Sunday, February 22, 2009
There are times when a client may come to you complaining of pain in a joint or around a joint and you need to assess to know if it is muscle pain or joint pain like bursitis. An easy way to do this to to check passive and active range of motion. You can also do resisted range of motion to really activate the muscle, and if the pain gets worse, you may be dealing with a muscle or muscle tendon issue. So, I've been working with Tito who beats on Kimbo (names have been changed to protect the identity of individuals). Tito came to me complaining of pain right on top of his knee cap. It did not hurt on active range of motion and didn't really hurt on passive range of motion. It hurt when his patella was palpated right on the most anterior portion of his knee. After assessing a little more and researching some to dig deeper, it seemed it may have been a bursa that was inflamed. (We have MANY bursa for our knee joint). Tito is a fighter, he does a lot of sparring with Kimbo and does A LOT of knee flexion and extension with force. (like when kicking a bag or a person.) Sounds like overuse that irritated the bursa. So, ice massage was the rehab massage technique of choice. I took a plastic bag, filled it with ice, applied some lotion to the quadriceps and over the knee and began doing the ice massage. I also instructed Tito to ice it a few a times a day on this own with a bag of ice right over the knee cap. Within one day he was feeling much better and within a few days had no problems. In a lot of cases we tell our clients, "Stop doing whatever it is your doing that is aggravating your joint and causing the pain." I know there is NO WAY Tito will stop. So, more than likely he is going to be a longtime client. POST YOUR COMMENTS AND STORIES HERE!
For the record...my personal trainers are great and have helped me lose a lot of weight. But, what do you do when your trainer is injured and can't help you as much as you need him to? You offer to help him rehab from his injury. It's not great marketing if someone walks into the gym and the trainer there is limping around and incapable of actually training. This has been the story of my life for the last week. Both trainers at the gym I attend do Krav Maga, a highly intense form of martial arts. They spar A LOT and literally beat on each other. Needless to say, they both experience injuries from time to time. I have been doing all I can to get them back to a working condition. One of the trainers, we will call him Kimbo, went to kick the other trainer and had a bad contusion on the dorsal side of his foot. He actually found out he bruised down to the bone. There was no superficial bruising but some good inflammation and pain. Ice of course was the first step for rehabing this injury. (Although he complained about having to do it, and didn't do it some of the time that I told him to...Typical.) He did ok though, for following my instructions. The ice was about a three day time frame. Massage can be extremely beneficial almost immediately, that and range of motion. So, to get the ice and massage in, we did a little cryotherapy. I took a plastic bag and put some ice in it, applied lotion to the site of injury and massaged the injury with the bag of ice. This works extremely well because you can ice it and prevent the scar tissue from restricting range of motion all in one shot. Make sure that you have the client do range of motion AFTER icing the injury. Like we have talked about in class, have them do the ankle ABC's. Start off with them moving their ankle to try and spell the letters of the alphabet, starting with lower case, then upper case, then cursive. It may take some time for them to advance to the upper case and cursive letters. If they can do all three without pain, that is typically a sign that it has good range of motion back. Well...Kimbo is doing well, his foot no longer looks inflamed, and we are now to the heat stage. Of course don't apply heat after a workout or extreme use. Hopefully, I can get these guys to stay healthy so that I can be healthy. Post your comments or questions here!!