Atlant GYM

Where to treat sports injuries? Can the injury itself go through? And when to train again? Answers sports doctor to your questions

"Editorial: You are in the ""Health"" section - here we are talking about how to eat right, train and play sports for pleasure - and invite coaches, doctors and other specialists as experts.

This time, Artem Ryrzyko answered the questions of readers, who worked in the beach football CSKA and the Lokomotiv Academy, and now he has been working in the Ambal Bloggers team.

Some Similar questions we combined or immediately give one answer to several closely related issues. Read!

Approximately each of my (as well as my friends and teammates) a visit to the doctor on the topic of sports injuries was approximately the same: ""I am engaged in a volleyball, I have a knee hurt (shoulder, back)."" - ""Are you a professional volleyball player?"" - ""No"". ""You need to finish doing a volleyball."" It seems that there are few people who know how to treat sports injuries of lovers and few people want. Is it different and if it happens, then where?

Such a problem really is, it is difficult to find a specialist in sports injury, since most of them work in the teams. In general, there were many similar questions ""where to go what to do."" The level of my connections is not yet so wide to speak in the regions, but in Moscow you can contact Smart Recovery. There are doctors who have learned and continue to learn himself. Including Edward Nikolayevich Bezuglov - the chief physician of the Russian national football team.

In general, most issues related to a recent injury or vice versa, who began to disturb the old damage again, require full-time consultation. I can't call the magic tablets or a pair of exercises for 10 minutes. If you have the opportunity, please contact your full-time consultation with topical pictures. There you will accurately help, including consult about the exercises.

I had a trauma - I treated it / did not treat it. I do not know what to do now and whether to go to the doctor.

Before answering other questions, I want to leave an important disclaimer. Most of those requested a full-time consultation and in the online format to put a final diagnosis and prescribing treatment is simply impossible. Therefore, answers to questions: ""What to do? Will you go to the doctor? "" Will be unambiguous. Yes, go, take a picture and look after. No magic 5 exercises that will grow new bonds or muscle. Maybe I will show a sharp, but in some difficult or non-standard cases, the last place where you will tell you something, this is in the comments and remote consultations.

Without inspection and snapshot, I can not confidently say even with your diagnosis to your words. If you at least think about, to go to the doctor, it is already worth going. Health is what you can not save. I know that the consultation of a good doctor and MRI cost a lot of money, but absolutely any of your problem will progress without treatment and ultimately will cost more. And we are not only about money. Therefore, if you suddenly did not find the answer to your question below, it means that he is in this paragraph.

I broke the front crucible ligament 1.07.20, 1.10.21 made an operation using own biomaterial, tell me: How long after surgery, it is necessary to refrain from running, which drugs to take for speedy restoration and strengthen ligaments and joints.

A similar question doctors often hear from the coaches. The level of load, including running, does not depend on the dates. It all depends on the individual physical state of the athlete.

To run after plastic PKS, the athlete is starting when there is no episodes of instability, the volume of movements in the joint is complete, there is no pain or edema, and the muscular power is somewhere 80-85% of the healthy leg. When we talk about the terms, then only focus on the approximate time frames when the athlete moves to one or another stage of rehabilitation. Doctors will not prohibit doing something, because there was not enough time, if the athlete is ready for morally and physically, and on the contrary, it will not switch to more complex exercises and loads, if there is difficulties in the previous stage, although a lot of time has passed.

No drugs will replace hard work on the strengthening of the thigh muscles, proprice and stretching, so the answer to your question is - as soon as you have no feeling of instability with usual walking, the fast step and in general in everyday life. Naturally, it is also worth starting to start gradually and not start with marathons. Try easy runs within a literally 5-10 minutes if pain, instability, swelling and other symptoms do not appear, continue to increase the load. But in my opinion, preference is better to give bike and bicycle. It is much safer for the joint.

→ Cross injury - nightmare. In the submarine, they are torn increasingly, 30% receive relapses, and the reasons for a million (even shoes)

- How to protect your knees? It seems I do not give a strong load, but it became not comfortable, I especially felt when two hours are sitting in the same position.

