By Callum Denault
It was a normal day in May of 2004 for Jonathon Michael, and a good day at that because he was playing a game of soccer. That shouldn’t be a life changing event in of itself, especially for a middle aged man who actively played the world’s most beautiful game since he was seven years old.
When he was 16 and growing up in Scarborough, Michael successfully tried out for his high school’s representative soccer team, and has been playing in various recreational leagues ever since then. He is also currently the club president of the Toronto Markham Soccer Club.
In that fateful game in 2004, Michael was running alongside an opposing player who had the ball. He planned to step on the ball in order to stop it, and then cut to the right across the attacking player.
Michael went to a hospital’s fracture clinic, but the staff couldn’t find anything in the X-ray they took. Fortunately for Michael, his wife’s family friend was a chiropractor. He did a series of knee tests on Michael, concluding the veteran soccer player tore his ACL.
Princess Margaret Hospital did an MRI on Michael to confirm he did indeed tear his ACL, and that he had a long, hard road to uncertain recovery.
Another experienced athlete who suffered an unfortunate injury is Sean McInnes, a sales consultant at Bowen Brazilian Jiu-Jitsu and Kickboxing Academy.
Brazilian Jiu-Jitsu (BJJ) is known as the gentle art, because in spite of it being very effective at stopping fights, its practitioners aim to make their opponent forfeit the match as non-violently as possible by putting them in either a chokehold or joint lock until they tap out.
According to McInnes, competitions do not allow inexperienced lower belts to perform certain techniques that have a higher chance of causing injury if they’re done poorly. It is only when practitioners reach higher belt levels — and have the associated increased experience — that they are allowed to attempt flying attacks and BJJ’s full bevy of legal submission holds. McInnes described Brazilian Jiu Jitsu as a “long, hard road,” adding it takes 10-15 years for someone to get their black belt.
Unlike wrestling and Judo, there are no hard body slams allowed in most BJJ competitions, and unlike a lot of martial arts there is no striking. McInnes does have a partial cauliflower ear, but that was from getting kicked in the head while kickboxing using Muay Thai style.
However, that does not mean injuries are completely unheard of in BJJ.
“I’m injured right now,” said McInnes, “I dislocated my thumb, tore ligaments and stuff. It’s messed with me, it’s been almost a year and it still hurts.”
McInnes was grappling with a partner in class, and attempting a punch choke — which involves grabbing the collar of the opponent’s uniform — when his thumb got caught.
“He wasn’t doing anything wrong,” said McInnes, referring to the partner he was sparring with. “He was just trying to escape, and my thumb was caught in the [uniform], and it, y’know, popped it out.”
McInnes added he could feel the pressure building in his thumb, but refused to let go against better judgement.
In order to fully recover from these kinds of injuries, it is important to understand the science behind them, and what experts say are the best courses of treatment.
The science behind recovery: what hyperextension injuries are and how to treat them
The human body is a complex, fleshy marionette doll of muscles, bones, joints, and connective tissues, and sometimes when those body parts are overworked, they start to have issues. One example is overuse injuries, which is when someone repeats a motion too many times —often incorrectly — leading to wear and tear of the muscle, tendon and/or ligaments in the area of the body being overworked.
Chris Haas is a kinesiologist at Ace Sports Clinic Toronto, who is mainly referred to for patients dealing with shoulder problems. Those who are injured should expect inflammations.
“When someone injures themselves,” said Haas ”the first thing the body does is inflame to protect the area. Then when the inflammation goes down, the muscles around that injury will start to get tight because it’s trying to guard the area that was hurt.”
He said the first strategy for dealing with inflammation is called RICE: Rest, Ice, Compression and Relaxation. The next step is to reduce the muscle tightness that comes after inflammation, as well as get a person’s strength and full range of motion back. Haas said it generally takes two to three weeks for inflammation to go down, but it varies widely from case to case.
Haas is often referred patients by his clinic’s physiotherapist, and one of Haas’s common jobs is to help patients avoid compensatory movements.
“When someone compensates for their movement, their muscles aren’t working properly,” said Haas. “So what the body does to compensate, the body does everything it needs to do to make that movement happen, but it’s not using the proper muscles designed to do the job.”
If someone has a shoulder injury, they can lift their arm, but might not be using all their shoulder muscles to do it, instead relying on and being restricted by other muscles connected to the shoulder.
