Dr. Gregory Johnston B.H.K., B.Ed., D.C.
Last month we discussed the healing process in-depth. A thorough understanding of this process is important to understand how to best treat an injury once it has occurred. Proper treatment and subsequent rehabilitation is crucial in managing injuries, however, as a chiropractor I am more interested in helping people to learn how to avoid injuries in the first place. To this end, this month’s article will focus on the prevention of injuries. One of the most important steps in the prevention of injuries is to understand why they happen in the first place, therefore, a discussion of the cause of injuries will also be included.
A great variety of causes of injuries exists, however, the following list comprises the majority of causes of most injuries. It in no way should be considered exhaustive but will serve our purposes here.
This is obviously a long list and each item on the list, in and of itself, warrants an essay. As a result it is beyond the scope of this article to address all of these issues. Instead, we will address some of the more common problems which contribute to injury as well as suggest techniques to avoid these problems.
Flexibility training is one of the most powerful preventative methods that can be used to prevent injury and is also one of the most misunderstood and ignored. Stretching is most commonly considered a warm-up activity. This is one of the most common misconceptions regarding flexibility training in my view. Stretching is an important component of the warm-up as we will discuss later, but, it should be considered as a major segment of any fitness program along with aerobic activity and resistance training. Stretching becomes increasingly important with age because flexibility decreases as a person grows older.
When stretching, it is important to realize that stretching a cold muscle may put one at greater risk for injury. Light aerobic activity to raise the heart rate and temperature of the muscles should proceed stretching. Stretching of all muscle groups is important, however, common problem areas include the calves, hamstrings, hip flexors, lower back and shoulders. These areas require particular attention. A stretch should never be painful, mild discomfort may be experienced but never pain. A stretch should be relaxing and should be held for a minimum of 15 to 20 seconds. Remember to breath while you are stretching as oxygen helps the muscles to relax. Never bounce while stretching, simply assume the stretch until you feel a slight pull and hold. If the stretch becomes painful while holding then back off slightly. Ideally stretching should be done on a daily basis, however, if it is done correctly 3 to 4 times a week you will be amazed at how much improvement can be made in a short period of time.
Biomechanics is an area of scientific study that is concerned with the movement patterns of the body as they relate to the anatomical design and structure of the body. In very simple terms one can consider the body to be a machine which absorbs and transmits forces. It is designed such that these forces can be absorbed and transmitted without exceeding the anatomical limitations of the tissues of the body, however, due to a number of causes which are again beyond the scope of this discussion, circumstances arise which weaken areas of the machine and it breaks down resulting in injury. The factors which weaken the body can all be categorized as biomechnical imbalances. These imbalances arise due to decreased flexibility as already mentioned, as well as muscle imbalances, muscle tendon imbalances and joint restrictions.
Many of these biomechanical imbalances develop and exist over long periods of time as a result they go undetected. These imbalances change the way that the body absorbs and transmits forces causing tissues to be stressed in ways for which they were not designed resulting in “microtraumas”. They are called microtraumas because they do their damage slowly over time. A small amount of injury which does not immediately result in symptoms occurs and over time these small injuries have a cumulative affect eventually causing a symptomatic injury. This is quite often the reason why people experience injuries for which they think there is no explanation. I often discuss this with patients that are confused because they suffered an injury from what would be considered a trivial event. Every chiropractor has counseled a patient who has explained, “I don’t understand Doc, all I did was bend over to pick up a pencil and wham, my back locked up”. The problem was not the pencil. The problem was the weeks, months and years of poor posture, weak and imbalanced muscles and aberrant joint mechanics causing cumulative microtrauma. The pencil was quite literally, “ the straw which broke the camel’s back”.
Biomechanical imbalances generally occur for many reasons:
What can you do to try to eliminate these imbalances? One of the best ways is to exercise regularly and properly. Seek out a qualified professional to design a program for you. Go to the library and read to develop an understanding of exercise and how to develop a program. Assess and correct your posture as instructed in a previous article. Think of ways to improve the design of your work station to make it more ergonomically correct. Visit a chiropractor. Chiropractors spends years of study developing the techniques necessary to assess the biomechanical operation of the body. Chiropractors will also suggest exercises or give advice regarding a program that you are already using. Best of all a chiropractor can help eliminate biomechanical imbalances through various adjusting techniques and soft tissue therapies.
Warming up is still one of the best preventative measures which can be used to prevent injury. A good warm-up should begin with some form of low intensity aerobic activity such as a light jog, using an exercise bike, jumping rope or even just running on the spot will suffice. The goal is to increase the heart rate, increase blood flow and increase the temperature in the muscles. This activity should be continued until a light sweat begins. A general stretching routine should then follow, particular attention should be paid to the parts of the body which will be under the most stress for that day’s activity. Refer to the information on stretching given previously for specific instructions. Follow the stretching routine by slowly beginning the days activity. If you are lifting weights do a light set or two before loading up the bar. If golfing, start by swinging the short irons before pulling out the driver. These examples should give you the idea.
Eliminating injuries before they occur is the best way to manage injuries in my view. Injuries occur for a myriad of reasons as can be seen by the information provided above. I hope that I have provided some practical suggestions to help you stay healthy and injury free. As a final suggestion, I commonly tell patients to listen to their bodies. Many injuries occur because people ignore the warning signs that their bodies give them. If you feel particularly tired or stiff before a work-out or activity, heed the warning and take it easy that day. One light work out is better than having to miss 3 or 4 weeks due to an injury. The information and suggestions given here are in no way exhaustive. If you have any questions for me please submit them to Daniel’s mailbox and I will be sure to address them in upcoming articles.