- How to maximize to protect yourself when playing amateur football after a PKS break? (2 years ago there was an operation). Now I play in the podkolenik 1-2 times a week.

After the injuries of the knee, in particular after operations on the PKS, our task is to help the tops as much as possible. First, due to the strong muscles of the thigh and the bark (buttocks, the muscles of the abdomen and the lower back) - they will help to additionally stabilize the joint. Secondly, try to keep yourself in shape - any extra weight accelerates the development of such complications as osteoarthritis, and since any operation on the joint also brings it to it, then it is doubly feared.

The picture shows the stages of osteoarthrosis. If the first two is an absolute norm for sports people, already by 20 years, then 3 and 4 stages can already cause significant discomfort during loads or even at rest.

The worst thing is that the process can only be slowed down, it is a normal ""wear"" of the joint. It's just that someone comes to the last stages to old age or does not reach at all, and someone worries even during a football career. Injuries, operations, overweight, improper workouts - all this reduces the durability of the joint.

How to protect yourself? First, to train under the supervision of professionals - that in the hall, which is in amateur football. Secondly, in the hall, preference is better to give a bike, bike and swimming, since in this case the axial and shock load are minimal. Optimally - healing before training in the hall on the exercise bike and in the days of cardiotranspare also give preference to it.

Another nuance. 2 years after surgery, and you are still in the knee pad. It should accurately refuse him, in general orthesis and other orthopedic devices are needed in a sharp period to unload the injured limb from new damage. In your case, the leg is already healthy and the muscles must be performed. And Ortesom you only interfere with it to fully recover. I am ready to argue that now the injured side is still a little behind because of this.

If there are psychological problems with the refusal of orthhemus, then try to kinesiotapproving instead. TEYP will help you to keep the sense of support, but it will be much less to unload muscles and will help fully finally recover.

When playing football bruise thumb. Nail blackened. In ordinary life does not bother. But sometimes it hurts 1-2 days after the game of football. Is it worth contacting the surgeon?

It is better to turn to the surgeon. This is a typical story for football players, but it is better to carry out a full-fledged inspection to avoid infection and other complications.

How much useful tipping, orthopedic holders and clamps?

Let us delimagize the aid you listed, as they are used with different purposes and at different stages.

1. Ortesa. Clamps of varying degrees of hardness. Used in a sharp period after severe injuries of bones, ligaments and joints to avoid new injuries. With orthaisms, we limit mobility in the joint in cases where these movements may cause new injuries. For example, before surgery on an anterior crucible bundle, the instability in the knee joint may additionally injure meniscus and articular surfaces in order to avoid this we minimize the movement in the joint with an orthosis.

After a complete recovery, wearing them ""for prevention"" is not necessary and even harmful. Thus, you do not give your muscles to fully fully and take on your role of additional stabilizers.

2. Tipping. There is rigid tipping and kinesiotapproving. Hard use as a measure of support and prevention after injuries, for example, ankle joint bundles. When an athlete just recovered after injury and / or afraid to get a new one. That before the kinesiotapprovacy, this is a good auxiliary method, in many respects due to the psychological component. The kinesiologists, of course, will tell you about the wonderful all-dependence of their ribbons, but we will be realistic. In my opinion, this is a good method of support after recent injuries, in the process of recovery, including the psychological method (patient, feeling support, is more willing perfectly.

But what is exactly effective, it is a lymphatic drainage. It helps to get rid of edema and hematomas faster, but I repeat, any tipping is only auxiliary method.

How do you feel about manual therapy? It is believed that it is dangerous or at best useless. Also like there is a study that it helps somewhat reduce back pain. It is simply used by many athletes (at least at least a huge number of UFC fighters). Do it use manual therapy in football? Very interesting.

