Common Basic Training Injuries: Prevention and Management

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In this article you will learn the prevention and management of common basic training injuries.

First, we will look at how to prevent training and musculoskeletal injuries. The information is the same whether you need it for common military training injuries or personal training injuries.

Next we go into how to manage notable training injuries.

Environmental injuries are heat and cold related ailments.
Then comes common musculoskeletal injuries that, in most cases, you can self-diagnose and treat.
Finally, we talk about superficial injuries, e.g., cuts, bruises, and blisters.

Superficial, environmental, and musculoskeletal injuries in the military are the same as you might get when training in the Survival Fitness Plan.

In the last section you will learn about how you can still undertake personal training with injuries.

IMPORTANT: None of what is in this article replaces professional medical advise. If you get injured, ask your physician for the best course of action.

Training Injury Prevention

Injury prevention is best type of injury management.

Here are fundamental guidelines that will help prevent most types of training injuries.

Aim for all-round health and fitness. Cardio, strength, and flexibility.
Avoid uneven and/or hard surfaces when doing high impact activities, e.g., running
Eat a nutritious diet.
Hydrate! Drink lots of water before, during, and after training. But don’t gulp it. Drink small, slow, and often.
Lose excess weight.
Maintain your gear. If your gear breaks your chances of injury increase. In activities such as rock-climbing, it can be a big issue.
Replace salts. Nutritious food and diluted sports drinks. Research environmental conditions before training. adjust your dress and regime to suit. Some examples of bad training ideas are:
Doing parkour in the rain.
Swimming in a lightening storm.
Distance running or hiking in extreme heat immediately
Start easy and gradually increase intensity. This applies to single training sessions and overall long-term goals.
Strengthen your supporting muscles before trying anything major. For example, strengthening your calf muscles will prevent tendonitis. Superburpees will strengthen these and many other supportive muscles. Some types of yoga are great for strength training also.
Take extra good care of your knees and back. Don’t overuse them. If they hurt, let them rest.
Warm up/Cool down and stretch before and after training. Learn more about that here.
Wear the right clothing for the activity. Footwear that provides proper support is important.

Training Injury Management

While injury prevention is general, specific sports training injuries need specific treatments.

Environmental Injuries in Sport

Dehydration and Heat Exhaustion in Sports

Dehydration and heat exhaustion occurs when fluid loss is greater than fluid intake.

Dehydration leading to heat exhaustion is one of the more common endurance training injuries, but it is easy to prevent.

Avoid drugs (including medical) and alcohol.
Maintain adequate hydration and nutrition.
Take the time to acclimatize.

How to Acclimatize to Heat

The body can deal with heat if introduced to it slowly.

Acclimatize in similar conditions to what you will be in, e.g., if you are going somewhere hot, it is best to acclimatize somewhere hot.
Exercise moderately for 1 to 2 hours a day for 8 to 10 days.
As the days go on, gradually increase intensity and time spent working.

Dehydration and Heat Exhaustion Symptoms

Chills.
Dizziness.
Elevated respirations, pulse and temperature.
Headache.
Nausea.
Sweating.
Vomiting.

How to Treat Heat Exhaustion

Rehydration (using a re-hydration plan).
Place a moist, cold compress on the armpits, chest, groin and neck.
Remove restrictive clothing.
Rest in a cool environment.

Rehydration Plan

Only use oral rehydration if the patient is capable or it may cause more harm than good, e.g., if the water goes into the airways.

You can buy oral rehydration solutions or make it by combining 6 teaspoons sugar, 0.5 teaspoon salt and 1 liter of drinkable water.

Intake 50 to 200 ml/kg/24 hours (the stomach can only absorb 1 liter of liquid per hour).

Fainting

Dehydration and/or low blood sugar are casues of exercise induced fainting.

