I got caught in an arm bar last Monday night at the Forge, where I am learning MMA. Yes, apparently, I suck; however, after being caught in this rather precarious maneuver, I thought my elbow had been broken. Not so much from my arm going numb, or the excruciating pain in my elbow and shoulder, but mostly because of the huge tearing sound that made my opponent let go and say “did I break it”. Not exactly what you want to hear. Now the critical point… Am I just “hurt”, or am I “injured”. If I’m hurt but not injured, should I continue fighting or should I rest? How do I know?
Pain vs Injury
Let’s define the difference between hurting and injuring your body. Here is my own rough definition. When you are hurt, your body has sustained some sort of benign pathology, or an “ouchee” that is sensitive to movement or touch. The integrity of the tissue is usually not compromised to the point where continued movement will cause more or excessive damage to itself or surrounding tissue. In other words, you’re ok; it just hurts like crazy. And then there is injury.
I don’t like any of injury’s definitions I googled, so let’s look at some cinnamon’s (ha-I crack myself up). My “Pfiesterisms” for injury are destruction, ruin, impairment, mischief. If tissue is destroyed or ruined, it could be said to be “injured”. I’m not Webster, but let me make this clearer. When part of your body is compromised to the point that further use is unavailable, or attempting to use said body part may cause more damage, I would define this as an “injury”. Now knowing these terms, how do we distinguish between being hurt and being injured, without diagnostic equipment like an X-ray or MRI (or one of those cool scanners that “Dr Bones” had on Star trek)?
To determine if you are injured or just hurt, in most cases, you can do a quick field assessment to get a rough idea if you should continue training/fighting/playing. You must take into consideration your pain threshold when assessing your status.
For instance, if you’re like me, you could have a paper cut and think you need stitches or, on the other end of the spectrum, be like my father in law who could have a bone sticking out of his leg saying, “it just a little bump”.
If the pain was acute from a blow or a spasm, or a movement you just did during exercise, you may need to rest at least a day, as pain, adrenaline and activity can mask your diagnosis. Even if the incident is acute, you can still use these principals as long as your better judgment prevails. This assessment is most accurate for a potential injury sustained over time, when the origin of when the pain began is rather ambiguous.
Usually if you sustain an acute, “potential injury” during training, it is usually best to stop the training session at least for the day, observe the pain pattern, and -of course- ice immediately.
If you find yourself hurting, and wanting to determine if you should train through the pain or not, try these simple rules.
5 Rules for the Injured
- If the pain subsides with rest and continues to improve, you may not need to go to your physician. If the pain worsens or remains exactly the same for longer than 4-5 days, it would be prudent to seek medical attention. No matter how minuscule, if the pain decreases at all, you might be able to continue training with modifications
- Establish if you have maintained full range of motion. Decide with each movement if the pain decreases, increases, or stays the same. If the pain does not increase with each rep, continue to train but modify and decrease your intensity. If you do not have full range of motion, train in the range you do have, as long as the pain doesn’t worsen throughout your training session.
- After training lighter and or modifying movements, decide if the compromised tissue is exacerbated immediately after training or throughout your day. Did training aggravate it, if so, try to modify your movements further during your next training session.
- Upon waking up the next day, is it better, worse, or the same? If the area is stiff but not worse, then you may be able to continue to train with modifications and with decreased intensity. If it is better, you may want to slightly increase your intensity or range of motion.
- Continue to increase your range of motion, resistance, and intensity as the involved area continues to feel better. It’s a slow process, but conservative measures will rehab the area and allow you to continue to train.
Please don’t take this to extremes. I am only trying to give helpful hints so people who are serious about training can continue with some sort of confidence. It is not the most conservative method out there, but it is a realistic approach for most of us who want to train hard or go home.
PS: I have a degree in physical therapy, so I am sharing my knowledge and personal experience from a therapeutic side – not just a guy who likes to lift weights. 😉