Manual therapy is a separate medical specialty recognized in the Russian Federation (31.08.40). Often this is a good method to get rid of pain caused by muscle spasm. You just need to understand that the pain, especially in the back, can be caused by a huge number of often non-other reasons. Therefore, if you came to the conclusion when consulting with different experts, that it will help you, then try it. About danger I can say simple - all methods have contraindications, both absolute and relative. If you ignore them, you can have anything dangerous.

If you can, tell us about vitamins in sports nutrition. Many controversial information - benefits, neutral, harm (write on studies, where the control group hosting vitamins on an ongoing basis, the risk of cancer increased from 4 to 8 percent, i.e. twice).

It should be understood that the quality and credibility of research is also important. With proper Reserche, you can find research, where Onkorisk increases even water. As for the bodies, with balanced nutrition and sufficient calorie intake and the body, we usually receive all the necessary vitamins in sufficient quantities. Exception - Vitamin D. In Russia, even in the southern regions, its deficit, therefore the athletes of all levels, from the Academy to the RPL, periodically supply the vitamin D course. Dosage depends on age, your dimensions and related diseases, so it is better to consult a doctor.

For the most part, the reception of the dubble with vitamins is safe and maximum than you risk is allergic. Bring yourself to hypervitaminosis with the help of dietary supplements is very difficult.

Tell us about restoring after football games, which is available at home. Thanks!

In fact, most of the recovery after the matches takes place in the evening and at night. The most important thing is a full and healthy dream. Everything else is supplements.

There are also detailed recommendations from the RFU Medical Committee:

1. Active recovery - a hint at a low pulse, jogging, exercise bike.

2. Cold baths - 4-7 minutes in water with a temperature of 10-12 ° C (it is better to start with 1-2 minutes). Accept to such procedures must be gradually. If there is no access to cold baths, you can simply take ice packs in the medical office and put them on the most vulnerable areas - places where injuries were; Plots for which painful blows received.

3. Power ""in time"" - receiving carbohydrates in the first 30 minutes after the end of the heavy load at the rate of 1.2 grams per 1 kg of body weight and 20-25 grams of protein.

4. Replenishment of fluid losses - according to the formula (weight upload - weight after load) * 1.5 = The required volume of fluid for 1.5-2 hours. It can be ordinary water, isotonic drinks, morse. If it is difficult and uncomfortable, just focus on the feeling of thirst. The belief that it is impossible to drink during training and even dangerous - nonsense.

5. Compression knitwear - 2-3 hours after the end of the load. Always use when flying. Compression linen helps to avoid stagnant phenomena in deep vessels, this is a good prevention of thrombosis.

6. Sleep - sufficient sleep time allows to reduce injuries and improve the accuracy of technical action. This is the best recovery tool. During the period of intense training, the footballers should sleep at least 8-9 hours at night and preferably at least 1 hour day.

Tell us how best to remove pain in the muscles after training. And what is the role of bath / saunas in this role - in many sports halls they are, in what cases are it appropriate to visit?

Above I talked about methods with 100% proven effectiveness. As for the sauna, in the FIFA Recovery Program, oddly enough. Despite the fact that, in general, the effectiveness of the impact of heat on the muscles and the fatty fabric of doubts does not cause, there are still no detailed studies proving the efficiency of the sauna as prevention measures and recovery. In general, this is a good method of resting and training cardiovascular system, but no more.

- Chondromaging of the patella. How often meets? For the first time I learned about it only after MRI ... I did not find any specifics how long it is treated, and is treated at all. Doctors prescribe a kneather, chondroprotectors ... Is there a chance to play football? (III stage in the conclusion of MRI)

- How much do the joints of the legs of professional football players wear out? And is it true that after the completion of the career, they suffer from the effects of loads? Or is it myth?

I mentioned above osteoarthritis, but there are many other diseases associated with large loads. As far as the percentage is faster than the joint athlete, I will not say, but there is a similar problem. The myth is more like that absolutely all athletes suffer from wild pain and heaps of complications. No, it is, of course, not so. Basically, pain worries in the area of ​​injured / operated joints and depends on a number of individual characteristics - the state of cartilage, its structure, nutrition, the complex. I would say that many athletes after completing the career in one degree or another have problems with joints, but you should not make directly disabled from them.

