I’ve seen my fair share of accidents and apologies in both weight lifting and training in martial arts. People often question whether or not they should seek professional help, or just ice and elevate after some mishap; so, I’ve compiled a short list of common injuries and what to do in their response.
I am fully aware that I am not a doctor- and you should be fully aware of that too. All of the information I am providing comes from a very helpful book that is cogently put together, and I recommend as a larger source-book for medical knowledge; but not as a supplement for professional advice, nor professional education on the subject matter. Rather, the text and this article should be used as a reference, not as medical treatment. The book I am referring to is “The Medical Care of the Judoka,” by Anthony J. Catanese.
Dislocated/tendon ruptures/broken fingers: These injuries are usually not diagnosed when they happen. People typically shrug them off as a sprained or jammed finger, and believe that Ice will do the trick after a few days. If you can’t bend or move your finger, you should go to the hospital because you’ve either broken your finger or you’ve ruptured tendons. You can attempt to feel for a break in your finger, but it is most beneficial if you sought actual medical treatment and an X-ray; because most of these injuries “are difficult to repair once they reach a chronic stage,” (p. 67). Dislocated fingers usually show deformity (like bent in an abnormal way or crooked near the joint), and they need to be reduced. This should be done by a professional. Professional advice should be sought after because if the extremity has been dislocated, there is tendon damage; which should be assessed by a doctor.
Concussions: Catanese defines a concussion on p. 24: “Concussion occurs when some traumatic force is applied to the head with immediate and transient (temporary) neurological impairment. The hallmark of concussion is confusion and amnesia. The condition may last for only seconds, or it may take days to resolve.” Because concussions can only be diagnosed by a medical professional, it is wise to consult a doctor if you’ve suffered confusion, dizziness, stammering, or a ringing in your ears after a forceful blow to the head. There are two very important things to note about the possibility of a second concussion: (1) if you have had a concussion before, you are more likely to have a concussion again and (2) if you become concussed before a previous concussion is healed, “the brain can swell or even rupture,” (p. 27). Concussions aren’t something to be taken lightly, and should be diagnosed by a doctor if symptoms are shown after a blow to the head.
Acromioclavicular Injuries: This is the AC joint in the shoulder. Your AC joint can get separated if there is a large impact directly on the shoulder; which can happen from a fall, a weight pulling on your arm from the shoulder joint, or something of that nature. Catanese argues that most of these injuries are not serious, because they mostly result in swelling. The most severe aspect of separation is where it becomes completely torn and requires surgery and immediate attention. The difference in pain is an obvious indicator of the degree of injury; but if repetitively injured, you should seek medical advice as the separation can increase over time with resulting weakness of the joint.
Shoulder Dislocation: You are not Mel Gibson in Lethal Weapon. If your shoulder has become dislocated, a professional doctor needs to reset it. A muscular person will have a more difficult time reducing the shoulder, as well as someone who has never dislocated their shoulder will struggle more than someone who dislocates the shoulder frequently.
Bicep Tendon Rupture: This injury is where a major tendon in the bicep detaches from the joint (either at the shoulder or elbow, but more commonly at the shoulder) which is indicated by a distinctive noise. Sometimes this noise is loud and sometimes soft; it essentially depends on how long the tendon has been tearing for. In some cases, the fibers slowly tear off, leaving only a few to hang on until the bicep is over exerted and snaps. Depending on the severity the tendon can either be left alone to die off and decompose or be surgically reattached; however, this decision should be left up to a doctor, and not you.
ACL and MCL Tears: The scope of this article and my knowledge does not permit the depth it takes to describe either of these injuries. Here, I am just describing the what it might feel like and when to know if you should seek medical attention. Ligament tears are similar to the Bicep Tendon rupture in the sense that the ligaments can be tearing for a long period, and eventually snaps. Depending on how long the ligament is tearing, the snap may be extremely painful, or you could be left asking yourself whether or not you actually tore it.
