sports injuries - mixed martial arts training

This neck problem started a few weeks ago, but I didn't think it would be anything this serious! Realism sets in, the panic is over and I know I'm not really paralyzed. I sigh, and pluck up the courage to do what needs to be done- I take my chin in my hand, and breathe out slowly, preparing myself for what is to come.

1, 2, 3... A sharp twist to the right, followed by one to the left; Crack! Crack! Pop! Ahhhh, that's better...

Tension gone, I can move my head again.

Even with the remarkable safety record MMA has there's no denying it is a hard sport on the body. With joint wrenching submissions and brain rattling punches, few parts of the body are safe from attack. In a fight, the most common injuries are small cuts and contusions. Rarely do serious injuries take place due to the ability to submit and the vigilance of the referees.

In training however, it is a different story altogether. Everyone knows the importance of drilling a technique dozens, hundreds, thousands of times to ensure perfection. But think about the stress this puts on an isolated part of the body. For example, an arm is only meant to bend a certain way. But when you've got someone using their whole body to try and take it past that 180° "comfort zone", things can start to go wrong even if your partner is considerate of the potential damage he could do. Repeated stress will take its toll- often leading to seemingly minor injuries that can develop into major problems.

I write this article for a few reasons-

A) I've been carrying a few niggling injuries lately

B) Quite a few of the people at my gym have the same; one unlucky soul popped their knee recently and requires surgery.

C) There is a culture in our sport that seems to promote the macho ideal, the old "warrior spirit", that its ok to train through injuries. (Although this might not be strictly true- I think its more a case that we all love the sport too much to stop!)

D) I heard a saying the other day: That almost all "Jits" players suffer from bad knees and elbows (not to mention the occasional cauliflower ear).

I'm completely guilty of point C) I'm afraid. My body is telling me in no uncertain terms that it wants a rest- "Sure," I think. "You can have 2 days off".

"Wow," thinks my body. "Thanks!"

"No problem, but after that you've got a 2 hour Vale Tudo session to look forward to (the reason I'm having trouble moving my neck), and the day after that you're going to a 4 hour Greco Roman seminar. Have fun!"

So now we've identified that the majority of us are mad and refuse to stop training, what do we do about it?

Well there's always self-treatment. Most of us are familiar with the maxim RICE.

REST

ICE

COMPESSION

ELEVATION

But how many of us actually bother with this? "Oh, a hot bath and I'll be ok. It's normal to feel a bit roughed up after a good session." The thing is, problems don't just sort themselves out, and if you want to get back to training as soon as you can then it may be best to seek professional help.

15 years ago, you would be hard pressed to find a physiotherapist outside of a hospital or a top sports team. Nowadays, all you have to do is look in the yellow pages; you'll see physios, chiropractors, osteopaths and massage therapists all offering their services... All a bit confusing really! Which one does what? I may have a bad knee, but is that osteopath going to help or am I better off seeing a chiropractor? Does a massage therapist offer anything a physiotherapist can't?

Hopefully, I'll be able to shed some light on this conundrum and give some advice for those of you walking/sitting/training in pain. I'm not going to offer any advice on actually treating injuries- with this guide you should be able to find out who does what and who you are best seeing for a given problem.

The main people who can help us as mixed martial artists and fighters are as follows:

Doctors/GPs
Physiotherapists
Osteopaths
Chiropractors
Sports Massage Therapists
Podiatrists
Dentists
Alternative therapies

Lets take a look at the primary roles of each:

GPs

A General Practitioner is an all rounder- in the course of a day he could be treating writing sick notes for absent school children, helping the coffin dodgers stay warm by letting them sit in the waiting room, lancing boils and writing prescriptions for antibiotics. The GP is your first port of call for referral into the health service (unless you're unlucky enough to end up in casualty). GPs are not traditionally sympathetic of sporting injuries- if you turn up on their door with a swollen ankle from an awkward fall they will most likely turn you away with an icepack and a shout of "next!"