Sport of higher achievements is impossible without injuries, and all injuries have consequences. Everyone in each case individually.

For example, in such cases as chondromaging of the patella, in later stages, surgical treatment is already recommended. You should make a re-picture and contact a specialist about this face with a disk of MRI. The operation can be delayed using hyaluronic acid injections, but this is a temporary measure and is not always so effective as I would like. And yes, play after a complete rehabilitation most likely you can, but it is worth watching individually, what method of treatment you will choose and how effective it will be effective.

Tried Menisk, I did not do the operation. Just dumped up the joint liquid and that's it. It took 5 years, nothing and never bothered. Could all all right? Or is it all equal to the risk of recurrence more higher than if there were no damage?

Could, but for this you need to come up a lot of factors. Firstly, the types of meniscus rupture a huge amount and tactics of their treatment directly depends on its complexity and length. See for yourself.

Secondly, the localization of the gap is important. Menisk is powered indirectly, through a joint capsule. In children, the vessels germinate deeply into the thickness of the tissue of meniscus, but with age, the blood supply is worse. It can be divided into 3 zones.

The red zone is the closest to the periphery, there the blood supply is still good and the probability of healing is quite high. However, this is a rather small zone, literally the most edge. Next is the red and white zone - a plot, where some kind of blood supply remains, but not so active. And the white zone, where meniscus gets nutrition indirectly, according to the residual principle. The further damage from the red zone, the lower the likelihood of successful healing.

In general, each injury is unique in its own way, this is a creative part of our work, if you can say so: you can choose the right tactics for each individual. Therefore, if you are worried about the condition of the knee, take a picture and consult a disc to a specialist.

Tell us about publicly available and legal preparations for increasing endurance during the game and accelerate recovery after (I only know about Mildronat). What can be taken by an ordinary lover?

Mildronate has a negligible evidence base and its effectiveness is extremely dubious. And it is mildly. And why his and other similar substances prohibit WADA - the topic for a separate conversation.

Now the fully safe and legal, both from the point of view of the WADA and the Criminal Code of the Russian Federation, the way to lift the performance is caffeine. It has been proven that one cup of espresso (30-60 ml) is enough to increase the performance and sports results statistically significantly. So the old good cup of coffee in the morning or energy, oddly enough, much more efficiently and safer quite a large number of substances.

As for recovery, then, again, neither citrullin nor Mildronat, nor other similar drugs have shown significant effectiveness. Better adequate, rehydration and healthy sleep has not come up yet. You can help with this can be received (an additional source of essential amino acids), protein (protein, if the load is extremely intense and you cannot physically eat the protein)), creatine (participates in the energy exchange, carefully with the dosage, strongly delays water, can ""fill "").

However, most of the sports nutrition is designed for professional athletes who cannot cover their needs due to food. Therefore, if you do 1-3 times a week with sports, it is not particularly intense what is called, for yourself, it is enough to fit into its calorie norm and BJ.

I am interested in the nutrition of athletes. I myself sat on the right nutrition, lost 10 kg, but fell NG, I saw the medicine - did not help. What to do? I think nutrition is not correct.

Continuing the pace of food. My most unloved phrase - ""PP"". There is no product, excluding (or adding) which you lose weight by 20 kg per week. The process of setting the shape and its maintenance is complex and complex.

First, you must fit into your calorie norm and BJ. If you want to lose weight - cutting part of the calories, mainly due to carbohydrates. But in no case do not exclude them completely. Carbohydrates are not an evil in the flesh, but the main source of energy in the body. First of all for the brain. Therefore, without carbohydrates, you will not lose weight, but only become aggressive and you will think tight.

