定義：
急激に骨格筋が収縮した結果、筋膜や筋繊維の一部が損傷すること。（完全に断裂する禁断列、直接的な外力による打撲とは異なる）
Case：
100mダッシュの走り込みの際、3本目のスタート直後に発症。
患部：
ハムストリングス上部。解剖学の言葉ではsemitendinosusを負傷。
原因：
リサーチによると主に３つの理由に分けられる。1:神経の二重支配（大腿二頭筋の長頭-脛骨神経、短頭-腓骨神経）なので屈曲時にずれが生じやすい。2:二関節（股関節と膝関節）に作用する。3:とても大きな力を出すので疲労しやすい。つまり地面を蹴るなどの強い力を生み出す一方、負荷がとてもかかる構造になっている。自分が怪我した時はちょうどトップスピードに乗る手前、つまり加速段階で体が耐えられなかった（アップは30分以上かけて行ったが、疲れが溜まっていた）
症状：
症状により３段階に分けられる。
１.軽度：筋肉自体や筋周膜にはほとんど変化はなく、筋線維束が引き伸ばされた程度のもの。局所の圧痛のみの事が多い。全治１、２週間
２.中度：筋周膜の断裂、ごく一部の筋線維の断裂があるが、圧痛だけでなく軽い陥凹や軽い運動痛もある。陳旧例では瘢痕、癒着は比較的軽症なもの。全治３から６週間<ちなみに自分はコレにあてはまる
３.重傷：筋周膜の断裂はもちろん筋自体にも部分断裂があり、圧痛、局所陥凹、運動痛も著しい。陳旧例では瘢痕、癒着が高度のもの。リハビリに約３ヶ月。
重度の肉離れは競技中にはまずあり得ない話。教科書には載っているけど、実際は交通事故とかで起こる筋肉断裂。自分の場合は中度でした。「ブチッ」という音が聞こえて歩けない程でした。
応急処置:
PRICE処置（P：protection保護 R：rest安静、I：icing氷冷、C：compression圧迫、E：elevation挙上）受傷後なるべく早く（数分以内）開始する。時間がかかるほど、効果は低くなる。
理由として二次的低酸素症（secondary hypoxic injury)：一次的外傷性損傷の周辺組織に十分な酸素を供給できない結果として発生する。損傷部から末梢にある壊れた血管では血流が停止し、炎症性のうっ血と泥血のため、その部分にある他の血流が減少する。結果として起こる酸素不足は、最終的に細胞の浮腫、破壊、アシドーシス、そしてライソソームによる消化をもたらすことになる。細胞膜の崩壊とライソソームから細胞内への酵素の放出は、細胞の壊死につながる。そこで生じる細胞片は、血腫に加えられる。従って、損傷を受けた組織の総量は増加する。なので二次的低酸素症を防ぐ為にPRICE処置を速やかに行う必要がある。
自分で見積もった全治3週間を1週間（スパーリングを休んだ期間）に抑えたレビュー＞
アイスマッサージ：
これはアスレチックトレーナーの友人にアドバイスされました。患部が明らかに分かっていて怪我の範囲が狭い場合はアイシング（いわゆるアイスパックを巻いて固定）ではなくアイスマッサージの方が効果的だということ。確かにそうでした。局部がしっかり芯まで冷えて炎症を抑える効果がありました。やり方＞小さめの紙コップに水を入れて冷凍庫に入れる＞紙を破って氷の部分を患部に当ててマッサージ＞氷が全部溶けるまでマッサージし続ける。ずーっと同じ部分に当てないので凍傷にならなくてすむ。
鍼灸：
受傷部周囲筋に刺針し、受傷ショックで短縮した筋の緊張緩和を図る。ここでの鍼灸の治療の目的は筋の伸縮力の改善であって、障害筋全体に刺針施灸して、血行促進を図る。先生曰く、怪我してから早ければ早い程いいみたいです。幸いボストンに日本人の先生がいて、怪我した当日みてきただきました。
鎮痛剤：
鎮痛剤にもいろいろ種類があって、痛みだけを抑える薬もあれば、痛みを抑えて炎症も抑える効果がある薬もある。アスレチックトレーナー曰く、最初の2、3日つまり回復期の間は鎮痛作用だけ（例、タイレノール）でアイシングに徹し、その後に炎症を抑える効果のある鎮痛剤に変えるのがいいのだそうです。一回400mg（2粒）を限度に一日二回が定められた分量ですが600mg（３粒）を一日３回つまり1800mg摂取してました。薬漬けにしても試合までに間に合いたかった...