Compensated movements can lead to issues later on, such as tightness in areas that should not be tight. Haas said the brain also gets trained to keep doing that compensated movement without a person thinking about the fact they are doing it. He added his clinic regularly gets patients who have this problem.
One Client Haas saw had been sitting at a desk for eight to ten hours a day as part of his job, and he was curving his spine more than it should normally bend, as his body was compensating for what he was doing at his desk each day. He was unaware he was compensating because the patient had not yet been experiencing any pain, but Haas found out he was doing this during a full body assessment.
“[Compensation] happens all the time,” said Haas. “In the gym when someone is doing a movement that is too much for them to handle, they will compensate to do that movement even though they don’t know it’s happening.”
Another way injuries can cause tightness is scar tissue, according to Shawn Raycraft, a registered massage therapist at Massage Addict who also performs acupuncture, cupping and lymphatic drainage. He said when an injury heals, it leaves behind excess tissue, scars that limit motion.
““You can feel scar tissue,” said Raycraft. “It feels ropy and tight. Just by massaging and stretching, you’re going to work that to be smoother and more elastic.”
Raycraft added a person’s recovery depends on how bad their injury was, and while scar tissue might not be able to be completely broken down, massage “generally helps.”
The long road to recovery
After tearing his ACL, Michael connected with a sports doctor. He had to exercise his knee for six months to build muscle and get it ready for surgery. Michael’s rehab exercises included leg presses, weighted squats, and lateral movements wearing a knee brace.
With a knee brace, Michael was able to play soccer in October of 2004 to June of 2005, which is when he was scheduled for surgery.
He ended up having to do nine more months of the rehab. “At the time,” said Michael, “I was determined to get back into playing soccer. I just turned 30 at the time, and I knew for a fact I was not done with sports, still wanted to be active in life.”
Seeing himself with many years ahead playing soccer, Michael pushed through the rehab, and fortunately for him, he recovered.
Haas said the best way to recover from an injury is to stop doing whatever motion led to the issue in the first place, especially with severe injuries.
“I’m not the best model to do stuff for preventing injuries or doing stuff that the doctors says,” said McInnes, “I’m one of those people that’ll do it anyway.”
McInnes said doctors told him to take six months off rolling — what sparring is called in Jiu-Jitsu practices and competitions — but he only took two months off before popping his thumb back in and going back to grappling. He also said they estimated he only had a thumb sprain or tear as opposed to what he felt was a full dislocation.
“A lot of it is psychological,” said Haas, referring to people who keep doing motions against medical advice, “and I’ve done it myself. I’ve played football for 14 years and had my fair share of injuries.”
Haas said people think they can go back to what they used to do, just because they do not feel pain anymore. However, he said the muscles around the injured area are still deconditioned after recovery, and need to be trained back to their original strength.
“If they tell me to stop,” said McInnes, “I’m gonna do it anyway. I’ve been doing jiu-jitsu for so long now, it’s part of my life.”
He added it is a mental health benefit as well, when McInnes gets to go out and be active in his community as opposed to sitting on the sidelines.
McInnes started rolling again while wearing a brace for his thumb, and he continues to wear the brace to this day. He said he also still feels pain in his thumb.
How to prevent these injuries from happening
Even if you are unable to afford a massage appointment or physiotherapy session, there are plenty of cheap and easy ways you can take care of your body through daily routine. This is true for people who do pay to see professional therapists, as both Haas and Michael said they show their clients exercises to do on a regular basis from home in order to see a full recovery from the issues they may be dealing with.
Muscle tightness can be kept at bay by regular stretching and foam rolling, which is a way people can independently massage their muscles using a specially made cylinder of foam.
“It’s a large tube of solid foam, usually two feet or so long,” said Raycraft. “Typically most people will lay on them and roll through their spine back and forth, like you’re sitting a rolling pin let’s say.” He added foam rollers can also be used to massage a person’s quadriceps, hamstrings, calves, abs and arm muscles.
While generally safe to use, Raycraft said it is still important people use foam rollers with proper technique, because while muscles can be kneaded into shape, tendons and ligaments cannot heal themselves as easily due to a lack of blood flow. In particular, Raycraft said people foam rolling their hamstrings need to avoid massaging their IT band, which runs from the back of the knee to the pelvis alongside the outside of the thigh. This is because the IT band is a tendon, and unlike muscles, tendons do not have the same ability to repair themselves. While muscles can get stronger and more flexible, massaging or stretching a tendon just risks damaging it.
