Basic Treatment For Aikido Related Injuries:
by Charles T. Taft
First and Foremost, the Disclaimer:
I am not a medical doctor, I am a licensed massage therapist and a certified neuromuscular therapist in the State of Fla. The information I give here is intended as basic treatment for common martial arts injuries. If the injury causes any immediate swelling and bruising, causes a joint to be obviously dislocated, shows any evidence of a broken bone then immediately seek medical attention. If you re not sure of what is wrong seek medical attention. It is your body, it s your choice.
The Bruise, or the reward for a regretful moment of unskillfullness:
Bruises come in all sizes, shapes and colors, just like people. From the small, perfectly round, uniquely brown yonkyo bruise to the grapefruit size, multicolored lump in your thigh caused when an elbow came from the sky and landed point first in your leg, like people, some are just a pain and others can be dangerous.
First Aid for bruises is, ( remember this, you will see it again ), R.I.C.E., Rest-Ice-Compression-Elevation. Rest: I shouldn't have to explain this one. Ice: A wonderful thing for all types of soft tissue problems. It penetrates the body quickly, the application of cold to the body causes the blood vesicles to constrict, slowing the leakage of fluid, blood etc., into the surrounding tissue. It s primary use is to control swelling. Compression: Time for the old ace bandage you keep in your dogi bag. Wrap from the side of the bruise farthest from your heart first working toward the heart. Make the wrap as tight as is almost comfortable, if the body parts below the bruise start to go numb or turn blue, IT S too tight, loosen it alittle. Elevation: This is pretty simple, try to keep the affected part raised above the heart. This helps the return flow of blood to the heart and helps control swelling.
Please remember that a bruise the size of your fist, think in 3D, can be very serious. The rule of thumb is, that size bruise means about a pint of blood has leaked into the muscle tissue. You only have a few pints, get medical attention for this one.
Age and medical condition also play an important part in the treatment of brusies. The problem of blood clots in the tissue entering the blood stream and causing blockage of vessels in other important parts of the body, like the heart or brain, is a serious problem for older people and people with other heart/circulatory problems.If you are reading this as an instructor or dojo owner, KNOW your students history in this area.
Please, use common sense. If you have a bruise on your arm, and you can't open or close your fingers, it s not a good thing. The damage that caused the bruise can also cause damage to the nerves in that area also. Keep aware of your body, if you have problems that bother you in any way, see your doctor.
Sprains,Strains and overzealous nages:
Sprain: When a joint is extended beyond it s normal range of motion, without any dislocation of the affected joint. There will be soft tissue damage, this can be on a microscopic level or look like a good bruise. The only good bruises I can think of are...oh well, back to the reality of this. Treatment for sprains is the same as for bruises, R.I.C.E.. Add to that massage, when you can rub the area without too much discomfort, rub the entire area. Why, you may ask ? The tissue that was damaged consists of tendon and ligament tissue. This tissue doesn't have a blood supply of it s own, it must absorb oxygenated blood and nutrients then give off their waste products through the cell walls. If this sounds like a slow way to recovery, your right, but it s nature s way. So, if it feels good to rub it, rub it.
Strain: This is a serious one. There are 3 classes of strains. Num.1; the joint is dislocated but returns to normal position. There will be tissue damage and swelling the tissue damage, in this class, is moderate normally over stretching the ligaments and tendons. The integrity of the joint has been compromised and there may be damage to the joint capsule. Compression and ice are very important and should be applied as soon as possible to control the swelling. Remember R.I.C.E., in these injuries the more you can control the swelling the quicker you will heal. After the swelling is over and you can apply pressure to the area, rub hell out of it, it will need all the circulation it can get. As you can put weight on it make sure you don't feel any grinding sensations as you move it, like the feeling of bone on bone, if you do see your doctor. If after the swelling is gone the joint feels locked in place and you can tell it s not muscle related, see your doctor. If there is any thing you are uncomfortable with, see your doctor.
The remaining two, class 2 and 3, require a doctors attention. They are, 2. the joint remains in an un- natural position, tendon and ligament damage is severe. There may be detached tendons and ligaments but normally just some fibers are torn. 3. the joint remains at an un-natural angle and the ligaments and/or tendons are torn from their attachments. Treatment: Secure the affected joint in the position it is found in. Do NOT move it to try to straighten it. When it is secure. Apply ice and transport to the appropriate medical facility.
Rehabilitation of soft tissue injuries, acute and chronic.
I know, I know, this isn't about crunching calcium. I realized that I was getting ahead of what I wanted. Since most injuries associated with Aikido are soft tissue, I should spend more time here. There is little anyone can do for broken bones in the dojo, unless you are a board certified Orthopedic surgeon with your insurance paid up you don't ever want to try to set broken bones at home.
I have covered acute, fresh, injuries in the previous text. Remember R.I.C.E. There is something I need to cover about ice. As was said previously, ice penetrates the body quickly. Therefore some guidelines are necessary, apply ice for a maximum of twenty minutes at a time. You may have noticed, if you use ice therapy, that the body goes through 3 stages, first cold, then hot, then numb. When the area becomes numb, it s time to remove the ice for awhile to let the skin warm up. Why? Because the next stage is frost-bite, this will slow your training allot.
There has been some good advice on the list about shoulder and elbow problems. Most of it has been about stretching and flexibility and that is most important. There has also been some advice about strengthening muscles that overlie painful joints in an effort to relieve the discomfort. This needs some clearing up.
What causes chronic pain, why does it come and go? Inquiring minds want to know.
Any time a muscle is damaged it sends a signal to the spinal cord, telling it that the muscle is in trouble. The nervous system, in it s infinite wisdom, sends a signal back causing the muscle to contract. This is to protect it from being over stretched and torn. What happens in the muscle tissue is;
The blood supply to the tissue is restricted due to the contracted tissue around the veins, capillaries, etc. As a result, the veinous return is restricted. This causes the bodies ability to clean the tissue of dead cells and waste products to be greatly impaired. As a result the muscle tissue is irritated, causing a signal to the spinal cord, over the same nerve path as the original, telling it that the muscle is in trouble. The spinal cord sends back a message to contract the muscle to protect it. And the whole process starts all over again.
If nothing is done about the problem, i.e.: stretching and/or massage, eventually the discomfort will drop below your bodies pain threshold and it won't bother you again. Until, something causes more stimulus to affect the muscle then normal. This will push the irritation back over the bodies pain threshold and it will hurt again. This cycle will continue, each time it will take less and less stimulus to return the discomfort.
As you can see, making the muscle contract more, by strengthening techniques, will perpetuate the problem.
The first thing that must be done to repair the problem is to get the muscle fiber back to its normal anatomical length. Stretching and massage work very well, the most important thing is to return the muscle its normal length, what ever works for you. When everything is back to normal and there is no more discomfort, then start to rehabilitate the muscle how ever you choose to do it. Just start slowly.
I know, this kind of says that you shouldn't train when you re injured. Maybe you shouldn't, it s all up to you. If you choose to train the recovery will take longer, you will most likely fix the problem but it will take longer.
While I ve been writing this section I have decided not to go ahead with the first aid for broken bones. If anyone has any questions about that or anything about this post please Email me direct and I will try to help as much as I can.