Shoulder Injuries - Prevention

[gkygrl]

I currently do Combat Hapkido and just received my Orange Belt. It's been a tremendous amount of fun and physically challenging.

Currently, during a belt test, my testing partner torqued my shoulder too far and hyper-extended it. I am awaiting to have an MRI.

This kind of stuff happens, I know, and given my situation with MS, I may be a little more prone except that I think my joints are just a little looser than some other folks.

My question is: What can I do to prevent myself from re-injuring my shoulders. This happened to my right shoulder about 6 months ago and now my left. It is seriously inflamed and although only an MRI will tell, I need to know what I can do to prevent some of these things.

For me, quitting is not much of an option. I enjoy it so much and this was just a matter of an over-pumped classmate I am sure. My partner CC and I were actually going to try MJJ with a local instructor who does a lot of pressure point fighting as well. I'm going to wait a little on that until the shoulder is more rested and I know what is going on.

Can anyone give some strengthening tips, etc?

Thanks!

Diana

 

[Touch Of Death]

The more you do this stuff on eachother the more conditioned your joints become. Injuries will still pop up but the constant practice should help.
Sean

 

[7starmarc]

Nothing you can do about an over-pumped classmate except talk to them. Before sparring, tell them to take it easy on your shoulders, as they have been injured recently. If they can't handle that or accomodate, ask for a different partner.

For yourself, get a proper diagnosis, as I know you will.

Following the resolution of this acute injury, see if you can see physical therapist for a specific program to address shoulder instability. Mainly rotator cuff strengthening and conditioning, but also other shoulder girdle muscles will help.

Talk to you instructor, you may have developed some bad habits along the way which put your joints at risk-- by assuming certain positions, or allowing your opponent to gain advantage in a way that puts your shoulder at risk. Perhaps you go for throws without a proper base of support, or overextend on strikes, allowing your opponent to use your arm as more of a lever, or some other correctable technique issue.

Best of luck.

 

[gkygrl]

Thanks for the advice ... I will look into the strengthening and talk to my instructor as well

 

[Hyper_Shadow]

I got dropped on my shoulder, did some serious damage, I've been told not to train otherwise it'll take twice as long. Well, to hell with that, I'll just have to suffer! Seriously though, shoulder injuries take ages to sort out and they never go quite right after you get em.

 

[bluekey88]

Welp, I've not done Combat Hapkido, but I do have an AIkido past (similar exposure to joint locks and throwns), so here's some things I always keep in mind for my training to avoid injuries.

Not much you can do if your partner is over-zealous (except prompt them ahead of time to go easy or not work with them).

Injuries from bad falls can be prevented by doing extra working on rolling and falling (never a bad idea).

Tapping is crucial. I used to be known as "gumby" in my old dojo. There was a time when I'd make my partner "work" to get a lock on...I don't do that anymore as it leads to extra torcing of joints. If I need extra stretching...that can happen after class. Once your partner has a technique locked on...tap, don't show off. (That's not what happened to you , that was me...however given what you said is up with oyur joints due to MS, tapping sooner is better than tapping later.)

Extra strength training. It was told to me by those who know better that strong muscles will help prevent these sorts of injuries. I've since come ot learn the hard way that these folks were right. Look into doing some extra strenth training (and by this I mean working with free weights preferrably doing compound body movements like squats, presses, rows, etc. with a program designed to add strength not hypertrophy) done properly you will not lose flexibility and you will be able to strengthen the muscles around sensitive joints and prevent injury as the stronger muscles will lend support. It'll also improve you strength, speed, and explosiveness in class.

Rest. Once inujured, take the appropriate time off to heal up. Again, I've learned the importance of this the hard way.

That's all I can think of right this sec. Hope it helps.

Good luck and get better.

Peace,
Erik

 

[jks9199]

I got dropped on my shoulder, did some serious damage, I've been told not to train otherwise it'll take twice as long. Well, to hell with that, I'll just have to suffer! Seriously though, shoulder injuries take ages to sort out and they never go quite right after you get em.

Follow the doctor's advice. Not only will healing take longer -- you may not heal completely or at all, if you disregard it.

But there are other ways to train! Visualization is a very powerful tool and method of practice that you can use when injured. You may be able to work different skill areas, too. For example, your shoulder injury may prohibit you from taking false or even practicing hand strikes. You can still kick, and practice your stepping. You could apply visualization, and take some time to write out notes on how to perform various techniques.