Fainting Treatment

Unless there is a serious underlying problem, most people won't take long to regain alertness.
If the patient feels he/she will faint before it happens, have them sit down and put their head between their knees.
If you see them fainting, lower them to the ground onto their back.
Cool the patient if hot.
Give the patient fresh air.
Loosen constrictive clothing.
Lie patient flat on his/her back and raise their legs 60cm above their heart/head.
Slowly sit the patient up when ready.
Eat and drink when alert.
Continue to rest until strength returns.
Assess for other injuries, e.g., concussion from fall.

Note: A person who faints from a seizure will have jerky movements or will stare into space. This requires different treatment not covered in this article.

Heat Rash

Heat rash (prickly heat) occurs when the sweat ducts become blocked and swell. You will usually find it on body areas covered by clothing.

Symptoms of Heat Rash

Itching.
Red or pink rash-like dots or tiny pimples.

Heat Rash Treatment

Avoid ointments or other lotions.
Dry and cool affected site.
Heat rash will usually dissipate within 10 days.
Loosen or remove clothing.
Antihistamine.

Hyponatremia Management

Hyponatremia occurs when there is excessive water consumption with inadequate salt replacement, e.g., when someone sweats a lot and drinks water to stay hydrated, but does not eat to replace salts.

Hyponatremia Symptoms

Decreased mental status.
Dizziness.
Headache.
Muscle Cramps.
Nausea.
Loss of co-ordination.
Tremors.
Vomiting.
Vital signs and core temperature are often normal. immediately

Hyponatremia Treatment

Drink a full strength sports drink, but only if mental status is okay.
Eat when able.
If unable to drink, consider intravenous therapy.

Hypothermia

Hypothermia occurs when the cold overwhelms the body’s ability to produce and keep heat.

You can prevent hypothermia by:

Acclimatizing to cold weather.
Avoiding alcohol and other recreational substance use.
Dressing for the cold.

Hypothermia can be mild or severe and it progresses through very definite symptoms, i.e., the patient will have mild hypothermia and, if untreated, it will progress into severe hypothermia.

Symptoms of Mild Hypothermia

Body temperature between 35.5 °C (96 °F) to 32 °C (90 °F).
Difficulty speaking.
Intense shivering.
Irritable.
Lethargic.
Loss of fine motor coordination.
Sluggish thinking.
Withdrawn.

Symptoms of Severe Hypothermia

Body temperature below 32 °C (90 °F).
Blue, puffy skin.
Coma.
Decreased vital signs (pulse, respiratory, B/P).
Jerky movements.
Muscular rigidity, i.e., no more shivering.
Respiratory and cardiac failure.

Hypothermia Treatment

The treatment for hypothermia whether mild or severe is the same. The earlier you treat it the better.

Cover the top of the head.
Do not rub or massage extremities (in case of frostbite).
Heat packs on armpits, chest, groin and neck.
Insulate from below and above, starting from the ground up.
Increase heat production, i.e., exercise.
Remove causes, e.g., block the wind, remove wet layers.
Warm, non-alcoholic and non-caffeinated liquid (only if the patient is capable).
Immersion heating (e.g., a warm bath), only if in a controlled environment. The possibility of after-chill may make it worse. immediately

Notes:

Only exercise after eating sufficient food and fluid, and when mental status has improved.
Re-warming a patient with skin-to-skin contact inside a sleeping bag (or similar) is a survival technique but may cause the body-temperatures of all involved to drop.

Minor Musculoskeletal Injuries

Sprains

A sprain is when a ligament (the fibrous tissue that connects one bone to another) is over-stretched due to the forcing of a joint beyond its normal range of motion.

A twisted ankle is a common sprain.

Symptoms of Sprains

Bruising.
Pain.
Swelling.

Treatment for Sprains

Most sprains will heal over time. Severe knee sprains may require surgery.
RICES
Anti-inflammatory.

RICES

RICES is an acronym for a common treatment of musculoskeletal injuries.

