By Dr. Shayne Baylis, Doc Hockey
You struggle to the bench and you’re out of breath and pain is radiating in the back of your thigh.
It feels like a “pulled muscle” in your hamstring when you overextended lunging for the puck. The trainer asks you, ‘Are you hurt or injured?’
You contemplate the question as you walk around on your leg testing if you can balance your weight on it and if you have a good range of motion.
You are asked what level of pain is it out of 10 (10 being the worst pain you have ever felt). You wait a moment – ‘3,’ you reply.
You make the decision that you are hurt not injured because you can play through the pain without further long-term injury and it will not compromise your play where it might be detrimental to your team.
You go out the next shift and while trying to avoid a hit, you end up colliding thigh on thigh and suffer a “charlie horse.”
Once again you are hobbling to the bench. You immediately know there is trouble putting weight on your leg while walking.
The familiar words come to your ear: ‘Are you hurt or injured?’
As your hockey pants are removed to take a closer look at the injured area, you can see the leg is swelled. You report your pain being a 5 or 6 out of 10. You are advised by the trainer to ice your thigh and to rest for the remainder of the game because playing will increase the risk of myositis ossificans developing in your thigh, and in addition could cause long-term disability.
The first injury is an example of something you can play through and the other incident is not to be played through.
A proper return from injury
Often muscle strains in the first situation can be taped to help limit further injury and you can return to the ice.
The second injury is more serious because myositis ossificans can result by deep muscle damage and blood pooling under the skin, producing calcium in the muscle because of continual trauma to the area, vigorous exercise, or deep massage. Long-term disability of the muscle can result.
Treating the first injury would include a functional assessment of the individual and their range of motion, restoring range of motion through active release technique (ART), chiropractic adjustments, and massage, followed by strengthening isolated muscle (physiotherapy), and whole body strengthening (the CORE).
The second injury would be treated immediately with compression, ice, elevation. Stretching would also be helpful after the acute phase of inflammation and pain has subsided.
Ultrasound is also beneficial for breaking down calcium and healing injured cells. X-ray or diagnostic ultrasound should be rendered in order to ensure no calcium is present in the muscle.
The biggest concern should always be long-term consequences of an injury and if one’s continual play will harm the body further.
A concussion is also an injury that should not be played through because of the chance of second-impact syndrome, where the brain swells and can cause permanent brain damage and/or death.
Fractures, ligament sprains and disk injuries all need to be evaluated for proper return to play. If the pain is over 5 out of 10, it is often a better idea to sit out and rest. Short-term success is no substitution for long-term health.
Most importantly when you have an injury it is necessary to seek treatment to restore muscle, bone and joint integrity. Stretching and strengthening after full range of motion is achieved and the functional motion analysis is improved. When things are not improving diagnostic imaging and diagnostic tests should be ventured.
Find a local ART chiropractor provider for those acute and nagging pains and get back to the game faster.
Visit dochockey.ca for more information.