Overtraining the body during practice is an important way to prepare for competitions, said Haas. He said if someone is training to compete in a five kilometre run, they should be training to be able to run a 10 kilometre run so their body will be capable of doing what it will be asked to do.
“Let’s say a baseball pitcher, he or she has to train their shoulders specifically, “said Haas, “because that’s the biggest injury in pitchers — to do more than they would pitch in a game. That’s the biggest preventative strategy I could ever give someone, is to overtrain muscles to do more than in a game or whatever they’re doing.”
Alongside physiotherapy, massage therapy can help keep either athletic or non-athletic people in shape, particularly sports massages and therapeutic massages. Raycraft said relaxation massages involve lighter pressure and work down around relaxing parts of the body such as the feet, hands and head.
In contrast, Raycraft said therapeutic massages go deeper into the tissue, and are more for people who are dealing with a particular issue, such as back or neck pain. Sports massages are similar in that massage therapists go deeper into a client’s muscles, and they can be useful either for athletes recovering from an injury or who just want relief from general tightness.
If a regular massage is too expensive, Raycraft said massage schools which have clinics can be an alternative which offer treatments for around $25 to $30 dollars.
“If money is the issue sometimes that helps,” Raycraft said. “You’re also assisting the students in learning too.”
While connective tissue injuries like the kind that Michael and McInnes had are something every athlete should look out for, another all too common type of serious injury is head trauma.
Head pains? Concussions, CTE, migraines, and other head problems
Carmela Tartaglia is a cognitive neurologist and scientist for the University Health Network and University of Toronto. In her line of work, Tartaglia both does research, and sees patients who have neurodegenerative diseases such as Alzheimer’s, temporal lobe dementia, multiple concussions, or persisting symptoms from concussions.
She said patients with possible symptoms of concussions may come to her with trouble concentrating, mood problems, headaches, dizziness, or visual impairment. Tartaglia also sees former professional athletes who are worried about getting Alzheimer’s or Chronic Traumatic Encephalopathy (CTE).
According to Tartaglia, concussions happen from any kind of hit to the head, or a hit to the body which transmits a lot of force to the head. She said the symptoms are generally the same regardless of how the injury was caused, such as a car crash, sport accident, or slip and a fall.
“We have concussions from synchronized swimming,” said Tartaglia. “Of course you can get concussions from every sport, [such as] gymnastics. It’s just a matter of quantity, you can get concussions from swimming, you can get concussions running. You can fall.”
The most common sports Tartaglia sees patients get concussions from are hockey, gridiron football and boxing, followed by soccer and rugby. What’s worse, the more a person gets concussed, the easier it is for them to get concussed in the future, and the more likely it is those concussions will have longer lasting symptoms.
“Sometimes I see younger people,” said Tartaglia, “like maybe they’re 13 or 14 years old, and it takes them three or four months to recover from a concussion.”
With underage patients, Tartaglia usually sees them to treat their first concussion, which makes her worry how long it will take for her patients to recover if they later get a second concussion. She said concussions are especially dangerous in children, because their brains are still developing, so “the risk of a poor outcome is quite high.”
When asked if there were any sports Tartaglia thought children should not play, she said she does not think children should be in football, hockey or boxing if there is a risk they can get concussed. She also recommended children adopt their playstyle to be a bit safer until they are at least 17 or 18, such as only playing sports where no concussions happen during practice, and avoiding risky behaviours such as hitting a soccer ball with their head.
She added while physical exercise is important for children — and not every kid may be inclined to only play non-contact sports — parents should consider what is best for their children, especially if they had a concussion or prolonged concussion symptoms.
Sport organizers themselves can also take steps to protect players. In the Ball Sports Polson Pier soccer league, referees will encourage players to stop playing if they appear to be suffering from a head injury.
“With head injuries, that’s been a focus in sports lately,” said Saleem Haddad, league manager for Ball Sports Polson Pier. “ If someone is obviously not moving well on the field, [the referees will] strongly recommend they stop playing. They can even talk to a player’s captain or coach if either are present.”
Despite the league’s referees being well trained in giving first aid and treating head injuries, Haddad said they can only advise players to leave the game after they take a serious blow to the head, and referees in the adult league do not have the authority to stop a potentially concussed person from playing.
Tartaglia said Second Impact Syndrome (SIS) is a condition that happens when someone gets multiple concussions within a short amount of time. For instance, if a person gets concussed during a practice, and then gets concussed again playing sports on the following day, that could lead to SIS. The big risk with this syndrome is when a person’s brain starts to swell up after taking multiple hits, which can have deadly consequences.