Doctors advise to give preference to fruits and more complex carbohydrates. Not because buns are absolute evil. All because in 100 grams of the apple about 50 kcal and about 10-15 grams of carbohydrates, and in the usual bun, more than 350 kcal and 50 grams of carbohydrates. So think what you will be easier to ride, not going through the daily rate and not starving most of the day?

Secondly, physical activity is needed. Sitting on the sofa, even with the most correct nutrition, you will not lose weight. Therefore, even if you managed to come into shape, you will always follow these principles.

Regarding the second part of the question, you should turn to the attending physician with all the details, as there can be a lot of reasons.

I study at the 3rd year of Medical University. I put the goal to become a sports doctor. Advise how I can develop in this direction until graduation. Maybe there is any online / offline webinars, lectures that can be attended to learn more about the future craft? Where can I find useful links?

FIFA FIFAMEDICALNETWORK Course - Free FIFA Course for Sports Doctors. Basis.

Footballmed - Instagram Medical Committee of the RFU.

The undeserted opinion is my telegram channel :) about injuries in big football and interesting cases.

The game without injury - lectures and seminars. Many. Interestingly, but expensive.

Be sure to find a circle of sports medicine at your university or universities of your city. Plus, because of Kovid, many meetings occur remotely. Therefore, subscribe to SCHenovsky University and Pirogov.

Otherwise - PubMed to help, with research in all interesting cases.

How to avoid repeated injuries or reduce the risk of obtaining them?

There is a special FIFA protocol. This is the FIFA 11+ program. It is used to prevent injuries in certain modifications in many top clubs and european academies. Exercises are divided into 3 levels (green, yellow and red) by complexity, so they can be made even for children and lovers. Using them as a warm-up, you can reduce the risk of injuries by 32%, if you believe in FIFA data.

And there is still a whole textbook how to properly fulfill this program.



Click on the picture to open in a large size.

***

Artem has already answered questions of readers - whether to do the operation after the passage of Menisk? How to cure pain in the groin area? How to recover after ""yard"" injuries? When to return to training after plastic PKS? Read these answers in the article and subscribe to Artem's blog, where he tells about injuries in football and other sports.

Telegram Channel Artem Ryrhenko about injuries

More about training, nutrition, sports medicine and sports as a lesson - in the ""Health"" section

Subscribe to Health Channel Telegram

Photo: pexels.com/pexels, rf._.studio: pexels; RIA Novosti / Alexey Malgavko"

Why do you need power meter if you plan to participate in cycling competitions?

"Power meter (eng. Power meter) is a device that measures the effort created by the cyclist during a ride. Since the speed of movement is influenced by the relief and counter / passing wind, it is the power that performs a more accurate indicator of the current athlete performance.

Power in this case is calculated as a product of torque (pressure force on pedal) on the cadence (the frequency of rotation of the pedal). To measure the torque, electronic strain containers are used, which measure the applied force and on the basis of this calculate the value of the power in watts.

Most often, the drops are placed in connecting rods and pedals. To work with the sensor, you will need a bike computer for data recording: almost all power meters use the Ant + protocol for communication. Some also apply Bluetooth, thanks to which you can write a track in Strava on your phone.

Power meters are needed to lovers who train to serious goals

In recent years, the use of power meters in the training process in triathlon and cycling lovers is becoming increasingly popular. The drops are cheaper, because new manufacturers come to the market, and competition increases.

Expert and coach Roy Holmes in an interview with Road.cc told than the power meter can be useful in training and competitions, as well as after injury and breaks: ""Power meters actually do not tell you what to do, but they give a data set, which Earlier was unavailable. This information is incredibly useful for both cyclists who train independently and for coaches that work with students. ""

Reloometer gives accurate data and helps optimize training plan

The power meter accurately determines the efforts that you attach while driving, regardless of the terrain, conditions, physical form or other factors. The sensor provides figures that can be used to evaluate progress. In combination with a pulsometer (it considers the heart rate frequency) you get an ideal pair of devices: one measures the force generated by the body, the second is the reaction of the body to the load.

The power meter allows you to get accurate data regardless of which track you train (mountain or flat route). At the exit you receive no time passing the distance, and the average value of the applied effort.

