What you need to know about physiotherapy and podiatry.
Physio&SoleClinic Physiotherapy October 8 2015
Here is an account from Guojie, our principal physiotherapist who went to play basketball recently:
I used to represent my school for basketball and I was a pretty decent player. I used to play it almost daily and trained hard physically for it too. That was more than 13 years ago.
Recently, I represented my department in a 3-on-3 basketball competition. Did a few sessions of friendly games with friends to prepare for it, kept up my exercise regime to keep fit and I did okay.
So, I didn’t think much when my friend asked me to participate in a 2-hour session of 5-on-5 basketball 2 weeks ago. Overall, I was still physically fit for my age and I still exercised regularly. How did it go?
When I reached the court, I saw some dudes sprinting up and down the court, I knew this was the real deal. I was 15 minutes late and they have already started the game. Booking of OCBC Arena at Singapore Sports Hub costs money, so they didn’t waste time waiting for everyone to arrive before starting, moreover there were players enough to form 4 teams. I thought, it was 13 years since I last played 5-on-5 basketball! This would be pretty exciting! During the intermission, I jumped right into the next team and we started playing. The games were really painful (physically). I was considered the younger player in the team so I played as a forward and I was ‘supposed’ to dash up the court whenever we acted on a fastbreak. Needless to say, my skills were all over the place, shots were off and my immediate reaction after the game was to buy a ball to work on my shots and handling. The aches were secondary.
The next day, my thighs ached and it felt good. I thought, it must have been a fantastic workout last night! I went for a morning workout in the community gym and I hopped onto the treadmill for my warm-up jog but my right groin pulled badly!
This was where it all happened, the adductor muscle group.
I never pulled my groin before, so this was embarrassing. Everyone was jogging or running on the treadmill but I was walking. I could only do a walk at 4km/h and went ahead to do my resistance workout. Every squat, lunge, deadlift reminded me of my right groin and I had to go lightweight. I thought it would be great to wear a headband with the message,
“Sorry, I pulled my groin.”
1 week later, I still couldn’t jog, so I did a fast walk and replaced my running with more resistance training. It felt better, probably about 30% better. I was constantly reminded of my groin in all my leg exercises. It was really irritating that I couldn’t do my regular workout, I had to improvise and work on other areas of my body. There was no hurry, I thought.
It’s 11 days later now. I am able to do a 2.5km run at a moderate intensity with a mild ache in my right groin. I couldn’t have done it without some warm up of light jogging and dynamic stretching of the thighs and groin.
It definitely helped to reduce the ache when I ran. Previously, I didn’t need any warm ups for a moderate intensity run. I probably would require more strength in my groin muscles and think twice about sports-specific physical conditioning. My goal is to return to running the 2.4km under 10min 30sec at 6 weeks after injury!
With this lesson learnt, I would like to share a few take home messages:
I was fit, yet I got injured.
Being fit doesn’t guarantee you to be injury-free. Clearly, what I did was way different and past my usual exercise routine. If I can remember, I sprinted at least 20-30 times up and down the basketball court, sometimes in different directions at maximal effort. The load that I placed on my thigh muscles from all that sprinting and swift change-of-directions were tremendous, nothing like my usual training.
When you put sudden and/or excess load to your body, your body is going to react with increased muscle soreness of worse, injury. If I had done this a decade later, I might even tear a muscle, tendon or something like that!
I didn’t warm up before my basketball game. Usually I don’t warm up before my aerobic exercises. That was a big mistake. There is research in soccer <link is broken/no longer available. Physio & Sole to advise if there is an alternative article to link> to justify the importance of warming up to prevent knee injury and it is currently implemented in most professional sporting teams. Judging from instinct, this was not the best decision. After my groin strain, I could sense the importance of warming up the strained muscle as starting ‘my engine’ to jog was a torture. If you have no idea how to warm-up the right way, try this!
Warm-ups should begin with a 4-5 minute, low intensity sport-specific aerobic activity to raise the heart-rate (swim, jog, jumping-jacks), followed by dynamic stretching of the various muscles used in the sport. For lower limb sports, use simple exercises like squats, walking lunges, side-to-side movements.
KEEP CALM. If you are not a professional sportsperson, there is no hurry to get better.
All injuries follow a time-specific duration to recover. The severity of the injury usually is proportionate to the time it takes for recovery. On an average, soft tissue recovery requires 6-12 weeks but rehabilitation begins on the day after you get injured.
Using my groin injury as a guide, I can jog with mild tightness after 11 days as my tissues are recovering and is possible to load it lightly with light jogging. Hence, I should be mindful that I do not exert 100% because the recovering tissues cannot handle the demand. On the other hand, I should not wait long enough till I feel 100% better before I start jogging, as I would have become significantly deconditioned and will take a longer time to return to my previous shape. Usually, you would require a Physiotherapist’s help to determine what you can or cannot do.
Professionals eat, sleep, breath and think sports, we don’t. The differences between professionals and us are:
A Physiotherapist is there to guide you to rehabilitate the correct way, not the fastest way! Nobody can speed up your body’s recovery except yourself. And the smartest way to do it is to eat, sleep and exercise right.
Set a goal and discuss it with your Physiotherapist.
KEEP CALM. Even if you are a professional, getting anxious and worried about your recovery isn’t going to get you back faster. In fact, it will only slow things down.
Yes, getting back to 100% is your livelihood, we acknowledge that. Being a rehabilitation specialist, I am stressed to take you to the highest level as soon as possible too. When I work with professionals, I often find that they express a strong desire to return to their sports sooner than they physically can. When they are held back, they get worried, they think for the worse (catastrophize).
There are many research papers published to support that anxiety and catastrophizing usually slows down your body’s recovery and are big contributions to the persistence of pain.
Instead of worrying about when you can start again, focus on getting better every single day. Think about getting that shot into the hoop, completing the 100m dash at the finishing line.
Think twice about sports-specific (functional) conditioning for any sports that you do.
Before you start a new sport/game, ensure that you have gone through some specific movement exercise to prepare you for the demands of the sports.
If you are rehabilitating from your injury, make sure that you go through sports-specific functional exercises. A workout based on sitting on the bench or weights machine will not be enough to cope with your sporting demand. Most sports demand fast thinking, swift reaction, and strong muscles to move fast and change direction. These are the exact components that require training.
Last words before I go purchase a basketball to practice on my ball-handling skills…
There is probably no way you can prevent yourself from getting hurt (can you ever avoid stepping into a pothold (pothole?)?) but you definitely can reduce the chances of self-inflicted injury/re-injury, or making sure you can recover completedly from your injury by following the advice above!
Thank you for reading!
Senior Musculoskeletal Physiotherapist