Powerlifting Injuries – How Muscles Get Injured And How To Treat Them by Ken Kinakin, D.C., C.S.C.S.
:: Powerlifting :: injuries can come from a variety of sources. Examples of this may be poor lifting technique, lifting beyond your capabilities or training too often without proper rest or recuperation. All of these sources can lead to microtrauma, or small injury, that can get worse over time. Because you don’t recognize that the is injury there, you reinjure yourself frequently. This repeated microtrauma can eventually have a profound effect on the specific action of the joint and the surrounding tissues. The effects of the microtrauma include the microtearing of the muscle, the sheath around the muscle and the adjacent connective tissue, as well as stress to the tendon and its bony attachments. The microtearing of the muscle tissue leads to microscopic bleeding, all of which affects the entire area around the injury, contributing to what is commonly know as inflammation. Most people assume that inflammation can be easy to detect like the swelling around a badly sprained ankle. This is not always the case however. Microtrauma causes a corresponding low level of inflammation that cannot be seen or palpated.
The body responds to this myofascitis, inflammation of the muscle and fascia, by forming fibrous adhesions, or scar tissue in the muscle, between the sheaths of adjacent muscle groups and between the fascia and the muscle sheaths. These fibrous adhesions limit the ease and range of motion of muscles and joints and can decrease the muscles lengthening and shortening capabilities. Once the normal biomechanics of the joint is altered, this can lead to further inflammation and the pattern becomes a vicious cycle of long-term wear and tear.
This fibrous adhesion pattern can be seen in people who do certain exercises such as bench press and complain of the same pain in the exact same spot. This doesn’t happen by chance. The fibrous adhesion formed in the shoulder muscle is preventing proper motion and pulling on the various soft tissue structures like muscle, fascia, tendon and bursae when trying to perform the bench press.
Taking time off lifting will decrease the chronic inflammation, but it will not decrease the fibrous adhesion. As soon as you start lifting again, the fibrous adhesion will increase the inflammation and stop you from doing this exercise due to pain. An analogy would be if your car tire hit the curb on a icy road altering the tire alignment causing the tire and car to shake when driving. Putting the car in the garage for one month and not driving will prevent further damage to the tire and steering linkages, but it will not fix the wheel alignment. You have to take it to a mechanic that will properly assess the altered wheel alignment and then he balances it until it spins perfectly again. The same thing occurs when you have an injury. You have to identify all the possible fibrous adhesions in the muscle, then perform some soft tissue therapy on the muscle to break up all those fibrous adhesions in the muscle, muscle sheaths, tendons, ligaments and fascia. This will restore normal motion to the muscle and joint allowing proper movement and function. One of the latest soft tissue techniques that is being used on athletes all over the world is call Active Release Technique (or A.R.T.) that was created by Dr. Micahel Leahy D.C. A.R.T. is aimed at manually breaking up adhesions, the scar tissue that can entrap muscles, tendons, ligaments and even nerves.
The new procedure is similar to some massage techniques, only it’s more aggressive. You must be able to locate the adhesion and know how to use active motion of the body part to break them up. To break up an adhesion, you must actually put your thumb or fingers on the scar tissue and make it move in a way that breaks it away from the tissue it has adhesed to. Depending on the amount of chronic inflammation and severity of the adhesion, the pain can be minimal to quite intense, but the procedure is only done a few times and the relief from the injury can be almost immediate at times. Sometimes with less severe injuries only three to six sessions are needed to restore normal muscle and joint function along with proper guidance of exercise technique, stretching and diet to prevent the injury from reoccurring. More severe injuries can take longer and other forms of therapy must be regularly performed to fully restore normal muscle and joint function. After the adhesions are broken up, a rehabilitation program should be used to strengthen the muscles since certain muscles in the point will have been not properly strengthen due to altered biomechanics.
This has been a very useful and common sense therapy that has worked very well for my patients and complements all the other treatment modalities I use. It has allowed many of my patients to get back to the weight room pain free, full strength or runners back running at their full potential. If you have a current injury that will not go away, even with other forms of treatments or rest, this maybe an appropriate therapy for you to try.
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