CONNECTIVE TISSUE INJURIES

Injuries can be a considerable hurdle to progress in any sport. Aside from the physical pain, there can be psychological effects - loss of morale and motivation. One of the most malign aspects of an injury can be loss of confidence in technique where the practitioner, consciously or not, trains in a way that's intended to avoid the injury recurring, but may in fact increase the risk of such an event, or may cause a different injury.

This article covers injuries to connective tissues (ligaments and tendons). I have personal experience of these problems and their successful self-treatment. It's not a definitive guide, nor a medical text.

The onset of these injuries is often gradual, though there are traumatic forms, such as sprained ankles or tears to the knee ligaments. Either kind of injury can cause considerable pain and discomfort, and can hang around for months.

Areas likely to be affected include the ankle ligaments, Achilles tendon, knee and shoulder structures and tendons in the hands. Professional assistance may be the only option in some cases. However, there are steps that can be taken by the practitioner to control and treat problems in these areas:

RICE: Rest, Ice, Compression, Elevation - these are the watchwords of treatment. The body's natural reaction to tendon or ligament injury is localised swelling. This needs to be controlled and reversed as quickly as possible.

Rest is vital - a strained ligament or inflamed tendon sheath does not thank you for continued exercise. However, as with all injuries, it's important not to overdo this component, for reasons explained below.

Ice and Compression: These help to cool the affected area, reducing the inflow of fluid. Never put ice directly onto the skin or you'll suffer an ice burn. Ice cubes in a towel or flannel, or a proprietary gel pack kept in the freezer are good options. Compression needs to be done with care to avoid causing more pain and in some circumstances, e.g. strapping in the immediate aftermath of a sprain to the ankle ligaments, it should be done by a professional, or someone trained in first aid.

Elevation: Raising the affected area allows fluids to flow away from the injury under gravity. It's also relatively easy (resting your leg on a table slightly higher than your seat, or raising your arm above your head).

Contrast bathing: Once the initial 'over-reaction' of the body has been controlled, we need to promote healing by improving the blood flow to the affected area - ligaments and tendons have a poor blood supply.

Contrast bathing consists of the application of a cold compress or cold water, alternated with a source of warmth, such as a heated gel pack or flannel soaked in hot water. Warmth promotes the influx of healing nutrients. The application of a cold pack forces the blood back out, allowing the removal of waste. Again, the application of ice directly to the skin should be avoided, as should a source of heat that scalds or burns.

Another promoter of blood flow is exercise itself. It's important to work the affected area once the initial swelling has reduced. However, such exercise should not hurt, as this simply indicates that further injury is being caused. Returning to exercise is also important to avoid muscle wastage that can increase the risk of further injury when you return to full training.

Personal experience is that tendonitis (swelling of the sheath around the tendon) comes on gradually, causes considerable pain and discomfort that can affect your quality of life outside of training as well as in the kwoon, but will recede after a few weeks of using the techniques above.

Observation of others who suffered more traumatic injuries, such as sprained ankles, suggests that residual weakness in the affected area often remains. Good technique and maintaining confidence in your abilities are the keys to avoiding recurrence.