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TREAT YOURSELF RIGHT
Author: Peter Sherrill, M.D.
You know the person: a promising martial artist, really talented, who gets hurt and then never seems able to shake the injury. It's not a motivation problem; when they're able, they're back in the dojang. It's not technique; they'll go at it 100% until they have it perfect. It's not conditioning; they work out as often as they can. It's not attitude, they give it their all, even when it hurts. Somehow though, the injury just keeps resurfacing. Or maybe they hurt someth ing else. Lastly, out of frustration, they admit defeat and quit trying.
Sound familiar? It should.
Injuries are the number one reason students leave the martial arts.
The number one disabling injury in the martial arts is the soft-tissue injury: muscle, tendon and ligament. These usually heal completely if they're cared for properly.
Ironically, they're the biggest source of disability because they're so often mistreated.
There are very few situations where soft tissue damage is so bad you have to quit permanently. But, any problem that's ignored or poorly cared for can turn into a nagging, chronic injury that may never heal. A minor nuisance can snowball into a debilitating, longterm deficit.
Students in the lower belt ranks tend to get hurt more often during training. Limited experience and incomplete conditioning leave them open to sprains, strains and overuse problems like tendinitis.
Higher ranking students know enough to avoid these pitfalls. Their injuries happen most often at tournaments, especially while sparring. It seems that when motivation is high, they're willing to take more risks. The resulting bruises, sprains, hematomas and scratches are usually inflicted by their opponent. This is a sharp contrast to the lower ranks, whose problems are mostly self-inflicted.
Obviously, the first line of defense is prevention. Novices need to be taught thoroughly arid supervised closely. No student should try moves beyond his or her skill. Higher ranks must learn to know and respect an opponent's abilities as much as their own. Instructors need to set a positive example by stressing injury prevention at all times.
Still, injuries are inevitable in this, or any other physical discipline. And there's the problem of time: too much time off is wasteful but returning to normal training too soon almost guarantees a reinjury. Our martial art mentioned above is an example of the commonest mistake: returning to full training before the time is right.
Hear that? Let me repeat it: before the time is right. It's not true that you must wait until you're 100% healed to get the dobok back on, but it is true that
you should be near 100% healed before you workout at 100% of your pre-injury intensity. Meanwhile, there's plenty for you to do to help your body heal properly.
TREAT YOURSELF RIGHT
Think of it this way: when you were a white belt, no one expected you to perform like a black belt. You had to advance through the ranks step by step. This same course applies to your injury: it simply can't perform as it should until you take it through all the steps nature designed into the healing process.
START WITH ICE
Treatment should begin immediately after the injury. Put ice on the area for five minutes, then answer these questions: Does it still hurt? Is it swollen, discolored or deformed? Is the range of motion diminished or painful? Is normal function weaker, slower or less steady?
If the answer to any of these questions is "yes," you have a significant injury.
PLAY IT SAFE
See your doctor. If the injury is significant, it deserves evaluation and whatever x-rays and diagnostic tests are necessary. Once you're satisfied there are no fractures or other worrisome internal injuries; you can begin rehabilitation.
REHABILITATIONIT'S JUST A PHASE YOU'RE GOING THROUGH
When beginning rehabilitation, it is important to remember the following rules:
1) Exercise your injury as much as comfort will permit, but-
2) Keep your workout just below the level of pain. Forget the "no pain, no gain" theory. If you're causing pain, you are aggravating the injury. That, in turn, can prolong or prevent complete healing.
3) Make steady, painless progress through the steps outlined in this article (mild muscle soreness is acceptable). If your pain increases, you're progressing too fast. If swelling, discoloration or deformity worsen, stop.
4) Ice massage the injury before you begin stretching. Repeat for five or ten minutes after you've finished the workout.
5). Rehabilitation sessions should be kept at the same interval as your pre-injury workouts. For example, if you trained three days a week, an hour per session, use the same schedule for rehabilitation. It's good to keep the same rhythm in which your body is accustomed.
6) BE PATIENT! Most soft tissue injuries take a minimum of six to eight weeks to heal completely, and often longer. There is simply no way to speed the process. Sadly, there are plenty of ways to slow it down and if you get in a hurry or skip steps, you'll do just that.
PHASE ONE:
STRETCH IT OUT
This is the hardest stage to endure because it feels as though you're not doing much to aid your recovery. It's an important stage though: we're laying the groundwork for your body to heal with a minimum of scarring and a maximum of strength and flexibility.
Look at the "Rehabilitation" diagram. Phase One is divided into stretching which should take up the first two-thirds of your time, and strength which is the last third of the workout. Begin with passive stretches, then active, then combined (see sidebar). If your workout lasts an hour, this should take about forty minutes. The last twenty minutes are devoted to maintaining strength. Isometrics are the safest and least painful way to start. Hint: an isometric builds strength in about twenty degrees of motion. For example, if you are doing isometrics for your biceps, start with your arm fully straight and execute the isometric exercise. Then, flex your elbow about twenty degrees and repeat the isometric. Flex another twenty degrees, repeat, and so on. Exercising in this manner will build strength in the muscle's entire range of motion.
When you have stretched to your full range of motion, and the isometrics are entirely painless, you may move onto Phase Two. Phase One should take at least one week. Never spend less than a week in any phase.
PHASE TWO:
ENDURANCE AND POWER
From this point onward, your workout will be divided roughly in thirds. The first part of the workout will be a shortened version of what was done in the previous phase; the later parts will focus on of a week; and that would be for,a mild problem. Serious sprains and tendinitis often need two to four weeks in this phase. Don't get in a hurry: grit your teeth, curse your luck if you must, do your work and wait it out. This is the phase most try to hurry through. When the injury is reactivated, it sends you back to Phase One.
When you're strength has returned to its pre-injury level, it's safe to begin the next phase.
PHASE THREE:
SPEED
By now you're roughly two to four weeks into the healing process. This is a risky time: although the symptoms of the injury are pretty much gone, the damaged soft tissue still have another couple of weeks (minimum) before reaching full strength. Now, it is still very possible to re-injure yourself. The strength training you've just completed helps: well-conditioned muscles can often support neighboring injured ligaments until healing is Finished. Still, speed and control are inversely proportional. This means that more speed equals less control. With speed training, start easy and increase a bit at a time. Keep all speed moves well controlled.
Speed moves include flying kicks, spinning kicks, free sparring and punching-bag work. One saFe way to begin is to use half the speed and half the repetitions you were doing before your injury. As long as your workouts are comFortable, advance at fifteen percent per week.
If you have access to a swimming pool, practice sparring moves while neck-deep in water. The resistance is good for conditioning, and the speed is automatically controlkd. If a pool is not available, shadow box in fTont of a full-length mirror and imagine you're underwater. Keep your moves slow and fluid. Resist temptation to accelerate; it will come with time. Plan to be in this phase for at least two to three weeks. The previous rules still apply: ice massage as needed. Warm-up and stretch first, then work on isometrics, endurance, power and lastly, speed.
You're ready to return to your pre-injury training schedule when your moves are all as fast and as controlled as they were before the injury. Allow about a week to phase out the rehabilitation exercises and ease in the customary routine. Abrupt training changes are risky: they are a prime time for re-injury. That sends you back to Phase One.
To many, this program may sound as though it takes too long to return to training. You'll hear many stories about faster recoveries, but don't forget: you only hear about the successes. The ones who re-injured themselves aren't talking. By taking your time and working with nature, your chances for full recovery are as good as they're gonna be.
Treat yourself right when injured or you may be in for a long recovery.
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