If you have think you have a bothersome non-urgent problem (e.g. You dislocated a finger, it popped straight back in but you have been getting occasional problems with the mobility and the joint does not seem to be as it once was), and you wish to see someone in the NHS who specializes in that field the doctor will refer you to a hospital where you can see a consultant. If you wish to be referred, this process can take anywhere between weeks and months depending on the nature of your injury. To receive some kind of treatment can take months, or even in some cases over a year.

GPs can prescribe painkillers and may be able to offer advice on relatively simple injuries but because of the nature of their position lack detailed knowledge of sports-related injuries. If you find a really nice one he may even agree to drain your "caulis" for you.

Physiotherapists

What is Physiotherapy?

"Physiotherapy is a health care profession concerned with human function and movement and maximising potential:

It uses physical approaches to promote, maintain and restore physical, psychological and social well-being, taking account of variations in health status
It is science-based, committed to extending, applying, evaluating and reviewing the evidence that underpins and informs its practice and delivery
The exercise of clinical judgement and informed interpretation is at its core."

"Physiotherapists identify and maximise movement potential through health promotion, preventive healthcare, treatment and rehabilitation."

The above definition is taken from the Chartered Society of Physiotherapists Curriculum Framework (January 2002).

A prospective physio has to do three years in university, followed by a one-year course if they wish to specialise in sports medicine. The abilities of a good physio are wide ranging; they are able to advise on nutrition, exercise coaching, administer drugs, and of course administer treatment for many muscular-skeletal injuries.

Accredited sports physiotherapists are true professionals when it comes to sports injuries, and will often have an interest in the science of sport. They go through rigorous training, are tested on practical knowledge as well as theoretical and have to undergo strict testing if they wish to become "chartered", i.e. recognized by the government as a "state registered" practitioner.

Physiotherapists are able to administer treatment through a variety of methods, including "hands-on" treatment such as massage or by mechanised modalities. Electro-physical appliances can include heat lamps, ultra sound, microwave, electronic interferential waves, air compression devices, and in some cases laser treatment.

The benefit of seeing a physio is that they will have a deep understanding of anatomy and the principles of sports related injuries. The downside is that being qualified does not always "give them good hands", as a physio told me once. Because they become so bogged down in theory, they can lose their hands-on approach and become reliant on machinery to do their job for them. This suits some people, but many find this a little unsettling and prefer to be subjected to traditional massage or manipulation techniques.

If you plan on seeing a physiotherapist, make sure you ask them if they specialise in sports injuries.

Reasons you may go to see a physio:

Sprained joints such as ankles, knees, shoulders, and thumbs.
Strained muscles such as "pulled" hamstrings, calves, quadriceps, rotator cuff and groin.
Over-use injuries such as shin splints, runner's knee, jumper's knee or thrower's shoulder.
Tendonitis such as Achilles tendonitis and other tendon inflammations.
Knee pain and patella-femoral pain.
"Tennis elbow" or "golfer's elbow".
Shoulder impingement and "swimmer's shoulder".
Neck and back dysfunction.
Chronic and recurring injuries.

As well as being able to provide treatment for the injury and advice on rehabilitation, a physio can also advise on appropriate sporting equipment, protection, supports, splints, and wrappings.

Osteopaths

What is Osteopathy?

"Osteopathy is an established recognised system of diagnosis and treatment, which lays its main emphasis on the structural and functional integrity of the body. It is distinctive by the fact that it recognises that much of the pain and disability, which we suffer stems from abnormalities in the function of the body structure as well as damage caused to it by disease."

[Description by General Osteopathic Council, 28th October 1998]

While osteopaths are generally associated with the treatment of back injuries, they are also able to provide expert treatment of certain sports injuries.

Osteopaths work with their hands using a variety of techniques. These include soft tissue techniques such as massage, joint mobilisation or high velocity techniques (often a sudden jerking motion, much like the one I used to sort out my neck this morning).