Other than concussions and injuries which may have caused them, headaches can also be caused by muscle tightness, according to Haas who said tight muscles in the neck or shoulders can pinch on the nerves. However, in her line of work surrounding mild traumatic brain injury, Tartaglia said she had not heard of headaches being caused by muscles impinging on nerves.
However, Raycraft agrees with Haas’ statement, adding he has had “a lot of success” relieving headaches in clients by “just doing shoulder and neck work”; although, he added this might not be enough for everyone and some patients may need multiple forms of treatment.
How the right gear can protect your body: helmets, tape, sleeves and other equipment
There are a variety of tools you can use to reduce your risk of injuries in sports. Drawing on his many years in jiu-jitsu, McInnes recommends grapplers use finger tape. He said there is specifically made finger tape for wrestling-style sports, but if that is not available, then other types of cloth tape such as hockey tape or medical tape work as well.
He said certain types of grips put a lot of stress on the hands, especially if someone is using improper technique. A person’s fingers can get twisted if their opponent tries to break out of a grip.
“The tape just helps keep your grip strength,” said McInnes. “It helps prevent the twisting and everything. It reinforces your hand.”
In his job as a massage therapist, Raycraft sees a lot of health issues in clients who are runners, which is why he recommends they try special footwear. He said runners tend to have tight calf, quadricep, and hamstring muscles, while they also tend to have tight foot fascia as well.
Raycraft recommends orthotics, since shoes without an arch built into them will cause a person’s foot arch to fall over time, which can be very painful. He said it is better for someone to have shoes custom fit to their feet, but it is also possible to have orthotic molds shaped to a person’s foot arches which are then slipped into their shoes.
“I always say ‘talk to someone at a good sports shoe store,’” said Raycraft. “Make sure you know how your arch sits. Because you want the arch of the shoe to go with the arch of your foot, and not cause a drop.”
It is also good to change the type of shoe you wear depending on the ground, at least while playing soccer. Haddad said the kind of cleats worn for outdoor soccer can actually be dangerous when playing on the artificial turf that indoor soccer fields use, since cleats may dig in too well and cause someone to sprain their ankle if the cleat gets stuck during a sharp turn. Instead, he said either flat footed shoes or turf shoe s– which are similar to cleats, but designed to be used on turf – should be used for playing on indoor fields.
Michael said that shin guards are mandatory for players in his league to wear, due to how many leg collisions there are in soccer. However, this has not stopped people from trying to skirt the rule by pretending like they have shin guards on but not actually wearing them during play, claiming they feel like the shin guards are a distraction.
“I would say a broken leg is much more of a bigger distraction,” said Michael.
Some pieces of equipment, however, have mixed reviews. There are reports that cauliflower ear — a condition where a person’s ears become puffy and pale after being damaged — can be prevented in grappling sports by wearing specialized head gear.
“Some guys wear wrestling headgear,” said McInnes., “I don’t like that because it’s hard and it messes with everything.”
McInnes said while there are some cases in jiu-jitsu where a person might damage their ears — namely by pulling their head out of a headlock or triangle — these circumstances are rare and he does not know anyone in his gym with cauliflower ear injuries sustained from jiu-jitsu.
Still at it: McInnes and Michael
“You can expect to get hurt if you’re doing any combat art,” said McInnes. “Eventually, it’ll happen.”
However, McInnes knows to slow things down when he needs to in order to keep from re-injuring himself, and he credits the environment of his gym for keeping his body and mind in good shape.
“We’re a family academy. Our members are careful and take care of each other, as opposed to a specific fight gym where people go in to kill each other and themselves.”
Michael said he believes the safety of players in his sport is less reliant on the equipment they wear, and more on the mentality they possess.
“If you have players who are overly aggressive and going hard for tackles,” he said, “they’re obviously more likely to receive the same back.”
While Michael said he can “turn up” his aggression depending on the situation in a game, he also said he would rather let an opposing player kick the ball than risk clashing over it in a way that could break someone’s leg.
“I find personally, I’ve been more of a finesse player,” said Michael. “For me that’s served me well, obviously aside from an ACL injury and an ankle injury. I can say out of the 40 or so years I’ve played soccer, I’ve been able to play the majority of the time.”
While there are countless ways someone can get hurt in a way that prevents them from playing sports – be it head trauma such as concussions, ligament strains, or muscle aches – there are also many ways everyday athletes can reduce their risks of injury, and overcome those they endure.