Whether you have been training Capoeira for a while or are just starting out, you will face the risk of injury at some point.   All the twisting and turning can lead to any number of sprains and strains on your ankles, wrists, hips, and knees.  Muscle imbalances and weaknesses also lead to further injuries as well. 

COMMON INJURIES/ISSUES

• Sprains - injury to ligaments
• Strains - injury to muscle or tendon. For example, a muscle may tear from the rapid stop that occurs when you make contact with the ground or an opponent.
• Knee injuries - caused by the bent-knee stance (ginga,  esquivas, etc) and the use of forceful kicks that can injure the joint if  not done properly
• Skin damage - blisters and bruises and cuts
• Sore joints – aches and pains in joints
• Dislocations and fractures - specifically of the shoulder, finger, foot and toes
• Overuse injuries - any part of the body can be affected from overuse and fatigue

SPRAIN

A sprain is an injury to a ligament (tough, elastic-like bands that attach to your bones and hold your joints in place).  Ligaments can be injured by being stretched excessively from their normal position.  When too much stress is placed on the ligament, such as a fall, they can be stretched or torn. 

Of all sprains, ankle and knee sprains occur most often.   Sprained ligaments swell rapidly and are painful. Usually the greater the pain, the more severe the injury.  In mild cases, the force of the injury tears a few fibers of the ligament, causing mild to moderate pain and swelling, which usually subside within a few days.  A more violent injury may completely tear a ligament or muscle and involve bone damage such as a dislocation or fracture.

STRAIN

A Strain is a muscle or tendon injury.  When a muscle contracts it pulls on a tendon (which connects muscle to bone).  Although muscles are made to stretch, a strain can easily occur when the muscle is stretched beyond its limitation or while contracting.  Strains can also be caused by chronic activities that develop an overstretching of the muscle fibers.

SYMPTOMS OF SPRAIN OR STRAIN:

• Mild to severe joint pain or muscle pain which worsens with movement or pressure
• Swelling
• Joint stiffness
• Discoloration of the skin, especially bruising

Symptoms will vary with the intensity of the injury.  Serious ligament tears (Grade III injuries) cause an inability to use the affected joint and may lead to joint instability.  Mild to moderate injuries (Grade I & II injuries) may only cause pain with movement. 

Recovery time also depends om the severity of the injury.  For example, a mild ankle sprain may require up to 2-3 weeks of of rehabilitation; a moderate sprain could take 4-6 weeks and a severe strain can take 8-12 weeks to heal! 

CAUSES AND RISK FACTORS OF SPRAINS AND STRAINS:

Sprains and strains occur as a result of an injury when the joint is subjected to more physical force that it can withstand.   Previous sprains may weaken the ligaments that recurrence is possible with only minor pressure.

The risk of sprains and strains increases with obesity and poor muscular conditioning.

Poor technique - holding or moving the body incorrectly can put unnecessary strain on joints, muscles and ligaments.

Inexperience - beginners are more likely to get hurt because their bodies are not used to the demands of the sport.

Over-training too much and too often can lead to a wide range of overuse injuries as well as repetitive movements and the lack of cross training.



TREATMENT OF SPRAINS AND STRAINS

Keep pressure off the injured area until the pain subsides (usually 7-10 days for mild sprains and 3-5 weeks for severe sprains).  Rehabilitation to regain the motion and strength of the joint should begin within one week.  Treat your injury immediately! Early management will mean less time away from training.

First aid measures for a sprain or strain can best be remembered by  the acronym R.I.C.E. - Rest, Ice, Compression, and Elevation for the first 24 to 48 hours after the injury.

Rest the injured area immediately to avoid further injury!  Try not to move or put pressure on the affected joint.  A sling or splint may be recommended to immobilize the joint and allow damaged ligaments or muscles to heal.  Rest is recommended for the early recovery phase, lasting 1 to 5 days depending on the severity of the injury.

Ice the affected area to reduce swelling, pain and bleeding. After 24 hours, either ice or heat may be applied to reduce pain.  You can use ice bag, cold packs or frozen peas wrapped in a thin towel to provide cold to the injured area. The cold can provide short-term pain relief and limits swelling by reducing blood flow to the injured area.  You should NEVER leave ice on an injury for more than 15-20 minutes at a time.  Longer exposure can damage your skin.  It’s best to apply a cold compresses for 15-20 minutes and then leave them off for at least 20 minutes.  Do this several times a day.  Ice application should begin as soon as possible after sustaining a muscle pull.

Compress the joint by wrapping it in an ace bandage to help reduce swelling and pain.  If you feel throbbing, or if the wrap just feels too tight, remove the bandage and re-wrap the area so the bandage is a little looser.  Compressive wraps or sleeves made from elastic or neoprene are considered to be the best.

Elevate the joint to reduce swelling.  It's most effective when the injured area is raised above the level of the heart.  For example, if you injure an ankle, lie on your bed with your foot propped on one or two pillows. 

Also if your ankles are tender, avoid strenuous activity until the pain is gone so you don't aggravate the injury.



After a day or two of R.I.C.E., many sprains, strains or other injuries will begin to heal.  If your pain or swelling does not decrease after 48 hours, make an appointment to see your primary care physician or go to the emergency room, depending upon the severity of your symptoms.  Over-the-counter pain relievers, such as ibuprofen (Advil, Motrin, etc) may be helpful to manage pain during the healing process.

Once the healing process has begun, very light massage may improve the function of forming scar tissue, cut healing time and reduce the possibility of injury recurrence.  Gentle stretching can begin once all swelling has subsided. Try to work the entire range of motion of the injured joint or muscle, but be extremely careful not to force a stretch, or you risk re-injury to the area.  Keep in mind that a stretch should never cause pain!

Heat may be helpful once the injury moves out of the acute (initial) phase and swelling and bleeding has stopped. Moist heat will increase circulation and promote healing.  It’s ideal for sore, stiff, nagging muscle and joint pain and is generally used for chronic injuries that have no inflammation or swelling.  You can use a hot wet towel or heating pads and apply to the injury 15-20 minutes at a time.

After the pain has subsided, gently exercise the joint to regain strength and mobility.  A physician or physical therapist may help to devise an exercise program to aid in rehabilitation.

Surgery may be required in severe cases to repair torn ligaments or muscles.

PREVENTION

• Always warmup and stretch you exercise
• Wear protective footwear for activities that place stress on your ankle and other joints.
• Avoid high-heeled shoes.
• Avoid sports and activities for which you are not conditioned.
• Wear ankle braces or wrap your ankles with athletic tape to provide support and stability.

Stay tuned!  We will cover knee pain, sore joints, and other injuries and treatments on Thursday!


Cindy Lai is a NASM certified Personal Trainer and runs Cindy Lai Fitness Bootcamp, a bootcamp in Central park that incorporates all the above elements and a kettlebell bootcamp on the West Side Highway for non-traditional strength training. Check out her site for more details.

Photos by sryffel, awnoom, jepoirrier, and quinn.anya via CC BY-SA 2.0