Over the next five weeks most of us are going to be attempting the CrossFit open. Five work outs released over a 5 week period with 4 days to complete each workout and submit a score.
For all of us this should be a fun experience. During this period hopefully we will all go as hard as possible and be able to sustain this intensity over the period of 5 weeks. It is a great way to test our capacity, learn new things and challenge ourselves in ways which we may have never done before.
Despite this being a whole lot of fun, a big jump in intensity in training with new tasks can potentially bring an added risk of injury. Many sports related injuries which are not traumatic can come from this increase in load which our body has never been exposed to before as outlined in my previous blog post.
If we get an injury however it is not the end of the world, although it may seem like it due to the pain/swelling/lack of mobility over the first few days that is our body trying its best to heal and protect you by going through a series of phases.
Phase 1 Bleeding (2-24 hours)
Phase 2 Inflammation (First few hours and can last for a few weeks)
Phase 3 Proliferation( 24 hours- several months)
Phase 4 Remodelling ( 2 weeks- months or even one year after)
As you can see there is a lot happening in the first 24-48 hours of an injury, hence why most people will feel a lot of discomfort within this initial period which can sometimes resolve within a few days without any intervention.
What we need to do however is respect these phases in order to give our body its best chance to heal and recover with the ultimate goal to make the quickest return to sport.
What I intend to do is guide you through those initial few days/hours of Phase 1 +2 with advice which will hopefully lead to a more efficient resolution of your injury or more comfort until you are seen by your local health professional.
What to do if we have an injury:
Ice – Research on this topic suggests that there is limited proof that ice actually increases the rate of healing and leads to the athlete returning to sport any quicker, however what we do know is that it so far has not been shown to harm any injury, if anything it might help with the pain in the initial few days.
Keep it moving – Within a safe, pain free range, when you can start putting weight on it, but respect your body. Use pain as your limiter in the first few days.
Keep everything else moving – Although you twisted your ankle it may not affect your bench press or pull up, we often see athletes training with casts/splints/boots on and this probably does a lot for their healing physically and psychologically. See this as an opportunity of what you can train and not what you cannot.
Off load – Avoid doing any painful tasks for the initial few days, this could be a weight bearing task, a range of movement or even poking your injury too much with foam rollers/balls.
Begin the graded approach to return to sport – Once over the first few days/hours of healing your rehab can begin, this however varies greatly on your injury, the extent of it and your pain levels. This is when it may be a good time to speak to your therapist or coach, but the sooner you start beginning the small steps to getting back the better.
Sleep + diet – These two topics are widely discussed on our blogs and within our community and lets not underrate them, especially within the early stages of healing. Some useful tips on sleep can be found in coach Phil’s previous blog post.
What not to do:
Non Steroidal Anti-Inflammatory Drugs: Again a topic of debate, the most recent research does not come to a complete conclusion on the use of anti-inflammatories in acute injuries. However their use largely depends on the time scale and the structure involved.
Anti-inflammatories may be useful in the short term in acute tendon, ligament or nerve injuries, they may not be useful in acute muscle injuries and they have not been recommended to be used in any bone injuries.
If in doubt about their use as you are unsure what structure is harmed, the research recommends that paracetamol can be just as good to use to help with pain however carries less side effects. So if in doubt use paracetamol until you see your local health professional.
Train on an injury – Don’t rush back too quickly. Listen to your body and respect the healing times as outlined above.
Don’t over analyse or worry too much – Although injuries can be worrying and depressing, don’t let it bother you. Come to terms that it has happened and embrace the road to recovery however long it may be.
Despite all of the healing phases and recommendations, each athlete and injury varies. The return to sport will largely depend on the injury sustained and its severity, a number of tests on the affected limb by your therapist or coach, pain levels and muscle and joint function.
Non-steroidal anti-inflammatory drugs in sports medicine: guidelines for practical but sensible use. J A Paoloni, C Milne, J Orchard, B Hamilton 2009.
Non-steroidal anti-inflammatory drugs for athletes: An update J.-L. Ziltener, S. Leal, P.-E. Fournier, 2009.
Oral non-steroidal anti-inflammatory drugs compared with other oral pain killers for sprains, strains and bruises July 2015.
Regeneration of injured skeletal muscle after the injury, Tero AH, Järvinen, Markku Järvinen and Hannu Kalimo 2014.
Soft tissue healing and repair, Tim Watson 2006.
Brukner and Khan’s Clinical Sports Medicine Fourth Edition 2012.
Workout of the Day
Mini King Kong AMRAP 15
1 Deadlift 140kg/100kg
2 Muscle Ups
3 Squat Cleans 85/60kg
Workout of the Day
A) Shoulder Press 3×5 with KB/DB
B) 8 sprint sets:
12 Cal Row
8 single arm KB thruster (each) 24/16kg
*Rest 30 Seconds
Accumulate 5 Minute Plank.