Since the power meter shows the actual effort, it allows you to effectively plan training. You can set the time and the necessary capacity of the classes, and then go to the highway or relief and focus on the numbers that show a bicycle computer. No more assumptions: ""Do I stretch your training? And what if not improving? "".

Accordingly, both the coaches are easier to plan their student training remotely, asking the necessary time in each intensity zone. The swarm in the interview notes: ""The power meter will undoubtedly increase the efficiency of training, based on the time you have during the week.""

Holmes believes that one of the most common mistakes that cyclists allow, trying to improve their physical shape, is that they are always driving at a certain level, in the middle pulse zone.

Inexperienced cyclists, as a rule, gradually increase the duration of workouts in the mixed zone without varying the load. But if you always ride with comfortable intensity, you will progress only at the initial stages. In the future, you will have to change the approach to the training process.

Power meter is an ideal tool with which you can make a balanced workout planned: you will drive with the necessary effort on intense training and not exceed the permissible values ​​for regenerative.

Power meter allows you to see the shortcomings of an athlete

Power meter helps to accurately determine weak points in your physical form. If anaerobic endurance is lagging behind other indicators, the numbers will immediately show it.

Roy says: ""Data from the sensor can be visualized as a power curve. It shows what effort you attach in each workout, from five seconds to several hours. Having received these detailed data, you can see what type of rider you are, and what work should be done to improve physical form. ""

One of the errors that cyclist makes when the power meter is started is that they cease to use the pulsometer. He notes that the heart rate should be considered as the contribution of the body into the process, because the heart is responsible for the supply of muscles with oxygen.

You estimate the work of the heart using a pulsometer and measure muscle performance by the power meter. You can not just take and throw out one of the analysis tools. Over time, you can evaluate progress, correlating the pulse value in the blows and the issued effort in watts at a given distance, for example, within the framework of the test workout.

The data is transmitted in real time: it is immediately clear what to do: add or relax

Roy notes: ""The main problem with the pulse is that it shows the body's reaction to the load with a delay. For example, when running up the mountain, the pulse will reach maximum values ​​not immediately. ""

Power meter, on the contrary, provides instant feedback. He shows if you hit the specified intensity zone, or you need to add. It can be especially useful for high-intensity interval training.

The power meter can also suggest when it is necessary to take a break or reduce the load. Data from the sensor can be downloaded to the analysis program, such as TRAINING PEAKS or STRAVA, which calculate the level of training load.

Systems estimate the quantity, time and intensity of training and calculate the necessary duration of rest. This will avoid overtraining and burnout.

Power meter allows you to become a paismaker for yourself

You can also use the power meter to plan the load on competitions. If the test workout says that you can hold a given effort within a certain time, then on the basis of this you can develop a strategy for the nearest race.

Holmes says: ""Competition is a way from point A to point B for the minimum time, and the main rule here is not to start too fast. It is very important to correctly manage your efforts and pace, and the power meter can help in this. ""

You can compete with the highway and on the machine

The combination of platforms such as ZWIFT, and the power meter will give you more accurate results during workouts and road races.

Racing in ZWIFT can be an excellent competitive alternative especially with bad weather or cancellation of starts due to a pandemic. In addition, online competitions are more accessible, as they are held regularly, and you only pay for a monthly subscription on the site.

Helps when recovering after injury

Bilateral power meters measuring the efforts of the left and right leg separately. You can analyze the imbalance of the applied effort, which is especially convenient when you return to the system after a serious leg injury.

***

Power meter is a tool that will help you more competently manage progress in cycling. It will provide an additional set of data that, with proper use, can be useful for athletes and their mentors, both in the training process and competitions.

More about training, nutrition, sports medicine and sports as a lesson - in the ""Health"" section

Subscribe to Health Channel Telegram

Photo: pexels.com/run 4 ffwpu, pixabay, t b

We remind you that we have a section with discounts in which you can find promotional yandex market."