An osteopath will have either DO (stands for diploma in osteopathy) or BSc (Ost). after their name. They receive at least four years training, but do not necessarily specialise in sports injuries. They are able to assist in the treatment of sports related injuries, and often prove invaluable for conditions relating to spinal, skeletal or joint problems.

When would I need to see an Osteopath?

Slipped a disc lifting that heavy crate in work? Get yourself to see an osteopath. Wrenched your neck and having difficulty moving your head? So long as its not snapped, an osteopath may be able to help.

If you are inured, much like a physio an osteopath will consider all the factors which may have led up to and contributed to the problem. Sometimes what seems to be a sport related injury had its root in an everyday occurrence, slowly taking its toll on your body.

If you are going to see an osteopath ask if they are a member of OSCA, the Osteopathic Sports Care Association.

Chiropractors

What is a Chiropractor?

"Chiropractors treat problems with your joints, bones and muscles, and the effects they have on your nervous system. Working on all the joints of your body, concentrating particularly on the spine, they use their hands to make often gentle, specific adjustments (the chiropractic word for manipulation) to improve the efficiency of your nervous system and release your body's natural healing ability. Chiropractic does not involve the use of any drugs or surgery."

[World Federation of Chiropractic, 1999].

Chiropractors are very similar to Osteopaths but they tend to focus slightly more on the mechanics of the spine, and adjustments to the body through treatment to this area. However there is little difference between the two. Chiropractic has its origins as an American word, whereas osteopathy is the popular British term. Both sorts of practitioner will be able to offer you treatment relating to muscular-skeletal problems.

Sports Massage Therapists

Massage is recorded as one of the earliest forms of physical therapy. Evidence has suggested it dates back as far as 3000 years or more. Sports massage concentrates on the specific needs of an athlete, to either aid performance or as treatment to injury.

A sports massage therapist uses various stroking and kneading techniques to manipulate the muscles. Releasing tension in the muscles can aid the tendons and ligaments attached increasing performance prior to exercise. Massage also has the added benefit of breaking down toxins in the body and can aid flexibility.

Massage is an effective therapy for releasing muscle tension and imbalances in the soft tissue, which is beneficial for recovering muscles. As a stand-alone method of treatment however, massage is very limited in what it can achieve.

There are many courses available offering qualifications in sports massage. There is a big difference in someone who has trained at a University rather than a private college. These private courses are usually a couple of months long, and are relatively easy to obtain. A sports massage therapist does not always have a detailed knowledge of human anatomy, and there is no requirement to be affiliated with any association or council in order to practise.

If you are going to a massage therapist, make sure you ask that they are familiar with sports injuries, that they have experience of dealing with them, and most importantly that they are a member of an association such as the Society of Sports Therapists, or the Sports Massage Association.

When should I go to a Sports Massage Therapist?

Feeling stiff? Not in agony but can't quite work that knot out of your back? A massage may be able to help. If you are suffering from non-serious tissue injury then a massage may help, but do not fall under the spell that it is an all-encompassing treatment. There is only so much you can do by the "laying on of hands".

Podiatrists

What is Podiatry?

A podiatrist deals mainly with feet, but can deal with almost anything below the knee. A podiatrist is very similar to a chiropodist. They are able to treat ailments such as infections, ingrowing toenails or assist in the rehabilitation of fractures.

What is podiatric sports medicine?

"Podiatric sports medicine, or sports podiatry, is the application of podiatric medical principles to the sportsperson and the sporting environment," explains Mr David Dunning, a podiatrist with a special interest in sports podiatry.

[The Society of Chiropodists and Podiatrists website]

Our feet. Our poor, poor feet. Do you realise how much of a battering we give them every single day? We walk on them, run on them, and jump up and down on them… Its very easy to injure your foot, as even though they bear all of our weight they are actually quite delicate things, being made up of small easy-to-break bones and a mass of ligaments and tendons.

As well as the common problems people associate with feet, they can be responsible for many problems that you may not realise. That back pain you've been feeling for the past few years may actually be a result of an imbalance in your posture, caused by your heels being out of alignment. Sound funny? I had chronic back pain for three years until someone pointed this out to me. Not a day since have I felt a twinge. Good eh? Problems can occur in your back, hip or knee and be directly related to your feet.

