Sports injury prevention and rehabilitation

The core prevention logic of sports injuries is "dynamic adjustment to adapt to one's own abilities", and the core principle of rehabilitation is "progressive functional reconstruction without pain" - there is no universal standard that applies to everyone. All plans must match the individual's sports foundation, injury type and recovery stage. Blindly copying Internet celebrity tutorials and shouldering pain training are the core reasons for the recurrence or worsening of 80% of sports injuries.

I just picked up a 22-year-old boy from school last week and followed the Internet celebrity tutorial to practice the "100kg Squat Crash Plan" for three months. When I arrived, my meniscus had been damaged to the third degree, and my knees were shaking when going up and down the stairs. He said that after watching the video, the blogger did it easily, and thought he could keep up with it even if he gritted his teeth. Don't tell me, this kind of "filling your stomach by following other people's recipes" situation, I have really seen it too many times in the four years of exercise rehabilitation.

There are actually two factions in the fitness circle arguing fiercely about injury prevention. One faction is the "technical supremacy party", which believes that as long as the movements are absolutely standard, it is impossible to get injured. Even whether the knees can pass the toes and the angle of the back during deadlifts must be stuck to the millimeter level.； The other group is the "load-first party" who believe that as long as the weight and intensity do not exceed the body's load-bearing limit, there is no problem with slight flaws in the movements. Objectively speaking, both sides are right, but they are suitable for different people: novices who have just started exercising for less than 3 months, the logic of giving priority to movements is definitely correct. After all, you can’t even figure out the difference between quadriceps force and knee compensation. It’s strange that you can’t do anything while deadlifting with your waist tilted. ； But if you are an enthusiast with more than 1 year of systematic training, you really don’t need to stick to the so-called “standard movements”. Everyone’s hip, knee, and ankle mobility, and leg length ratio are different. If you force people with poor hip mobility to squat until their thighs are parallel to the ground, it will easily twist their waists.

Let’s just talk about lap running. Many people are taught that “the cadence must be 180 to avoid hurting the knees” when they first join the race. Last week, there was a girl who couldn’t even finish a 1-kilometer run. She forced a cadence of 180 with a metronome. After running for 3 days, her Achilles tendon became swollen like a steamed bun. Is there any universal gold standard? Your normal walking cadence is only 110, but when you walk up to it, you directly increase it to 180. Can your Achilles tendon not protest? There are also those who work all day at 996 and have to go to the gym to push weights even though their brains can’t move. They can’t concentrate at all, and they don’t even know if their movements are deformed. I’ve seen several young men who work overtime until 10 o’clock and still go to the gym to lift weights. In the end, the barbell slips and hits their feet, which is not worth the gain.

After talking about prevention, let’s talk about the most troublesome recovery issue for everyone. In the past, the concept of the older generation was that "it takes a hundred days to break the muscles and bones." If you are injured, you should just lie down and recover. Now the sports rehabilitation community is shouting that "early exercise will help you recover faster." Many people are confused. Who should they listen to? In fact, it is still divided into stages: within 72 hours of acute injury, it is definitely correct to follow the POLICE principle (protection, appropriate weight-bearing, ice, compression, and elevation). At this time, moving around will only aggravate swelling and tissue damage. ； But after the acute stage, it would be bad if you continue to lie still - muscles will atrophy rapidly and joints will become adhesions, which will slow down the recovery process. Last year, I had a friend who played amateur badminton. After spraining his ankle, he followed the doctor's advice and "rested" for a month. After he came back, he always felt that his ankle was as soft as cotton, and he twisted it three times after playing twice. After doing six weeks of ankle proprioception training, he now has no more problems when playing in municipal leagues.

Many people have very rough judgment criteria for recovery and think that “it means it’s fine if it doesn’t hurt.” This is not true. For example, for patients with lumbar disc herniation, the pain has subsided but the inflammation has subsided, but the strength of the core muscles has not been restored. The next time they bend down to lift a heavy object, the disease may relapse again. There are also some people who are eager for success during the recovery period and rush to do a 5km PB as soon as they can walk normally. As a result, they suffer a second injury. The injury that was supposed to be cured in one month is not cured even after half a year. I myself have experienced this pitfall when I was practicing CrossFit. After straining my shoulder, I rushed back to training. It hurt a little but I gritted my teeth and endured it. In the end, it resulted in acromion impingement. It took me more than three months to recover. I regret it now when I think about it.

In fact, after all, the purpose of exercise is to make oneself more comfortable, and not to make oneself a frequent visitor to the rehabilitation department for the sake of check-in data in the circle of friends and comparison with others. Look at the grandparents doing Tai Chi in the park downstairs. Their movements are slow and there are no "standards", and no one is injured every day. ； On the contrary, those young people who shout "no pain, no gain" every day come to me every day. Listening to your own body's voice is more useful than reading 100 internet celebrity tutorials.