Introduction
Clients with injuries are required to supply their trainer with a written physician's clearance. Personal fitness trainers are not doctors and (in most cases) are not physical therapists. As part of a team with other professionals, however, certified personal fitness trainers can contribute significantly and uniquely to your recovery and rehabilitation effort. It is necessary, however, for your fitness trainer to coordinate your training and nutritional program with your doctor, physiatrist, physical therapist, occupational therapist, chiropractor, special nutritional counselor, and/or alternative medicine healthcare provider(s).
Outlined below are some of the more common injuries that can result from sports, training, accidents or even daily activities. It is by no means a complete list of all injuries nor do we attempt a full scientific description or medical remedies. If you are injured or symptomatic of an injury or chronic condition, see a doctor. When an injury occurs, use common sense - the adage "no pain, no gain" does not apply here. Stop your activity immediately and initiate the four basic steps known as R.I.C.E. (Rest, Ice, Compression and Elevation) of the injured body part. If these measures are not sufficient, see a doctor.
Of course, focus should always be on injury prevention which can be advanced by careful attention to exercise form, a balanced whole body approach to strengthening and building opposing muscles, gradual (rather than abrupt) increases in workout intensity, stretching, cross training, focus on what you are doing and a healthy nutritional program.
Shoulder
Of all joints in the body, the shoulder is the most vulnerable to injury and the one that suffers the greatest number of injuries among people engaged in fitness and weight training activities. This is because the shoulder is constructed in a way to allow it a very wide range of motion. To enable this movement, the shoulder is held loosely together by a capsule arrangement made up entirely of soft tissue.
The best way to prevent and rehabilitate most shoulder injuries is to strengthen, not only the deltoids, or shoulder muscles, but also the supportive stabilizer muscles of the shoulder including the lats, pecs, traps, rhomboids and serratus muscles.
It is extremely important to engage in rotator cuff exercises, not only for the rehabilitation of rotator cuff injury, but for prevention as well. Rotator cuff exercises should be a standard part of any shoulder workout routine. Some shoulder exercises such as behind-the-neck presses, barbell upright rows, stiff-arm pullovers and lateral raises should be attempted with care. These exercises are on the top of the list for causing shoulder injury and are not for everyone.
Some shoulder injuries include:
Rotator cuff injuries -- The most common shoulder problems are rotator cuff related. These include tendinitis (inflamation of the tendon), myofascitis (inflamation of the tendon sheath), tears, calcium deposits (bone spurs), impingement and chronic degeneration. The rotator cuff is made up of the tendons of four muscles in the shoulder joint. These muscles are the supraspinatus, infraspinatus, teres minor and subscapularis. The rotator cuff tendons attach these muscles to the humerus (arm) and scapula (shoulder blade) bones and connect these two bones together.
Bursitis -- Including gleno-humeral, subacromial and scapula. Bursitis is the inflamation of one of these bursas in the shoulder. The bursas are the soft sacs filled with lubricating fluid that facilitate motion in the shoulder.
Shoulder dislocation -- This involves the entire shoulder joint and the humerus (upper-arm bone). Also effected is the soft tissue surrounding the dislocation including muscles, tendons, ligaments, nerves, and blood vessels. The humerus becomes displaced from its sockets in the shoulder joint.
Shoulder sprain -- Including acromio-clavicular and gleno-humeral ligaments. A severe overstretching of the ligaments in the shoulder joint. Ligaments attach bone to bone, in this case the clavical, acromion process and the gleno-humeral joint. If a ligaments becomes stretched or torn the shoulder joint become destabilized and can lead to rotator cuff tears, dislocation and can even result in pieces of bone being pulled loose. Severe cases require surgical repair. Post-ligament surgery requires complete stabilization of the joint and a long rehab process.
Back
Connecting our upper body to our lower body and enabling us to walk upright is our back. Our backbone is our pillar (and protector) and its braces are the surrounding muscles. The back is complex, made up of bones, discs, ligaments, the spinal cord, muscles and tendons. Back injury can involve any or even all of these components.
Strengthening the back muscles and connective tissue can go a long way toward preventing and treating some back injuries. It was once felt that working out the lumbar or lower back at all would lead to injury. Fortunately, most sports medicine doctors today encourage weight training protocols for lower back and see their muscular-skeletal benefits for back stabilization and strengthening.
Back distress is often exacerbated by weak abdominal muscle support or inordinate fat accumulation around the belly. Strengthening abs and losing the fat can make a big difference in back fitness.
Back injuries include: ruptured disk (herniated disk, slipped disk, herniated nucleus pulposus); back sprains (ligament injury) or strains (muscle injury) of the lumbo-dorsal, sacroliac, thoracic-spine, lumbar-spine regions; and sciatica. Although not injuries, the conditions scoliosis and lordosis, abnormal curvatures of the spine, can cause back problems if they are pronounced, especially when exercising. It is important for your fitness trainer to know if you have extreme cases of either of these conditions.
Knee
Second only to the shoulder, most sports injuries affect the knee. The patella (knee cap) is basically a free-floating bone resting over the joint where the femur (thigh bone) meets the tibia (shin bone). Cartilage and bursa cushion (or meniscus)the bones and knee cap from each other. An impressive array of ligaments connect the joint together and hold the knee cap in place.
In the course of daily use and especially during heavy fitness training, the knee joint withstands enormous pressure and is subject to a variety of injuries. To prevent these injuries attention should be paid to developing the quadriceps and hamstring muscles and to proper knee alignment when performing any exercise involving leg flexion, especially squats.
Knee injuries include bursitis (inflamation of the bursa sac), cartilage (meniscus) tear or rupture, dislocation (patella, tibia-femur and tibia-fibula), sprain (ligament pull), and ligament tear (most particularly of the anterior cruciate ligament or ACL).
ACL Injury -- The anterior cruciate ligament is the most commonly injured ligament in the knee. Ligament injuries of the knee have increased by 172% in the last 15 years The anterior cruciate ligament originates from the back of the femur and inserts on the top of the tibia . The ligament guides the tibia in a normal path along the end of the femur and maintains joint stability. Once torn, the knee usually becomes unstable. As instability increases, the shear forces across the top of the tibia increase, the meniscal cartilages tear, and the articular cartilage erodes.
Surgical procedures are required to repair and reconstruct a torn cruciate ligament. Protection against ligament injury and a speeding recovery after surgery can best be achieved by strengthening the muscles around the knee that act as shock absorbers and joint stabilizers. Specifically, hamstring strength protects the tibia from the anterior translocation that can rupture the cruciate.
