Tag Archives: Football injuries

24Nov/14
Sturridge thigh injury

One injury, and then another…and another….

Sturridge thigh injury

Sturridge | more thigh troubles

It is a common scenario sadly, both in professional and amateur sports. One injury, then another and another, each demoralising further. It is noteworthy that the science of pain would say that expectations and other thoughts about the pain and injury will affect the pain itself, potentially increasing the overall threat value — recall from previous writings that pain is a response to threat, and not to just that of the actual injury itself. We must consider any threat to the whole person, and this includes thoughts about oneself and one’s career.

When the body is sensitised by an initial injury, despite healing this sensitivity can persist subtly. In other words, at a certain level of activity there is no problem, no defence. But reaching a new level of training may then reach the current threshold that is not yet back to normal. The threshold is the physiological point where messages are scrutinised by the neuroimmune system that is already vigilant to potential threat. There does not need to be an actual threat, just a perceived one by these vigilant body systems, which then triggers a biological defence: pain, altered planning of movement, altered thinking etc.

The continuous journey back to full fitness requires a complete integration of physical and mental preparedness. As well as tissue strength, endurance and mobility, the controlling mechanisms must switch back to normal settings rather than protect — i.e. the upstream: muscles do what they are told by the motor system that originates in the motor areas of the brain, and the motor system plans and executes movement. The planning of movement not only occurs when the ball is about to be kicked or a run begun, but also when thinking about the acts or watching another. As well as these influencing what is happening, these are also great rehabilitation tools to fully prepare the system for the rigours of the game as well as ensuring completeness of recovery: the player resumes the right thinking, decision-making, motor control as well as fitness.

 

23Nov/14
Persisting sports injuries

Why do Arsenal and MUFC have so many injuries?

Football injuriesArsenal Football Club have apparently reported 30 injuries since August, and Manchester United 37 injuries. Why so many?

Injuries are more complex than perhaps initially thought. It is not simply that a player runs out onto the field, clatters into another player, changes direction or bursts into action. There is a huge amount of multi-system activity, both conscious and unconscious that biologically underpins every injurious situation.

For example, a seemingly ‘simple’ ankle sprain is this: a disrupted ligament releases inflammatory chemicals that excite the normally quiet danger receptors on nociceptors; nociceptors send danger signals to the spinal cord to communicate with secondary neurons that are influenced by a flow of signals coming downwards from the brain. The sum of this give and take reaches the brain. According to whether a threat is determined or not, the appropriate response is pain, drawing attention to the affected area so that the right behaviour can be assumed, promoting recovery and survival. Pain is a need state, driving and motivating action.

The danger signals, for there are no pain signals or even a pain centre in the brain, are chemical messages until given meaning by the emotional centres of the brain. This is based on the context of the situation, beliefs, immediate thoughts, previous experience and the environment to name but a few. The injury is deeply embedded within all these factors, none of which are stand alone.

To illustrate, a professional footballer who sprains his ankle could think: ‘how will this affect my career?’, ‘how long will I be out?’, ‘will this affect selection?’, ‘is this the end of my career?’, ‘what will this cost me?’ etc. The question to ask is how is this thinking likely to affect pain? Are those thought threatening? Of course they are, and hence affect the way in which the body protects. As well as promoting the right environment for healing (bottom up), one has to create the right conditions in all body systems (top down) by cultivating the right thinking and with definite action. Until thoughts and beliefs flavour nociceptive signalling, there is no meaning, and without meaning there is no pain. We need pain to survive, but we also need a logical and rational meaning.

Within the culture of football, there are certain beliefs and memes around injury. This will be the case regarding ankles, hamstrings and groins. Just listen to the pundits to hear their comments on these injuries to know this fact. How much of it is fear-based rather than being based on pain science and basic biology? Tackle this and you are more than half-way towards creating the right conditions for recovery.

Injury is incredibly complex because we are incredibly complex. Drawing upon this modern way of thinking about pain and injury and I believe we can tackle this increasing problem of recurring injuries in sport more effectively.

