This month we continue our discussion with common injuries to the wrists, ribs and spine. Please refer to part 1 of this article for a review of injuries to the knee and shoulder as well as some important definitions of Sprains versus Strains.
The wrist and hand is our connection to the bike. So much more goes on here than just steering. We have to manipulate the most important controls of the bike, manage the directional control and absorb the forces transferred through the front wheel all at the same time. Most injuries to this region occur not in the course of normal riding, but when something goes wrong and we get tossed. The natural reaction in this case is to stretch out the arms and land hands first rather than face first. The hand and wrist has to absorb the force of the body coming down hard. Sprains to the ligaments of the wrist will occur when the forces cause the hand to go past the normal end point of range of motion. Come down really hard and watch out for the fractures.
The opposable thumb is what sets us apart from the rest of the animal kingdom, but it also sets up the motocross rider for injuries due to the nature of the grip. Hit a whoop or rut harder than you anticipated and watch out for the sprain of the thumb. Fortunately, in the absence of the fracture, most injuries to the wrist and hand can be managed conservatively. A doctor of chiropractic is well versed in evaluating the positional alignment of the bones in the wrist, making necessary adjustments and in guiding the recovery of ligament sprains.
Rib injuries are rare in the absence of falls but as they say, "if you're not falling, you're not riding hard enough". It's usually the landing on the back or side that is the culprit in rib injuries. More common than the fractured rib is a condition that occurs when the head of the rib is popped out of place where it attaches to the spine. This usually results in local pain on the back at the head of the rib. This condition can only be corrected through the proper identification and adjustment by a doctor of chiropractic. Another condition known as costochondritis is felt as pain in the front of the ribcage and is noted with coughing, sneezing or laughing. The lower ribcage is connected to the breastbone by cartilage rather than the bone to bone connection of the upper ribcage. When the bone to cartilage interface is stressed during a fall, the cartilage can become inflamed and very tender to the touch. Usually a rib belt to stabilize the lower ribcage combined with rest is enough to calm this condition over a week or two.
The most common type of spinal injury occurring on the track or trail is the subluxation. A subluxation is the loss of proper position or motion of a spinal joint which causes local pain and inflammation and can impair the transmission of nerve impulses from the spinal cord to the various organ systems of the body. "Adjustments" can be delivered by a doctor of chiropractic to restore the proper biomechanics of the injured joint and improve nerve supply to the affected tissues. Subluxations can occur through repetitive motion injuries or through the traumatic ones. Repeated wear and tear to the spine can result in injury and eventually degeneration of the discs between the vertebrae. Though treatment is possible even at this stage, prevention is the key. Chiropractors are trained to not only address the injuries that we've been discussing but in prevention of these injuries.
Though professional evaluation is always recommended with any acute injury, there are some simple guidelines for home treatment of musculoskeletal injuries. The acronym RICE is the key to remember.
Rest - Immediately discontinue the activity. You prevent further injury to the area and provide your body the energy it needs for healing and repair.
Ice - Apply ice to the affected area. Wrap ice in a thin towel and do not leave in place for more than 20 minutes. Remove for 20 minutes minimum and repeat the process.
Compression - Wrap the affected area with an elastic bandage. Compression limits swelling which can cause further damage.
Elevation - Elevate the affected area above the level of the heart. Elevation diminishes the swelling and prevents further damage.
Though heat can be comforting, NEVER apply heat to an acute injury. Heat draws more blood to the area and contributes to more swelling which can cause further cellular damage and slow recovery time.
Simple steps to prevention that can be performed by all riders include the following:
Step 1 - Practice proper stretching of the back, shoulder, wrist and knee muscles before climbing on the bike. Athletes frequently injury themselves because they didn't take the time to warm the muscles through stretching before using them.
Step 2 - Eat properly during the off season and especially when you're in training. Your muscles need fuel to work properly and if you neglect to feed them or frequently eat the wrong foods then you might be doing more harm to your body.
Step 3 - Train and exercise properly during the off season and while readying yourself for an event. The more you work your muscles, the stronger they are and the more likely they are to take the pressure of Motocross.
Step 4 - Cool down after a routine and bring your muscles back to their resting state. Your muscles are working hard during a ride and they need at least ten minutes to return to their natural state to prevent serious injury.
Your chiropractor can assist you in all of the above steps as you learn the routine that works best for you.
Lastly, wear protective gear. Never get on your bike without the proper gear. At a minimum you need a helmet with eye protection, chest protector, gloves and boots. Knee and shoulder pads are extremely good at dispersing forces when landing on these points. Neck protection is more and more becoming the norm at motocross events for good reason. Riding pants and jerseys are designed for protection and warmth/cooling, take advantage of them.
Paying attention to the prevention steps listed above can dramatically improve your chances of an injury free season. When something does go awry, use RICE to your advantage. If there's ever any question about an injury, get professional advice. With the proper care you'll spend less time off your bike and more time on the track or trail!