Injury associated with
CrossFit, what does the evidence say?
Yesterday I presented
at the Therapy Expo at the NEC in Birmingham.
A big thank you to all
those who came to watch the presentation and for those who came to chat with me
afterwards.
Having looked at the
evidence from the literature, my research and the audits of my clinic
/competitions it is clear that there is a pattern emerging.
The pattern of injury
presentation of the shoulder, low back, knee and wrist as the most common areas
for injury has now been established in terms of evidence.
While other traumatic
injuries are acknowledged, they are rare with no established pattern.
The blisters on the
hands solution is simple. Tape up so you don’t have to man up! Or wear gloves
as I do for training.
The Rainhill Trials at
Sport City in Manchester has become the home for your
first CrossFit
Competition.
The event is run by
TRAIN Manchester who have three boxes in the Manchester area:
Train 1 - Castleford
Train 2 – Media City
Train 3 – Heald Green
The Saturday is more for those that are new to competition.
The Sunday is for those who are more competent at CrossFit.
Although the Workouts are very similar there is a big difference between doing Chest to bar pull ups or normal kipping pull ups.
The same with Toes to Bar and Ab Mat sit ups.
However, what this does is allow athletes to scale when there is a movement that they can no longer do. Or, could not do in the first place.
Competition will always bring out the best in us. But it will also expose our weaknesses.
As always there are injuries at the weekend. However, as usual these injuries are acute, mild and minor, responding well to Physiotherapy and Rocktape UK were there to scrape and tape as part of the athlete services.
This weekend’s Injuries
included:
•Hand tape x 12
•Shoulder x 8
•Wrist x 5
•Low Back x 4
•Knee x 4
•Calf x 3
•Biceps x 2
•Cervical Spine x 1
•Trapezius Tear x 1
•Shin splints x 1
•Ankle x 1
It was great to see Tom
Blay from Reebok CrossFit 3D competing.
He is a machine and my Coach!
An amazing weekend of CrossFit.
Well done to all competitors and for TRAIN for there superb organisation.
According to the
American Journal of Occupational Therapy,The U.S. Department of Labour
recognizes hand injuries as one of the most common, but preventable, injuries
in people of working age. Those and those familiar with teaching Yoga will
surely agree. Many new students have pre-existing wrist pain long before they
ever started practicing Yoga. The hands and wrists, made up of relatively small
joints with many muscles, tendons and nerves, are a delicate area.
They control fine motor
skills, and at the same time, are strong enough to bear a person's entire body
weight. Too many practices are ended early because of discomfort in the hands
and wrists. Thankfully, there are exercises to help with strained wrists and
sore hands. There are also props to alleviate straining altogether and
alternative positions to try that are less likely to cause pain.
First, consider props
that can help distribute the weight more evenly along the arm and spare the
wrist. A new prop that is getting excellent reviews is the Three Minute Egg, a
rounded, egg-shaped foam block that takes the place of traditional square
blocks or wedges.
By using the egg blocks
in each hand during asanas with weight on the hands and wrists, the pressure is
distributed up the arm and the pose becomes much more comfortable. In poses
like Plank, or Chaturanga, grasping hand weights can relieve wrist pain. Even
rolled up mats beneath the heel of the hand can provide some relief.
Assuming some wrist
pain is already present, the following are some simple stretches that can help.
Therapeutic Yoga for
Wrists and Hands
Handcuffs: Circle each
wrist with the opposite thumb and forefinger and squeeze firmly for 3-5
seconds.
Wrist rotations: Hold
the hands palm out flat and circle the wrists clockwise and counter clockwise.
Prayer pose, with both
hands together in namaste position. Exert gentle pressure pushing the hands
together, then lean them back towards the wrists: first the left hand pushing
the right back to a 45 degree angle, then right pushing left back.
Reverse Prayer: Behind
your back, put your hands together in Namaste mudra, with your fingers pointing
down instead of up. Hold for 20 seconds, or so, as long as it is comfortable.
Backward wrists: On all
fours, rotate your hands until fingers are pointing towards you, with forearms
facing the front and gently lean back. Go slowly and pay attention to any pain
in the muscles, as this stretch can be quite intense.
