the damage that can occur to joints and muscles during exercise, and how you can best treat such complaints.

Ligaments

Ligaments are tough fibrous bands that hold your bones together at the joints and stop them from extending beyond their normal range of movement. Most joints are supported by several bands of ligaments that take the strain from all directions.
Sprains and tears are the most common forms of injury to ligaments that lack elasticity.

This is usually caused by sudden extension of the joint, such as when you twist an ankle or knee. If such an injury occurs you can usually tell how bad it is by the size of the swelling; with a mild sprain the swelling is slight, but a severe strain can cause considerable swelling and is very painful.

Method of treatment

A mild sprain can just be bandaged, and a return to normal activity can be expected within a few days.

With a more severe sprain, crush some ice into a plastic bag, wrap the bag in a thin towel and place it over the injury for about 15 minutes. This will control the swelling and aid the healing process –and it feels good.

After this, bandage the injury firmly, using a crepe bandage and making sure that you cover the area well. Try to keep the affected part (leg or arm) raised when resting, and repeat the treatment every three hours for 24 to 48 hours, depending on the extent of the injury.

With a severe sprain do not try to move the joint until the pain, swelling, discolouration, heat or numbness have lessened. Once this has happened, slowly move the joint and then gently try out the relevant static exercise or manipulation, combining this with self-massage until full movement has been restored.

Do not return to full activity until the damage to the joint has fully healed.

If the ligament is ruptured or severed, prompt medical treatment is necessary and effective, but immediate first aid can be given while awaiting treatment.

Muscles

Muscles pass across the joints, which they move and help to support. They consist of long bundles of fibres enclosed within sheaths and are attached to the bones by tendons.

Sprains and strains

Sprains and strains mostly occur when a stiff muscle tightens too strongly or too quickly and is suddenly overstretched. This causes a sharp pain, followed by swelling, stiffness, tenderness and aching. The muscle is weakened and the condition is aggravated by use.

Bruising occurs as a result of a direct blow or knock against the muscle, or a fracture.

Both cause damage inside the muscle and bleeding into the surrounding tissues, and bruising shows when the blood flow reaches the surface, although sometimes it is contained within the muscle.

Method of treatment

The immediate application of an ice pack and, where possible, a firm crepe bandage will help reduce the flow of blood and fluid into the muscle. This should be repeated every two to three hours while the injury subsides. Keep the affected part raised and, as the pain gets less, tighten and relax the muscle without movement.

As soon as the symptoms of injury have gone, gently stretch the muscle by applying the appropriate static exercise or manipulation and self-massage.

Do not return to dynamic exercise until pain and stiffness have gone and the muscle is functioning well.

Cramps and spasms

Cramps and spasms arise in the muscles as a result of physical injury, over-use (how many footballers have you seen convulsed with cramp?) and acute mental stress. They are spontaneous reflexes that reduce movement in order to impose rest and prevent further injury.

Spasms in the limbs and lower back are most common as a result of misuse, over-use and injury, while spasms in the neck and abdomen are usually due to emotional stress.

During pain or acute stress, muscles do not tighten and relax in the normal way but remain in a constant state of semi-contraction.

Because the muscle fibres cannot relax, the blood cannot flow freely through them and remove chemical waste products or bring oxygen and nutrients to them to allow the muscles to work normally. This state of tension wrecks the muscles and gives rise to pain, which in turn produces more tension, and so on.

Sometimes if the cramp or spasm is acute the muscle fibres tighten to such a degree that they form tiny knots that feel very tender when you press the muscle.

Method of treatment

Rest, heat and massage are the most immediate forms of treatment. A hot bath or a hot water bottle encourages the muscle to relax and then a gentle massage should begin to restore movement.

When relaxation and movement has been restored, gentle stretching exercises will help the muscle restore its proper state of relaxation.

Inflammation

Inflammations of the muscles, tendons and joints are mostly caused by over-use and misuse. These conditions are usually extremely painful, swelling develops and the affected part often feels 'hot'.

It is best not to try to exercise any muscles or joints that are badly swollen, inflamed, discoloured, locked or extremely painful. Under these conditions consult a recommended osteopath, chiropractor or physiotherapist.

Recovery

If you rest for too long or don't treat the injury, resistance to movement increases and, because of this, trying to get the muscle or joint to work again can take far longer and be more painful.

Consequently the prompt use of appropriate exercises when the symptoms of injury have gone will increase your chances of a rapid and complete recovery.

The exercises must be performed regularly and carefully in order to extend the boundaries of movement and endurance gradually.

However, take care not to over-stretch or over-contract the muscles or joint during recovery as this will actually slow down your progress.

It is good to remember that after the appropriate period of rest, determined usually by reduced pain and swelling and bruising, only movement can restore movement however you should not resume normal exercise with an injury, do this gradually and progressively.

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