Rest. Do your best to cease using the limb.
Ice. Apply a cold compress (or similar) 4 times a day for twenty minutes during the first 48 hours of the injury occurring.
Compression. Apply a compression bandage after each cold therapy. Pad the area then wrap it starting below the joint and working your way up beyond it. The wrap should be as tight as possible without causing discomfort or impaired CSM
Elevation. Elevate the affected limb above the heart.
Stabilization. Depending on the seriousness of the injury, it may need a splint or cast.

Strains

Strains are when the muscle or its tendon (tissue that connects the muscle to connect to bone) is partially torn. Back muscles are most commonly strained.

Strains are common weight training injuries because of poor form.

Daily morning stretches and using correct lifting techniques will help prevent strains.

Correct Lifting Techniques

Don’t lift things whilst unbalanced.
Don’t reach for an object, i.e., hold it as close to your body as possible whilst lifting.
Don’t twist while lifting. Lift with your legs and a straight back.
If carrying a pack, keep the weight on your hips as opposed to your shoulders.

Treatment for Strains

Mild massage.
Anti-inflammatory.
Muscle relaxer.
Ginger and raw honey tea.
Salicin poultice.

Taping Injuries for Sports

Taping is good for immobilizing whilst healing and for preventing injuries, e.g., during sporting activities.

If taping around a whole body part (circumferential wrapping), e.g., for anchors, ensure swelling does not impair CSM, i.e., it is best to tape after swelling has gone down.

Here are some sports injury taping tips:

Anchor points are those to which tape can stick.
Avoid leaving gaps as they can lead to blisters.
You can use duct tape in emergencies, but it does not ventilate.
Ensure your skin is dry.
Follow the contour of the skin.
Keep your limb in a neutral position.
Overlap a half-width on each strip.

Ankle Taping

Taping an ankle

Taping a Wrist Injury

Taping a wrist

Broken Nose Recovery

A broken nose is a fracture of the nose caused by some form of trauma, such as a punch. It is one of the more common MMA training injuries.

Broken Nose Symptoms

Difficulty breathing through the nose.
Pain, especially when applying pressure.
Possible deformity.

Minor Broken Nose Treatment

Use both hands to straighten the cartilage.
Consider taping into position.
Place some ice wrapped in a cloth over the nose, for periods of 20 minutes throughout the day; do this for 48 hours.
Nasal decongestant may help with swelling in the nasal passages.

Cuts and Bruises Treatment

This last set of training injuries are usually minor and also the most common.

Bruises

A bruise occurs from some kind of trauma which ruptures the blood vessels. They are a little painful to the touch and may change color from blackish-blue to brown to yellow.

How to Get Rid of Bruises

RICES
In later stages, stretching may help.

Cuts and Scrapes Treatment (Open Wounds)

An open wound is anything that breaks the skin, e.g., cuts, scrapes, abrasions, punctures.

Basic Treatment for Open Wounds

Control bleeding with well-aimed, direct pressure.
Clean.
Cover with a sterile dressing. Immobilize high-risk wounds if possible.
Change the bandage and clean the wound regularly.
Monitor for infection and treat as needed.

Blisters

A blister is a protective pocket of clear fluid (plasma) underneath the layers of the skin. If filled with blood they are blood blisters, and if they become infected, they will fill with puss.

Cold, exposure to chemicals, friction, heat etc. are all causes of blisters.

The most common, troublesome blisters are those found on the feet caused by friction and heat whilst hiking or engaging in similar activities.

Before a blister forms, the area will often get red and painful. This is a hot spot. Treat it before it becomes a blister.

Treatment for Hot Spots

You can cover a hot spot, e.g., Band-Aid.
Ideally, raise the area around it and then cover it

Blisters Treatment

In controlled environments, leave the blister intact. The skin will keep it protected from infection.
Pad it like a hotspot.
If the blister may rupture, it is often better to drain it so you can clean and dress it.

Draining a Blister

Clean the area around blister.
Sterilize a needle and pierce the side of the blister.
Let the fluid drain.
Apply antibiotic ointment.
Cover and monitor.