After the ligament is torn, you may also be left questioning whether or not you tore it. This is because there isn’t pain associated with motion after the ligament is torn, nor a lot of swelling (although sometimes there can be). The tearing of these ligaments results in instability. Even there is ever a situation where you tweak your knee and hear a ‘snap’ or a ‘pop’ and your knee feels unstable, you should see your doctor. Depending on their diagnosis, you will probably receive an x-ray followed by an MRI- which is essentially an x-ray for ligaments instead of bones. In any case, it is best to seek professional help if there is a chance you’ve torn a ligament in the knee.
Rib Fractures: It is hard to ignore the pain from a fractured rib. An x-ray may be unnecessary to diagnose, especially if on the lower ‘floating’ ribs. You, or your doctor, would probably be able to feel where the rib is fractured. Now, doctors do not bandage ribs because it restricts your lungs capacity to breathe; and shorter breathing “can result in pneumonia or a collapsed lung,” (p. 95). If suffering a broken rib, you will either have to deal with the pain, or take pain medication so you are not averted from breathing deeply.
Exertional Collapse: Some people think that it’s a good sign if you pass out from working out so intensely; in actuality, it is quite the opposite. Catanese outlines four common reasons for collapse on p. 100: (1) Cardiac Causes, (2) Heat-related causes, (3) Sickle Cell Trait, and (4) Asthma. Numbers 3 & 4 are typically known to the person, so they will not be discussed here.
Cardiac causes have 4 of their own causes that Catanese describes as (1) Myocarditis, (2) Anomalous coronary circulation, (3) Prolonged QT syndrom, and (4) Hypertrophic Cardiomyopathy. These causes are generalized as “Myocarditis is a viral infection of the heart. Anomalous coronary circulation is a congenital situation where the arteries that supply blood to the heart are abnormal. Prolonged QT syndrome is a congenital anomaly of the nerve conduction system to the heart. Hypertrophic cardiomyapathy (HCM) is a congenital problem with the muscle thickness of the heart.”
That is a lot to digest.
The advice given by Catanese is boldly written (literally) as: “Any athlete who blacks out during exercise needs to be suspected of having a cardiac arrest until proven otherwise,” (p. 101). I think this is good advice, and calls someone to suspect the person who has collapsed immediately, engaging in following up on their heart circulation and their ability to breathe. This is important because, in the case of (4) HCM the resuscitation rate is extremely low, and decreases dramatically every moment that passes when the athlete is not treated with an AED.
Heat related causes are emergencies. Catanese shows (on p. 158) how rapidly the symptoms of heat exhaustion can progress to a fatal occurrence. They go from heat stress/cramps to heat exhaustion, and then from heat exhaustion to heat stroke. It is critical to pay attention to the cramps because that is the first sign and the other two problems can be avoided if properly treated when cramping. Cramping often occurs in the calf or the lower body, but can also occur anywhere else. You should immediately consume water, and if available, a liquid like Gatorade or Powerade the can replenish lost electrolytes.
Heat exhaustion has the symptoms of cramping, on top of which someone can experience “nausea and vomiting, headache, aches and pains, and minor alterations in vital signs… often starting to get slightly confused and may start hyperventilating,” (p. 159). One should be more aware at this point of the possibility of a heat stroke, and should cease all exercise.
Heatstroke can be fatal, and an ambulance should be summoned right away. This state is categorized by the lack of sweat, confusion, seizures, and coma. Catanese suggests the torso should clothes should be removed (or rolled up in females) and cooled with ice, cold rags, or whatever is available. The quickest way to cool a body is to apply cold packs to the armpit area as well as the groin. Emergency help is absolutely necessary.
Exertional collapse is common in the gym, and is most commonly seen in heat-related causes and hypertrophic cardiomyapathy; which are dangerous and can be fatal. With an exertional collapse, it is critical to call an ambulance and be sure to assist the victim as much as possible until professional help arrives.
There are hundreds of other common injuries that have not been outlined in this article. These are few, of many, that can be commonplace in the gym and so it could be helpful to have a little familiarity with frequented illnesses. In every case that results in collapse or a large amount of trauma, professional advice should always be recognized. Again, this is not professional advice. This article outlines a few excerpts from a well-written book entitled “The Medical Care of Judoka” and is far more helpful than what I’ve written. Perhaps this article may help someone in the future; but hopefully, you won’t have to endure any of the injuries listed here.
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- Baby Back Ribs - July 3, 2014
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