Injury management

By Dr. Michael Cerami

So you’ve injured yourself, and you are stuck physically and mentally on how to manage your training and emotions. My recommendations are as follows.


Take it day by day: Don’t cancel a race or change your plans within 48 hours of the injury. Being in a compromised state doesn’t allow us to make good decisions. Don’t let that “voice” have its way with you.


Functional management: Most of us know that sprains and strains respond well to RICE (Rest, Ice, Compression, and Elevation). In addition, try and treat the inflammation as soon as possible (think minutes or hours, not days). The quicker you can reduce the inflammation and its downstream effects, the quicker you’ll recover. Heat can be helpful for a lower back injury if limited to 15 minute treatments but never use heat on an acute injury. Ice is designed to reduce the swelling in the area by constricting the blood vessels: use for no more than 15-20 minutes per session from 1 to 72 hours.


Pain management: Instead of NSAIDS (non-steroidal anti inflammatories) try a natural approach. Injured muscles respond very well to Epsom Salt soaks (4 cups per bathtub for 15 minutes in hot water) because of the magnesium component. Also try Phenocane; a natural anti- inflammatory that won’t upset your stomach and contains Curcumin and Boswellia. Side note: I’ve been seeing more and more athletes taking NSAIDS prior to their events/races. Recent studies have found little actual performance benefit of taking ibuprofen and warn that masking pain can lead to increased risk of injury. Additionally, using NSAIDS during long endurance events is associated with water intoxication as they upset the salt/water balance in the body and can wreak havoc with your digestion or worse.


Breathe: When we hurt something, it’s hard not to pay attention to that body part. The problem is that we can overdo and under do this approach; it’s not good to ignore the pain because we can cause further damage to the area. It’s also bad to hyper-focus too much on the injury because we can spend too much time in our head creating all sorts of dialogue that’s not really helpful. I suggest you breathe into the area of pain as much as you can throughout the day. This will create a nice balance between giving the area the attention it needs while not letting your brain go crazy. Did you ever notice you can’t think and breathe at the same time? Very cool.


Going forward: It’s rare for me to tell an athlete to stop training altogether. Once we understand the source of the injury, we can usually modify their program to help them keep their fitness level up or, if we’ve solved the symptomatic problem we want them to “test drive” the new alignment with their regular activity to see if we really did make a sustainable change. I find that many of the athletes I see have a number of races or events planned that they have spent considerable time working toward. Unless there is an obvious reason (fracture, acute trauma, etc) it’s not very practical for them to stop all of their activity. Truth be told: most athletes will do what they want no matter what I tell them so we night as well try and work together on the solutions .


Dr. Michael Cerami is an avid runner, cyclist and triathlete. He is available for a no charge consultation one Saturday per month at The Salt Lake Running Company (700 East store) by appointment. He can be reached at 801-486-1818 or online at www.utahsportsandwellness.com


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