Injury
Rehabilitation
by Lynda Lehmann, WAIS Assistant Kayak
Coach & Dual Olympian
Whether you gained your injury through overuse or by some mechanical trauma, there are some definite steps that you need to take in order to return to training and competition successfully (ie, without losing more time than necessary due to the injury).
Assessment: When you first notice pain you need to make a sound judgement regarding its severity and the action that you should take.
If something begins to hurt while you are paddling, either stop what you are doing or modify it so that it doesnít hurt. Pain is the bodyís way of telling us that something is wrong. We ignore these signals at our own peril. Even a small niggle needs some kind of attention. This may be to stop paddling for a few days until there is no more small niggle, to ice the niggle over the next few daysí training until it goes away, to stretch appropriately, to get a massage or to get a physio treatment. Either way, it is unlikely that small niggles just disappear all on their own while still under training loads.
When you have a small injury that will warm up until there is no pain while you are training, it is OK to train on. However, the problem must be getting treatment or the problem will get worse, not better. Returning to training from an injury will often see you warming up and then making a decision regarding your ability to do the training session ñ continued pain says stop, no pain says OK. The fact that there is pain at all says that you are not out of the woods yet.
If you have an injury that hurts throughout the day, even when you are not using the part, you shouldnít attempt any activity, except specific exercises that your physio has given you.
Treatment: The course of action that you need to take in stopping training or returning to training depends on your decisions based on the pain indications above.
A small niggle means that there is something you are doing that is not quite right. Get a coach to look at your technique. Pay attention to warming up and cooling down, and seek advice on a stretching routine that is appropriate to you. Massage (either self-massage or a practitioner) will help enormously.
If the ìniggleî doesnít go away with a few daysí rest, or by modifying what you are doing, its no longer a niggle but an injury. Most pain is accompanied by inflammation, so your first action will always be to follow the ìRICEî principle ñ Rest, Ice, Compression (bandage), Elevation. This action should be administered immediately, just prior to phoning for an appointment to see your physio. The sooner you can get into the physio, the greater the effect of the treatment. Ice should stay on for 10 minutes and off for 20 minutes and should not be directly next to the skin. The cold needs to penetrate into the tissue not freeze the skin. Donít apply heat for the first few days.
The physio will make an assessment of the state of the injury. Something minor may only require one or two treatments to reduce any inflammation and some advice on avoiding the problem again. A more major injury may require a visit to the doctor for an anti-inflammatory prescription and a longer period of physio treatment.
Natureís way of treating an injury is to flood the site with various substances (inflammation) that will very quickly form scar tissue. This scar tissue is intended to limit movement so that we canít do that silly thing again. Nature doesnít realise that we have crazy passions for paddling and that we actually WANT to do it again! RICE, the various methods used by physios and anti-inflammatory drugs are designed to limit the build up of inflammation, and therefore to limit scar tissue. Inflammation can be quite severe before you become aware of it and scar tissue begins to form within a day or two. Treating the inflammation a soon as possible is, therefore, vital.
Returning to training: The speed with which you can return to training depends on the severity of the injury. Give yourself as long as you had off to get back to your full training load. Pay special attention to warming up, cooling down and stretching. Adhere to the advice of your physio and utilise the services of a good masseur to help your comeback.
Find the cause of what happened so that you can avoid the problem again. Seek lots of opinions, but make up your own mind ñ its great to get input from a lot of areas but you have to decide for yourself what is right for you. Be sensible about injuries ñ a little forethought and preparation goes a long way towards allowing you to enjoy your paddling for many years to come. But donít get preoccupied with having to adhere to certain training loads, the injury potential in an activity, how the poor old body is coping, etc. Relax and enjoy!