If you have any kind of foot or ankle injury, a podiatrist could help you.

If you caught your toes leg kicking someone but catching their knee, a podiatrist may be able to do something about the mess of broken digits at the end of your foot. If someone popped your ankle cranking on a figure-four, they may be able to help. If you are suffering from a consistent pain when running they should be able to isolate and identify the problem and hopefully fix it! Even if you can't get rid of that Athlete's Foot and your partner won't practice leg-locks on you anymore, a podiatrist should be able to help.

If you are unsure of whether you should go to see a podiatrist or not, it is probably best to go and see a physio first as they can diagnose the problem and determine if you would benefit from the specialised treatment a podiatrist offers.

Dentist

There's no denying that a mouthful of teeth is much more preferable to dentures or an oh-so-attractive smile full of gaps.

Whether you're getting a fitted mouthpiece made, or you got your teeth kicked out and need someone to implement damage control, a dentist is who you need to see.

Alternative Therapies

No longer the preserve of new-age hippies, there are numerous alternative therapies that have tangible benefits, and you won't even have to wrap yourself in bandages soaked in sheep urine or whip yourself with birch twigs under a full moon.

Some massage therapists may offer aromatherapy or homeopathy, but these are more "complimentary" to massage rather than stand-alone treatments.

If you are looking for something a little different to the majority of services offered, then you would do well to explore acupuncture.

Acupuncture is the ancient Chinese art of inserting extremely thin needles into specific pressure points located all over the body. Acupuncture claims to work as a remedy to all manner of ailments, from pain relief to helping cure addictions such as smoking.

"According to traditional Chinese philosophy, our health is dependent on the body's motivating energy-known as Qi/Chi- moving in a smooth and balanced way through a series of meridians (channels) beneath the skin.

"Western-style or medical acupuncture is a more recent development practiced predominantly by doctors and physiotherapists which uses a more limited range of techniques on the basis of a western diagnosis."

[Taken from the British Acupuncture Council website.]

This may sound a little unusual to the un-initiated, but acupuncture is a tried and tested treatment steeped in thousands of years of practice. Many fear it because of the use of needles, but in the number of times I have experienced acupuncture I have never felt any pain.

The treatment leaves you in a deep sense of relaxation, as natural endorphins are released and this can leave you a drowsy for a few hours. Its quite a strange feeling, but not unpleasant. I liken it to that feeling you have in the moments after waking up from an afternoon nap.

As a stand-alone treatment, it's uncertain how beneficial it can be for someone suffering from a common sporting injury, but as a complimentary therapy in conjunction with "traditional" Western medicines it is certainly worth exploring.

Conclusion

Sports injuries are no joke and should not be treated lightly. The amount of people I know who disregard seeking treatment out of hand isn't funny. I have heard excuses such as "it costs too much", to "it'll sort itself out"... These people then go on to splash out shed-loads of money on new rash guards, training DVDs, and of course more sessions at the gym.

For the price of a new T-shirt or a couple of CDs you can see someone who could potentially save you considerable pain, and allow you to return to the gym fighting-fit.

Hopefully this guide will be of use to you- if it opens your eyes to the many options available to you or spurs you on to biting the bullet and booking that appointment, I'll be happy.

Just remember these points before you part with your hard earned cash:

Always ask if the person you are going to see is a member of a national professional body.
Be cautious of someone who is keen to book you in for return appointments without starting a proper course of treatment.
If you are unsure of whether the person you are going to see can actually help, give him a brief description of the problem in your initial conversation. Just don't expect a full diagnosis over the phone.

Now, time to book that physio appointment - I can feel my neck getting stiff again.

SFUK is dedicated to supplying you with MMA news - free! We rely on writing/photo contributions. This entire site's contents is by fans like you for fans like you. - if you'd like to write, and think you can help, get in contact with us.