7 Jun 2013
The Basics of Treating Gymnastic Injuries
Lauren Downes MSPT
I receive many emails asking about the proper care of a gymnastic injury, ranging from lower back pain, to ankle sprains, to hamstring strains. Common questions involve length of healing time, treatment options, and further prevention of the injury. I thought I would provide some general rules of thumb to educate coaches, gymnasts, and parents of the basics of proper treatment.
Ice or Heat?
Many patients come to my clinic with an injury and tell me that they immediately applied heat to an injury such as a muscle strain. While heat may feel good temporarily, it can be detrimental to an acute injury such as a sprain or strain. Heat will increase tissue temperature, and will assist in circulation of fluids. When an injury occurs, bad ‘metabolites’ can circulate in the bloodstream around the injury, and heat will further circulate them around the injured area. If swelling is present, heat may further increase it and prevent the swelling from subsiding. Ice, on the other hand, will constrict the blood flow to the injured area (which is the goal, in order to prevent dispersing inflammation to surrounding areas). It also helps to prevent further swelling and decrease the current swelling.
When bruising is present, do not apply heat to the injury, as the heat will further circulate the blood and it may pool in other areas. Again, ice will prevent the blood with the bad metabolites from spreading.
For injuries such as a muscle strain, it is beneficial to apply heat when both the swelling and bruising have subsided, and the muscle causes a tight vs. a pain sensation. If a muscle continues to be painful with a stretch, it is not ready to be stretched yet. Picture a rubber band with a small tear in it. If you stretch the band, the tear will increase. A muscle tear or strain is quite similar, and may need a few weeks to heal before the muscle fibers have rejoined and are ready to be stretched. At this time, heat is the appropriate modality.
Don’t test an injury too soon.
I can’t tell you how many patients come to physical therapy a month after an injury occurs, and it takes them longer to heal than if they had started therapy right after the injury occurred. I typically tell gymnasts to give a muscle strain or ligament sprain a few days of rest, then re-assess the situation. If the injury continues to be painful, it may be time to seek treatment. If a gymnast tries to push through the injury too soon, the muscle or ligament fibers do not heal properly, and may give the athlete more problems in the future.
How long should a gymnast be out of training with a muscle strain?
Aahh, the million dollar question I hear from many readers! Usually I tell people who do not live nearby my clinic that they need to be evaluated by local health professional. There is not a set time frame for recovery from a muscle strain, and every athlete heals in their own time frame. Yet there are several factors that can determine an athlete’s readiness to return to a sport.
- The gymnast can complete a full range of motion, sustained stretch of the muscle without pain or discomfort.
- The gymnast can complete the actions of that muscle with resistance without pain or discomfort.
- The gymnast has not had any palpable restrictions or areas of increased density in the muscle belly.
- The gymnast can complete higher level functional exercises without pain.
- The gymnast can complete exercises that simulate all gymnastic activities without pain.
How Can a Gymnast Prevent Further Injury?
There are many ways to prevent injuries, starting with completing the proper dynamic warmup before training. It is beneficial for a gymnast to take every muscle through its full range of motion dynamically before practicing or competing. This will increase blood flow to the muscle, and is the preferred stretching method vs. static stretching.
Kinesiotaping is rapidly growing in popularity as a preferred method of injury prevention and treatment. Kinesiotape is an elastic tape that is widely used by physical therapists, athletic trainers, and health professionals to assist in healing a muscle by increasing blood flow or stabilizing it. For detailed information, visit www.kinesiotaping.com. I have used this method for several years with both patients and athletes, and have experienced excellent results with a variety of diagnoses.
An additional way to prevent injury, especially strains and sprains, is to be as strong as possible! Gymnastics is a sport that requires a high level of strength in many key areas of the body. If a gymnast does not possess that strength, muscles fatigue easily, can compensate for weaknesses, and breakdown if significantly challenged. It is imperative that a gymnast is aware of his or her specific weaknesses and addresses them. Hint: get evaluated!