Wrist Safety and Pain
Prevention in Yoga Class
To prevent hand and
wrist pain altogether during practice, modify hand positions during Yoga
sessions. In Downward Facing Dog, or Adho Mukha Svanasana, keeping the hands
flat and pushing back is responsible for a great deal of soreness. Bending the
fingers of the hands at the top joint, so the middle knuckles stick up rather
than lie flat, is an excellent modification that strengthens the forearms and
keeps pressure off wrists. In Upward Facing Dog, or Urdhva Mukha Svanasana,
keeping the hands closed in fists protects the wrists. Many other Yoga poses
can be modified by using the forearms to bear the weight - rather than using
the hands.
Additionally, chairs,
low stools, blankets, and bolsters can be used to modify postures, which put
too much pressure on the wrists. It may be necessary to take a rest from arm
balances entirely if pain is recurrent. Remember that Yoga works with your
body, not against it and honor its need for recovery.
Faye Martins, is a Yoga
teacher and a graduate of the Yoga teacher training program at: Aura Wellness
Center in, Attleboro, MA. To receive Free Yoga videos, Podcasts, e-Books,
reports, and articles about Yoga, please visit:
http://www.yoga-teacher-training.org/
When people look to towards
building strength they very often think about doing exercises that work the
larger muscle groups such as chest and back, and whilst these areas are very
important what seems to be often overlooked are the smaller muscle groups.
In this case were talking
about the wrists and forearms. Now the reason the lower arms are so important
is because it is due to these body parts that we're able to build upper body
strength in the first place, as they are the supporting muscles and joints.
After all, can you imagine attempting to build a strong chest by doing heavy
bench presses whilst suffering with weak and frail wrists. As inevitable that
the stronger the wrists are the more weight you will subsequently be able to
handle and therefore the greater the long term gains can be.
The same would apply to
other exercises such as pull up. If you suffer from weak wrists and forearms,
this will have a direct impact on your level of grip strength. Do you ever
recall attempting to do a set of pull ups only to have given up due to not
being able to maintain your grip? You see, it is only when it's illustrated in
this way that one begins to realize the importance that such seemingly under
rated body parts actually have.
Now having established
that wrist and grip strength can actually have a direct impact on your overall
performance, we might want to think about what wrist exercises we can start
implementing to ensure we maintain strong and healthy wrist joints.
Kettlebell and Gripstik
wrist exercises are an excellent choice as they both work in different ways and
provide great results in terms of grip endurance and overall wrist strength.
The kettlebell, whilst being more targeted toward core strength exercises,
requires enormous grip strength to perform many of the exercises, such as
kettlebell swings and Turkish Get Ups.
On the other hand, the
Gripstik is extremely good at directly working the wrists and forearms.
Building primarily endurance and strength as lactic acid build up becomes
predominant during high repetitions.
There are other old
school wrist exercises that can be used to develop wrist strength. Boxers for
example use a method where they tie a weight to a broom handle and using
repetitive twisting motions, slowly lift the weight from the ground up towards
the broom handle.
There are simply too
many to list here, but you get the point. They key issue here is to ensure you
find an exercise you feel comfortable with and start doing it. Just remember to
consult your doctor before beginning any new exercise or nutritional program.
Mo Mastafa is a
business management graduate and a health & fitness enthusiast with of 15
years experience in training and nutrition.
Visit my wrist
exercises [http://wristexercisesblog.com] blog now for more hints, tips and
tools to improve your wrists and grip strength.
The wrist allows you to
properly position your hand, representing arguably one the most complicated
joints in the body. There are 15 bones and 27 articular surfaces in the wrist,
not to mention its elaborate system of muscles, tendons and ligaments. Ligament
injury is quite common among athletes, as the repetitive action of the wrist
puts athletes at risk for injury. Wrist sprains result from a torn or partially
torn ligament, and wrist strains are the result of a torn or partially torn
tendon. The most common wrist fractures among athletes include: distal radius
fractures and scaphoid fractures.
The Four Mechanisms of
Wrist Injury
Throwing - With
throwing injuries, there is an overuse of the wrist. These are common in
baseball players, tennis athletes, and racquet ball participants.
Weight-bearing - There
are many weight-bearing injuries among those who participate in gymnastics,
weightlifting, and cheer-leading.
Twisting - With a
twisting injury, the wrist suffers from a rapid rotation that disrupts the
stability of the wrist. This type of injury is common with radical
skateboarders and snowboarders.
Impact - More common in
football athletes are impact injuries that result from either a direct impact
or a fall onto an outstretched hand.
