Getting back on track

This file photo showsa Lithuanian athlete, Balciunaite Zivile, receiving first-aid at the end of the world half-marathon in New Delhi. The most conservative treatment recommended for all kinds of soft tissue injuries is RICE (Rest, ice, compression and elevation).-RAJEEV BHATT This file photo showsa Lithuanian athlete, Balciunaite Zivile, receiving first-aid at the end of the world half-marathon in New Delhi. The most conservative treatment recommended for all kinds of soft tissue injuries is RICE (Rest, ice, compression and elevation).

Injuries that afflict long-distance runners and the rehabilitation process. By Dr. R. Gandhi.

The performance of successful middle and long distance runners is a combination of many factors like physiology, biomechanics and psychology along with proper injury management. These athletes are vulnerable to some common sports injuries and I will dwell on the various ways of getting back on track.

General preventive measures1. Always warm up.2. Avoid over training.3. Use the right shoes.4. Drink plenty of water.

5. Proper recovery measures need to be followed.

6. Do not increase the intensity suddenly.

The injuries that afflict middle, long distance and marathon runners and the rehabilitation methods are as follows.

1. Ankle sprain: The ankle sprain occurs when there is over stretching and tearing of ligaments with swelling surrounding the ankle joint. The symptoms include a sudden sharp pain at the ankle joint during exercise and at times you can hear a ‘pop’ sound.

Rehabilitation: No weight should be put on the ankle for at least 24 hours after being injured. Use crutches until you can put weight on your ankle. Apply ice to the ankle for 15 minutes four times a day for the first 24 hours. While applying ice, place a towel between the ice pack and skin to avoid ice burn. Use Cold Therapy (Rest, Ice, Compress and Elevate) technique. Use a compression bandage to minimise intra muscular bleeding. Gentle static stretches should be done initially. Rest with the leg elevated above heart level as this will help the blood and edema drain away from the ankle and help reduce swelling. Try to avoid heat of any kind like having hot showers. A sprained ankle usually takes about four to eight weeks to heal. Protecting your ankle from further injury is important because after a sprain, the risk of another injury is increased by as much as 50%.

2. Shin splits: This is an injury that manifests through pain in the muscles around the shin bones. The symptoms range from pain in the lower leg to tight calf muscles.

Rehabilitation: Rest is the best treatment. Returning to activity must be done gradually with non-weight bearing activity like cycling and swimming. Strengthening and stretching exercises will also aid recovery. Tape your shins to reduce stress but if the pain persists after three weeks, then consult a physician.

3. Knee injuries: Ligament injuries to the knee are very common in sports that require stopping and starting or quickly changing directions.

Rehabilitation: The physician will prescribe specific recommendations and delaying treatment can often result in a longer healing process. The most conservative treatment recommended for all kinds of soft tissue injuries is RICE (Rest, ice, compression and elevation). Many doctors recommend low-impact exercises like swimming, cycling and walking that strengthen the muscles without injuring joints. At times a physician may perform a corrective arthroscopic surgery.

4. Blisters: Blisters typically develop due to friction on the skin due to improper clothing or shoes.

Rehabilitation: To prevent blisters, wear footwear that fits. Keep a small stash of blister treatment products. Try to keep your feet dry or change socks. A simple treatment is to apply a generous amount of petroleum jelly. If the blister persists, wash it with soap and then puncture its tip with a sterilised needle to drain the fluid. After that, cover with a bandage.

5. Stress fracture: This is considered to be an overuse injury of the lower leg. Women seem to be at greater risk because of a condition called “the female athlete triad,” which is a combination of poor nutrition, eating disorders and infrequent menstrual cycles that causes thinning of the bones. High impact sports such as running, gymnastics and volleyball can increase the risk of stress fractures.

Rehabilitation: Taking a break from the routine and doing low impact exercise for a few weeks can help the bone heal. Adequate rest has to be taken else the injury will never heal properly. Eat well and include calcium-rich foods in your diet, especially if you are a female athlete. Any leg pain that continues for more than one week should be seen by a doctor for a thorough diagnosis.

The author is a national athletic coach at the SAI Southern Centre, Bangalore.