Preventing of Friction Blisters

Proper footwear.
Sock liners.
Cover blister-prone areas with Fixamol, a Band-Aid, etc.
Change wet/sweaty socks.
Foot powders to keep feet dry.

Nose Bleeding First Aid

The common nosebleed (epistaxis) is a hemorrhage caused by dry air, excessive picking, hypertension, irritation, trauma, underlying illness, upper respiratory infection, etc.

A blood nose is one of the most common boxing training injuries.

Treatment for a Nosebleed

Breathe through the mouth.
Do not swallow blood; spit it out instead.
Sit upright with head tipped slightly forward.
Ice pack to bleeding side of nose.
Pinch nostrils and push towards the face for 10 to 15 minutes.
If after 15 minutes the nose is still bleeding, repeat the pressure for another 10 to 15 minutes.
If still bleeding, flush with sterile saline, and then insert a thin strip of cloth drenched in epinephrine. Do not remove the packing for several hours.

Training Through Injuries

Training injured is possible, but extra care is needed. Here are some tips for training with injuries.

Training on injuries will only make things worse if you don’t rest the injured body part, but that doesn’t mean you have to stop training altogether. With a little extra care and creativity you can work around the injury.

General Tips for Training When Injured

Seek professional advise. They will tell you when you can resume exercise and the best way to do so.
Test all movements. And by all I mean ALL movements. It may surprise you at what movements will aggravate your injury. Test slowly and without resistance of every action you plan to do. Check range of motion, pushing, pulling, etc. If you feel any pain, stop doing that movement.
Rest. Rest the injured part and yourself as a whole. Get plenty of sleep.
Eat well. Lots of vitamin-rich foods.
Keep positive. Getting an injury will slow you down, but you can still train. Keep a positive mindset and find work-arounds.

Training Tips for Specific Injuries

Lower back Injury Recovery

Training for back injuries needs special attention as there are different types. Consult your physician before trying anything.

As a general rule, avoid any exercise that will put pressure on your back and stick to bodyweight exercises.

Low impact activities such as swimming and walking should be fine.

Wrist Injury

Wrist injuries are easy to work around. Avoid anything that puts too much strain on your wrists, e.g., push-ups.

Unless you have a major injury (like a broken wrist), athletic training with hand injuries such as running should be fine.

So are most other lower body exercises.

Elbow Injury Recovery

An elbow injury will hinder you from doing most upper body exercises. Lower body exercises will be fine. Abdominal crunches, lunges, sprints, etc.

Shoulder Injury Recovery

Be very careful with joint injuries such as shoulders and hips. Start easy and stop as soon as you feel pain.

Athletic training for shoulder injuries, like other upper body injuries, will confine you to lower body work.

Ankle Injury Recovery

An ankle injury means no jumping or other high impact movements. Also avoid anything that directly uses the ankle, e.g., heel raises and squats.

Non weight-bearing cardio and upper body strength training will be fine, e.g., swimming, crunches, and pull ups.

Kneecap Injury Recovery

A knee injury training program means avoiding high-impact movements. This rules out most team sports, running, parkour, etc.

Boxing drills are possible but you must be careful. Kicking is out of the question.

The biggest issue when training after knee injuries is that it rules out most cardio exercises. Training an injured knee confines to upper body strength activities while you heal. Ab work, decline pushups, planks, and pull-ups are good ones.

Common Exercise Injuries Conclusion

Physical training and injuries come hand-in-hand, and anyone that trains regularly will get injured every once in a while.

Minimize the chances of training exercise injuries with prevention methods such as warming up and stretching.

When you have an injury, rest the injured body part and your body as a whole.

Training around injuries is possible. Just choose your exercises carefully and test every movement you plan to do. Be sure to consult a physician for guidance.

Don’t try to “train through” your injury. It will only make recovery time longer and may cause permanent damage that wouldn't occur otherwise.

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