In other words -- you don't have to stop training to continue to rest and let your shoulder heal.

 

[Live True]

Extra strength training. It was told to me by those who know better that strong muscles will help prevent these sorts of injuries. I've since come ot learn the hard way that these folks were right. Look into doing some extra strenth training (and by this I mean working with free weights preferrably doing compound body movements like squats, presses, rows, etc. with a program designed to add strength not hypertrophy) done properly you will not lose flexibility and you will be able to strengthen the muscles around sensitive joints and prevent injury as the stronger muscles will lend support. It'll also improve you strength, speed, and explosiveness in class.

I think Erik has some great advice, and I'll will add one more thought to it. In most women, our shoulders, hips and knees have inherent differences in how the muscles and ligaments attach (angles mostly), which can encourage some weakness. Also, when pregnant, we get that lovely hormone relaxin that loosens our joints in preparation for delivery...so we have a few things, specific to gender, that require some attention. Still, I think weight training is an EXCELLENT boon to all women and one more should try out for its many benefits.

That said, I would encourage you to look into some strength training books that focus on female anatomy. Strength Training for Women by Lori Incledon has some good exercises with illustrations on form, and it has a good page or two specifically on shoulders and recovering from shoulder injuries.

Otherwise, rest and take care of yourself! And keep at it!!!

 

[chinto]

ok I absolutely agree with the get good treatment for the injury, and then go see a physical therapist and see about some exercises that will strengthen your shoulder muscles and rotator cuff muscles. also ask about any other joints you feel might be week or injury prone. They really are a great resorce for that kind of thing.

 

[Brian King]

"I currently do Combat Hapkido and just received my Orange Belt. It's been a tremendous amount of fun and physically challenging.

Currently, during a belt test, my testing partner torqued my shoulder too far and hyper-extended it. I am awaiting to have an MRI.

This kind of stuff happens, I know, and given my situation with MS, I may be a little more prone except that I think my joints are just a little looser than some other folks.

My question is: What can I do to prevent myself from re-injuring my shoulders. This happened to my right shoulder about 6 months ago and now my left. It is seriously inflamed and although only an MRI will tell, I need to know what I can do to prevent some of these things.

For me, quitting is not much of an option. I enjoy it so much and this was just a matter of an over-pumped classmate I am sure. My partner CC and I were actually going to try MJJ with a local instructor who does a lot of pressure point fighting as well. I'm going to wait a little on that until the shoulder is more rested and I know what is going on.

Can anyone give some strengthening tips, etc?

Thanks!

Diana "

Hello Diane
I feel bad that you suffered an injury at the hands of a training partner. That sucks and may well set up some issues that you will both have to deal with if and when they come up. We in the martial arts often speak of “mind, body, spirit” but then ironically separate the three in our daily lives. Hopefully we do not have to suffer through injury with the often long process of healing daily, but prevention on the other hand is something that we can embrace in our daily lives and both healing and prevention should be approached with mind body and spirit considered.

If you will stick with me, I will address issues that your training partner may be facing and might need your help in understanding and overcoming. When a person accidentally injures a training partner they will often feel badly, going thru the blame game of blaming the partner and their instructors and finally themselves. They often feel guilty and this guilt can often create a fear with-in them. This fear may manifest itself with a bravado that is easily seen through by those that look; this fear may manifest itself with an insecurity that can make a martial artist fearful to apply the techniques to their training partners a heaviness (a overwhelming fear of hurting or causing injury to their someone) that actually makes them more dangerous and more likely to injure their training partner.
Many a martial artist has left training because they have accidentally injured somebody and many people (non-martial artists) have this issue that causes all kinds of second guessing and emotional shut down and stagnation. To help your training partner Diane will help you as well (funny as how that is often the case and a lesson to be learned) but it will require faith and trust and most important patience. First you will have to forgive yourself for getting injured then you will honestly have to forgive your training partner. Only then when your shoulder is healed you should spend time working with your partner going over the technique(s) that resulted in the injury. Start very slowly (slower than tai chi slow) with little or no resistance and for your own understanding pay attention to what is happening in your shoulder and in your mind all the way through the technique from before contact is made to the pin or throw or whatever the finish is, your training partner should also be monitoring what they are feeling both in your shoulder and in their mind. Again start slow and take your time building up speed and resistance as you both feel more comfortable. It can and should take weeks of work. When your shoulder is healed physically you might notice that you will now have a fear (it is natural and something that can be noticed and manipulated in others during self defense situations) when you feel a technique working the shoulder. This fear makes the technique extra dangerous to you and your shoulder and will need to be cleansed before it transforms itself into physical symptoms. It sounds like your training partner might not have that much experience so you may (I suggest that you do) want to find a training partner (your instructor) who knows both you and the technique and is willing to work honestly. This training partner/instructor should then work your shoulder hard and honestly. It will take a few days (sometimes consecutive days but often a day here and a day there over months possibly) but if you do this the freedom that it will bring will be immeasurable to you. You will have to rebuild the faith that your shoulder and you are indeed healed and this is a spiritual and a mental process that takes place in the hard physical work. I know that you did not ask about how to heal your partner but I am surmising that even if unasked it is something that you will want to do and address.