Persisting sports injury? Recurring injury? Football injury? Call now 07518 445493

28Sep/14
Chronic pain and injury in football and sport

Premiership football injuries — all too common, time to re-think

Chronic pain and injury in football and sportOpening the sports pages this morning (Saturday), the news is abound with the football injuries in the Premiership. Manchester United report nine unfit players just a few weeks into the season. Nasri is ‘out for a month’ as he is due to have surgery for a ‘serious groin injury’ — if it is a serious groin injury and requires surgery, how can Nasri be back in one month whilst allowing for healing, re-training of body sense and control, fitness and an ability to perform free of any thoughts that impact upon his play? A return without fully addressing these fundamental factors will set Nasri up for a greater risk of future problems.

Just as the thinking in pain, the largest global health burden, needs to be constantly challenged, so does the way we think about injuries in football and sport.

Clubs, managers, fans and players alike want a rapid return to the field. The financial and footballing culture demands that players are back as soon as possible. The pressure is great, but pressure is created by the way one thinks and perceives a situation. Change the thinking and a different system will emerge that allows for improved preventative strategies, full recovery and gradual return. 80% recovered is not good enough, 90% recovered is not good enough; unless of course the risk of re-ignition of pain is deemed to be acceptable. We should always aim for a full and sustainable recovery.

There are simple ways of evolving thinking, beginning with players really understanding pain and injury — for example, the poor relationship between pain and the extent of tissue damage, the many influences upon how we control movement and perform, the context around an injury and how this affects the body’s response. This education and training should equally be delivered to managers, coaches and club owners. The biggest issues are the lack of understanding of pain and the communication around the injury. With understanding of pain and clear communication from the outset, there is a strong basis for optimal recovery.

Some pains come from incidents, such as a tackle (direct trauma) or a turn of pace (hamstring strain), and others from a prior injury that has not fully recovered or emerge as a result of the body gradually protecting itself more and more. This latter scenario develops from incomplete recovery from normal training and match play, i.e. there is not enough rest and recuperation time for normal tissue breakdown-rebuild. Both of these scenarios need greater consideration to keep the players playing. And sometimes, the wisest action is that they do not play.

Drawing upon the neuroscience of pain and performance, persisting injury problems in football can be addressed in such a way as to sustainably reduce the risk of re-injury and on-going niggles. We accept that sport can hurt. But when performance is compromised by factors that we can address, for the sakes of all those involved, we can think differently and take the treatment of injuries to a new level that is all about learning and moving forwards.

If you are a player struggling to return to play or a club, call us now to start your recovery: 07932 689081

12Mar/13

Early messages about pain

Our immediate and early thoughts about an injury or pain that we feel can have a significant impact upon how we cope and manage the problem. It is therefore vital that we have a really good understanding of what is normal and what we can do to optimise the conditions for healing.

Within this early experience, the messages that we hear from those involved including family, friends, team mates and healthcare professionals, can have a profound influence upon our beliefs about the injury that pervade our on-going, personal approach to recovery.

The way in which we behave when we are injured, in other words the actions we choose to take, will be determined by our belief system. This system evolves from a very early age as we learn what is dangerous in life, absorb messages from significant others (parents, teachers etc) and create strategies to deal with pain and injury. Cultural memes are those passed from generation to generation, keeping the story alive. However, these can be based on erroneous information and be perpetuating an ineffective way of handling pain. On this basis, we have an obligation to pass on information that is based upon what we know about pain rather than simply taking the actions of our predecessors, ‘because that was the way they did it’.

The messages and information given to an individual about their injury and pain need to be based upon fact. Imagery provoked by language such as ‘your spine is crumbling’ and ‘your joint is worn out’ can and often do create fear of movement and sensitise our thinking. Thinking is as much neuronal activity in the brain as a movement and we can easily become sensitised to our own sensitivity via this cognitive-emotional route. How quickly can we develop a fear? In a flash.

Imagery is potent. Close your eyes and think about placing a yellow, ripe, juicy lemon segment on your lips and tongue.

The medical management of an acute injury is important: i.e./ diagnosis, investigation, RICE. All of these you would expect. But, we also need to understand and know what is NORMAL and pain is NORMAL in this situation. Unpleasant yes, normal yes. Need for control with medication? By and large yes.

Let’s make sure that we send the right signals with effective language that promotes the right thinking and consequent behaviours.

 

12Mar/12

Football Injury Blog @Footymatters

Footy Matters

I am really excited to be writing a regular blog on the Footy Matters website looking at injuries in football.

Injury Time with Richmond Stace

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