Sports injury prevention and rehabilitation

The optimal solution to sports injuries is never to wait until the injury occurs before finding a treatment plan, but to "prioritize prevention over rehabilitation, individualized plans over general templates, and active intervention over passive maintenance." This is the most practical conclusion I have come to after following the provincial youth track and field team for three years and conducting nearly 200 injury assessments for ordinary fitness enthusiasts.

Don’t believe it, I just picked up Pamela, a 27-year-old Internet operation girl, last week. She danced with Pamela for 3 weeks following the online celebrity tutorials. Her knees hurt so much that she had to struggle to go up and down the stairs. An MRI showed that she had a mild anterior cruciate ligament injury. She herself was confused, saying that every move I made was based on the video, so how could it still hurt? I measured her foot arches and discovered that she was born with flat feet and her line of foot was crooked. Even if her movements were standard enough to serve as a demonstration, she would still have problems with her knees if she performed high-intensity jumping exercises for three consecutive weeks. To put it bluntly, those general "movement correction guides" on the Internet can only avoid 60% of common risks, and the remaining 40% are the "exclusive pitfalls" of each person's body.

Interestingly, regarding the priority of prevention, practitioners in different fields have quite different opinions. Most of the exercise physiology community recommends that ordinary people do an FMS functional movement screening before exercising to figure out the problems of joint mobility, muscle strength, and movement patterns first, so as to avoid compensatory risks from the source. A screening costs several hundred yuan, and it can indeed help people who have been sedentary for a long time and have no exercise foundation to avoid many pitfalls; but many front-line rehabilitation On the contrary, the teacher thinks there is no need to go through such trouble. Ordinary people do not want to compete in professional competitions. They just spend 5 minutes doing "movement rehearsal" before each exercise. For example, if you want to run, do 3 sets of high leg raises and lateral slides. If you want to lift iron, do two sets of target movements with an empty bar. Find the right feeling of force and then increase the intensity. It is much more cost-effective than spending hundreds of dollars for screening. There is nothing wrong with either statement. If you rarely move but feel pain all over your body once you move once in a while, then you should give priority to getting an evaluation; if you maintain exercise habits all year round and do not have persistent soreness and discomfort, just follow your own pace and there is no need to be overly anxious.

Oh, by the way, there is another controversial point that has been quarreling for several years: Should I do static stretching before exercise? In the track and field team I worked for before, the old coach required that the ligaments must be stretched for 10 minutes before the game until it hurts. At that time, there were two or three muscle strains in the team every month. Later, a team doctor with a professional background changed the pre-match warm-up to dynamic activation. He raised his legs, kicked his legs, and walked lunges for 15 minutes. The strain rate that year dropped by 32%. But that’s not to say that static stretching is completely useless. Many yoga and gymnastics practitioners still insist on doing static stretching before competition, saying that it can quickly improve muscle extensibility and is suitable for projects that require high flexibility. My own experience is that ordinary enthusiasts should remember: do dynamic warm-ups before running, jumping, and strength training, and do static stretching and relaxation after exercise. This is absolutely correct.

Someone must have asked at this point, what should I do if I am already injured? You can't just bear it, right?

This is another area where everyone has their own opinions: The view of evidence-based rehabilitation is that, except for injuries such as fractures and complete ligament ruptures that require immobilization, the sooner you do low-load active activities, the faster the recovery. For example, if you have a sprained foot, as long as there is no fracture, you can do ankle pump training the next day, and the swelling will decrease twice as fast as lying still. However, most old doctors of traditional Chinese medicine orthopedic injuries insist on complete immobilization within 72 hours in the acute phase to avoid secondary stretch injuries. I sprained my foot while playing badminton last year. I took a X-ray to confirm that there was no fracture. I started doing ankle pumps that night. I put on rigid protective gear and walked slowly the next day. I returned to the court to play health ball in 10 days. It was better than when I was in college and had sprained my ankle. Recovery is much faster after 3 weeks - but I have to say in advance that I dare to do this because I know how to exert force and judge the boundary of pain. For ordinary people, if the sprained foot is swollen like a steamed bun and hurts when touched, it is better to apply cold compress first and imitate it. Don't imitate it blindly.

Last week, a 60-year-old man came to me and said that his knees had been hurting for half a month after climbing Mount Tai. He thought he needed to replace the joints. I tested his quadriceps strength and found that it was 40% weaker than people of the same age. When climbing, the weight his knees bear is four times his body weight. His muscles can't bear it at all, but it doesn't hurt. I taught him two silent squat movements, 1 minute each time, 3 sets a day. Two weeks later, he sent me a message saying that he didn’t feel any pain after walking around for 3 hours. You see, many times it’s not a big problem at all. It’s just that the muscle strength can’t keep up, which makes the joints take the blame.

In fact, there is really no standard answer that is universally applicable when it comes to sports injuries. Your own physical feelings are always more accurate than online tutorials and other people’s experiences. If you feel pain during exercise, stop. Don't insist on shouting "No pain no gain". If it really develops into chronic strain, you will be the one to suffer. Oh, and one last thing, you don’t need to buy expensive equipment, but well-fitting sneakers are more useful than any limited-edition fitness clothes. I have seen too many people who wear canvas shoes to run 5 kilometers. It’s no wonder that their feet don’t hurt.