Healing:

+1 to the seeking professional help and diagnosis in treating your injury. I cannot offer medical advice but I am aware of and have witnessed a couple of healing methods (not just for shoulders) that I can share with you. The human mind is an incredible gift from God, one that we are just beginning to understand. I (along with others) believe that the mind along with our attitude can aid tremendously our healing. One way to harness this power is thru visualization. Before going to sleep, some people often go through a mental umm inventory, going through their various injuries and aches as they toss and turn seeking comfort. This is a mistake in my opinion. Rather than falling asleep with your mind on your injuries I find it is much more powerful to go to sleep with positive rather than negative thoughts. A trick that my teacher Vladimir told me about is to go back in your memories to when you were healthy and injury free (LOL no matter how long ago that was). The more intense, the more vivid the memory the more powerful it will be. For me one memory I have is as a child laughingly running around my home. I was barefoot so I remember what the grass and dirt felt like under foot, I remember and can again feel the warmth of the sun (it was in California) on my face, I can feel the breeze against my skin and I can smell the fields. My knees were like little machines pumping away without the slightest pain. Accessing this particular memory before I fell asleep I credit with increasing the speed of my recovery from knee surgery. The mind often has a hard time distinguishing between what is real, what is a memory and what is a dream. Rather than going to sleep dwelling on injury and pain going to sleep with a positive empowering thoughts is much more productive. I urge you to find a memory of you using your shoulders without pain the more vivid the better and harnessing it for your healing. (Diane, I also believe that this will help you deal with some of the symptoms of your multiple sclerosis)

Water can also help aid in injuring healing. In your case Diane you will need some help with this next technique. The Russians and many other cultures believe in dousing using cold water and I do as well. I you can do this outside on the grass and or soil I recommend doing so, but it will work in your bathroom as well. Have somebody pour water over your shoulder and let it run off. The water should be as cold as you can stand but it is not necessary to be a fanatic about it. The cold water will tense you and you will need to guard against this (breathing is very necessary) and this is one of the benefits. The tension that comes from the running water will lead to you learning how to totally relax the shoulder from the inside out. For beginners it is often easiest to exhale while the water is running over and down your shoulder and it is easiest to start the breathing before the water actually hits your shoulder. The water should run in as a smooth current as possible rather than one big slash. As you are feeling the water run down your shoulder let the tension also run down the shoulder and let your breathing also funnel through and out your arm (think a giant drinking straw) Let the tension and bad energy drain down the drain or into the ground. The cold water will draw out the heat and inflammation from the arm and will increase blood flow thru the injured area. If you douse that should be continued and if you do not douse you might want to start, two times a day. If you do not have a partner that can help pour water with a gallon or five gallon bucket then you will have to do it yourself. You will not be able to use a bucket but you can use a smaller container like a yogurt container or milk carton for example.

Another technique that I often use (whether injured or not) is to take some chain and make a pile of it on the floor then laying on the chain and moving around slowly. The chain that I found works best is stainless steel and about 3/8 of an inch thick. I use about four or five lengths that are about four feet long each and pile them into a pile that resembles a cow pie LOL. You will find that the cool metal helps to draw out the heat and inflammation and the links will move about and massage your body in a very interesting way. I have various friends that use this method of massage on a range of patients from infants to horses and have heard positive results on all. This is one of my favorite self massage methods.