Wrist Sprains
The most common wrist
injury among athletes is a sprain of the wrist. This often is an injury to one of
the ligaments - the connective tissue that attaches one bone to another. Most
sprains occur when the wrist is forcefully bent during a fall on an
outstretched hand. Wrist sprains can be mild or severe, and can be graded based
on the degree of injury. A grade 1 sprain indicates a stretched ligament
without apparent tearing. A grade 2 sprain, however, involves partial tearing
of a ligament. With a grade 3 sprain indicates ligaments are completely torn.
Distal Radius Fracture
The most common
fracture is called a "distal radius fracture." A distal radius
fracture is a break that occurs at the wrist end of the radius bone. These
breaks are common among athletes and can be mistaken for sprains. Wrist
fractures often occur during a fall onto an outstretched hand. With fractures
of the wrist, the break can occur in four ways: intra-articular,
extra-articular, open, or comminuted (in many parts). Many can be treated with
casting alone, though some require surgery.
Scaphoid Wrist Fracture
The scaphoid bone is one
of the smaller bones of the wrist, but it is one that commonly breaks during
sporting injuries. This bone is located on the thumb side of the wrist, and can
be difficult to treat due to its tenuous blood supply. As with most wrist
injuries, a break to the scaphoid bone typically occurs from falling onto an
outstretched hand. Treatment usually requires casting if not displaced, or
surgery if displaced.
Symptoms of Significant
Wrist Injuries
-Pain at the time of
injury
-Swelling
-Bruising or
discoloration
-Difficulty moving the
wrist
-A "popping"
or tearing sensation during the trauma
-Warmth and tenderness
of the skin
Treatment for Wrist
Injuries
Treatment really
depends on the type of injury you have. For mild sprains, the doctor will
generally recommend the "RICE" method and over-the-counter pain
relievers, like Tylenol or Motrin.
RICE
R - Rest the wrist for
around 48 hours.
I - Ice the injured
area to reduce swelling (use a pack wrapped in a towel).
C - Compress the wrist
with an elastic ACE wrap.
E - Elevate the injury
above heart level.
Nonsurgical Treatment
Simple Sprain -With
mild to moderate wrist sprains, you will need to wear a splint for 1 to 3
weeks. This keeps the wrist immobilized while it heals. If you develop
stiffness, I can teach you some stretching exercises to allow you to regain
full range of motion of your wrist.
Simple Fracture -If
your broken bone is in good position, it can be treated by applying a
fiberglass or plaster cast. This is done so that the healing wrist bone remains
protected from further injury while it heals. You may have to wear the cast for
up to 6 weeks, depending on your injury.
Closed Reduction -If
the alignment is out of place, your doctor may need to "reduce" the
bone and re-position the bone fragments. A "reduction" is the medical
term for this process, and because your doctor will not be operating on your
wrist, the procedure is called a "closed reduction". After the bone
is put in proper position, your doctor will apply a splint or cast for you to
wear for 4 to 6 weeks. Depending on the nature of the injury, the doctor will
take X-rays at weekly intervals for around 3 to 6 weeks. After a 6 week period,
your doctor may recommend physical therapy for you to help improve your wrist
strength and mobility.
Surgical Treatment
Complex Fracture -For
those fractures that require surgery, follow one simple rule - put the broken
pieces back into position and prevent them from moving out of place while they
heal. There are several treatment procedures for distal radius fractures and
scaphoid fractures, and the choice depends on your age, your athletic activity,
and your injury. As with most wrist surgeries, your doctor may order hand
therapy and rehabilitation exercises following the repair. It may take as long
as 6 to 8 weeks for a complex fracture to heal.
Open Reduction -To
perform wrist surgery, your doctor will usually make an incision directly over
the area of the broken bones and re-align them in a process called "open
reduction". It is considered "open" because the fracture has to
be surgically corrected. It may be necessary for me to insert pins, plate and
screws to hold the bones in place. As with other surgical procedures,You may be
required to undergo hand therapy after your cast or splint is removed. Keep in
mind, and open reduction surgical procedure takes a while to heal, but with
proper physical therapy and rehabilitation, you will regain strength and full
function of the wrist.
Dr. Ruhlman works
through Orthopedic Specialists of Seattle to provide top quality orthopedic
care to the Seattle area. Visit his website to learn more about him or to
contact him.