Finally, any work that you do on one side of the body you should also do the same or more on the other no injured side. You will find that your body will try to compensate for the injury and will work the other muscles and structures more than you are used to and they may become overworked strained and prone to injury.


Strengthening:

Regarding the strengthening I will have to disagree with the advice to do weight training in this case unless you have a physical weakness that affects the structure stability of your shoulders. This is my opinion and you will have to make up your own mind as to what you find valuable and helpful. Shoulder injuries are usually caused by biomechanical trauma (forcibly moved beyond their range of motion), percussion trauma (a fall or hit from a blunt object) or repetitive irritation and weakness. I have worked with professionals that had shoulder injuries, soldiers and athletes, men that are very strong and all the muscles still did not protect their shoulders. I have not met you Diane but I have to believe that these men had and likely always will have stronger and more musculature density than you will have no matter how much weight lifting that you do. Rather than trying to shield a mobile joint with increased muscle which often comes with a price of excess tension not to mention the fact that the muscle is temporary (failing as you age or do to injury or disease or slow down/stop the exercising), I believe that it generally makes more sense to increase your range of motion, to strengthen the tendons and ligaments and to free up the fascia.

I would suggest that you let the shoulder heal before you start to do the work to strengthen and increase your shoulder knowledge/awareness (body knowledge). Not much help now but here are a couple of partner drills/exercises that you can try, that will both increase the range of motion and strength of the joint but will also strengthen your psyche to better enable you to deal with joint manipulations. Often locks first start to work from tension (usually caused by fear) before the biomechanical physics kick in. By exploring the locks and especially exploring the fear and pain caused by them, a person can better protect themselves from the application of the locks and can further their own ability to apply the locks. Knowledge gives strength and courage.
The first is to get a partner or two (it is easiest for one partner to work with one other rather than multiples for beginners) and have them very slowly bend and twist your arms (in the beginning they should avoid wrist and finger work but that can come later). Have them actually start to slowly lock up the arm, they should be focusing not only on what they are feeling and doing, but they should also be aware of what the other arm twister is also doing, but as important or perhaps even more so is that your partners should be focusing on you extremely closely. The minute that a lock starts to effect you they should stop and hold it and let you explore it. Catch yourself if you are holding your breath and breathe, find the physical/mental tension that the lock is creating and see if you can release/or use the tension to reduce the pain and effect that the lock is beginning to have on you, can you bend your knees and/or move your feet to help release or use the tension. You should move slowly for if you are exploring the locks and how they affect your joints and body positions as well as monitor your fear(s) you will move yourself into more painful positions as well as releases as you explore the locks this is valuable and a great learning experience for both you and your partner. Once you are comfortable with the partially applied lock and have released the tension and regained your breathing and composure your partner should then slowly further apply the lock until you again are in pain and the procedure is again duplicated. Monitor yourself and have your partner switch angles and /or locks to give the worked joints a rest.

A interesting multiple drill (and one that specifically will strengthen your psyche) is to lay on the ground and have one partner on each arm and leg lifting and twisting and bending the limb that they have control of all should be working at the same time but independently of what the others are doing. Quick movements should be avoided and everyone should monitor the person being worked. For added difficulty the person lying on the ground being worked can be lifted completely off the ground, working their getting used to being helpless and in the control of others while at the same time adding bodyweight difficulty to the partners doing the work. For added combative difficulty use a fifth partner (as well as the four others working) add hits, hair pulls and slaps and kicks to the partner being worked. Switch after a few moments so all can benefit from the training and make sure that people switch limbs (from arm to leg from right to left etc).

A push-up variation that I have found interesting is to use shoulder tension and relaxation to explore the push up. It makes the push-ups look funny but who cares about that. Also placing your hands and arms in various positions while doing the push-ups and exploring (adding and releasing tension) using breath and tendons to do the push-ups. The push-ups can be done standing (against a wall) if needed as the exploring is the greater benefit.

Sorry bout the length of this post
Warmest regards
Good luck with the healing
Brian King

 

[Brian King]

I have heard a few different philosophies on training while injured. From not training until completely healed to cowboy up and train regardless. My personal philosophy is two fold. I do believe in getting back to training as soon as possible but with some modifications until completely recovered. In Systema we train to work using both independence and interdependence meaning for one example, that we should learn how to use our body to protect our body as well as to use our body to protect our limbs and we learn to use our limbs to protect our body and our limbs to protect that limb as well as the others. Training while injured allows us the opportunity to learn to work while protecting the injury (and make it look like there is no injury or weakness) so for instance if you have a bad knee using the other leg to intercept and redirect strikes targeting the injured knee and learning how to roll while injured brings more versatility to your ground maneuvers. The bad part o this type of training is that if done too long it sets up bad habits and reinforces fear surrounding an injury. You can stop this fear when watching people work that had bad prior injuries yet even though the injuries are healed they still protect the injury as if it were still fresh. To combat this tendency, I feel it is also important to work as if you are completely healed regardless of injury but work with a partner(s) that you trust and to work at a reduced speed and intensity. In this mode rather than protecting the injury with redirection or interception or deception you protect it by working slowly and carefully, escaping and working ahead of the technique’s pain but working and giving reactions as if there is no injury increasing the speed and intensity as the injury becomes more secure and healed. I find that utilizing the protection philosophy along side the training slow philosophy works best for me, allowing me to protect the injury while continuing my training and learning the maximum number of lessons that an injury can provide.

Your mileage may vary
Warmest regards
Brian King

 

[gkygrl]

Brian and Everyone who responded. I am indebted for all of the wonderful advice and support.

Here's the scoop on things. After my belt test and "injury", I did continue to train, saw a shoulder specialist and his PA and did some strengthening for awhile. In the meantime, the pain and some new numbness going down to my thumb intensified so that I pretty much had to stop going to class. My shoulder doc then ordered an arthrogram MRI which came back positive for a posterior labral tear, some kind of tendinosis and something else.

In sum, I have to have surgery because this is a second dislocation and there is a tear that will not heal on it's own and more importantly some nerve impingement.

I am going to discuss surgery details on 10/22 and will work on getting this done ASAP as I knoe the numbness is not good and I am getting some weaker muscles in the affected arm.

I don't like missing training at all and know the recovery will be a patient process back to training -- but I will learn to train creatively.

Thanks for the great advice and I will keep you updated.

Bless you,

Diana

 

[Brian King]

Dang, I guess that is some bad news. Surgery should be a last option but on the bright side they can do some really wonderful work now days and recovery time with some of the new techniques and methods that the surgeons now use has cut down from what it used to be miraculously.

I would try not to think as this interfering with your training but rather that it is some additional training and a great chance to learn more about yourself.

If you have the option to stay awake during the operation it can be very interesting, I did so during a knee operation and it was not only interesting but seeing the work being done as it was happening later helped me visualize and work on specific areas of my injury to speed recovery.

Good luck and thanks for the continued updates
Warmest Regards
Prayers and well wishes
Brian King

 

[trainable]

I suffered a dislocated biceps tendon 2 years ago, and had surgury to re-attach the tendon to my shoulder. The improper application of a shoulder lock caused the event, but it was as much my fault for not saying something at the time to stop the event.

After any surgury it is imperative that you follow the recommended down time (as previously mentioned), DO THE REHAB religiously. It hurts, it hurts, then it hurts. But, it will get better. You may not get full motion back after surgery, but you will strengthen everything else to compensate. My kicks got to awesome levels, my other tools are sharper, and I can still use my left arm to deliver some awesome elbow, forearm strikes.

The reality of life after being injured is that you should be more diligent in training. Pre-notify any sparring partner of the injury and dont train with people you dont fully trust. Keep the level of intensity under control and dont let your ego get you hurt again. Remember, the quality of the blueprints you lay in training will serve you in life. Speed and intensity do not make that mental stamp for you, but you should train to your limitations.

The great thing about this community is that there isn't a lot of quit in us. I have had abdominal surgery, shoulder surgery, broken toes, fingers and ribs, and I have found my way back to doing what I love. Every person I train with respects my limitations, and I respect them too. Love what you do, and keep your attitude positive. Visualize your recovery (as previously stated) and it will motivate you as well as get your mind-body machine working for you.

If you get down during your recovery, come here. We will carry you.

You can do this, and you will be whole again.

 

[bluekey88]

I'm sorry to hear you'll be down and otu of trainin glonger. Good on you, though for getting thing slooked at. Like others have said....do EXACTLY what your doctors and PA's recommend. If you are patient and follow your recovery program, you'll be back on tracm quicker than if you try to take shortcuts.

Good luck and keep us posted

Peace,
Erik