ウルトラサウンド療法：
今回のMVPですね。これは整形外科や整体の治療院に置いてある超音波装置です。今回これのポータブルバージョンをアメリカのアマゾンで購入（さすがアメリカ何でも手に入る...）安いやつで5000円くらいでした。市販のはだいたい１、３、５、メガヘルツの３つでハムストリングスなので１メガヘルツを購入。３、５は肘やヒザなどの関節や骨を対象とした強さです。ヘルプ必要なアスリート、連絡下さい。アメリカから送ります。きっと同じ様な悩みを持つ同志がいるでしょう...
キネシオテープ：
超音波で温めてアップ、ストレッチ後に付けて患部の保護と筋肉の動きをサポート。教科書通りのY字に貼ってサポートしました。
サポーター：
医者やATによっては治療のための圧迫を良しとしない方がいます。血流が悪くなる事によってアシドーシスからの回復が遅れるという理由から。自分の場合は練習時のみ保護と圧迫により保温効果と踏ん張りがききました。案外バランス保持やテイクダウンの防御とかに使われているんだなと実感しました。
奇跡的に発症してから1週間後に打撃のスパーリングに参加できました。その後も入念なストレッチ、運動後のアイスマッサージ、運動前のウルトラサウンド（コレが本当に効果アリ。患部がとても温まった）そしてキネシオを貼って練習開始という流れだった。
特に受傷後3日間は歩くのにも痛みを感じで正直終わった... と思っていた。レッドソックスのオルティスが怪我の治療に使って有名なPRP注射も考えたが日本帰国直前の忙しいスケジュールと保険でカバーされないコスト面で踏み切れなかった。もし痛みが続くようなら日本でPRP注射を探そうとすら考えていました。
※PRP療法は血小板が持ってる自然治癒を施す事。高濃度の血小板を注射して怪我の治りを早くする。臨床実験を経て美容でも使われてます。
キネシオテープで可動域を制限したり、怪我で弱くなった部分を補ってくれたくれたので、実践的な練習も出来ました。
最後に必要な備品や治療費を惜しみなく使えたのは8月のワールドチャレンンジャーズでいただいた協賛金と協賛サポートして下さった皆様のおかげです。
アスリートに怪我は付き物です。でも予防は治療に勝る！今回の経験を生かしてオーバーワークやつまらない怪我の防止に努めます。試合後のオフである現在、自分がするべき事は怪我したハムストレングスの強化と柔軟性の向上。リハビリではないけど次に繋げるトレーニングを中心にワークアウトします。
この怪我レビューが皆さんのお役に立てたら幸いです。
って、やっべーもうこんな時間。寝なきゃzzz
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Well, let me confess my pre fight situation. I actually had strained hamstrings 4 weeks before the fight. I was so embarrassed and mentally got worried, like "am I really fighting?" I know some of my blog readers are athletes and MMA fighters, so I would love to share my experience with you guys. Hope you like my injury review.
Definition:
A strain is an injury to a muscle or tendon in which the muscle fibers tear as a result of overstretching. A strain is also colloquially known as a pulled muscle. The equivalent injury to a ligament is a sprain
Case:
I heard "popping" sound at 3rd rep of 100 yards sprint. It was 5th or 6th step right after I started.
Part:
Upper hamstrings. In anatomical word, "semitendinosus"
Cause :
The role of the hamstring muscles is to bend (flex) the knee and to move the thigh backwards at the hip (extend the hip). Understanding how the hamstrings work give vital clues as to their modes of injury. Mild to severe hamstring strains are extremely common in sprinters and hurdle jumpers and in all sports that involve sprinting activities, such as football and rugby. During sprinting the hamstring muscles work extremely hard to decelerate the tibia (shin bone) as it swings out. It is in this phase just before the foot strikes the ground that the hamstrings, become injured as the muscles are maximally activated and are approaching their maximum length.
Severity:
Grade1:
There is damage to individual muscle fibres (less than 5% of fibres). This is a mild strain which requires 2 to 3 weeks rest.
Grade2:
There is more extensive damage, with more muscle fibres involved, but the muscle is not completely ruptured. The rest period required is usually between 3 and 6 weeks. < As long as I diagnosed myself, my case is this one.
Grade3:
This is a complete rupture of a muscle. In a sports person this will usually require surgery to repair the muscle. The rehabilitation time is around 3 months.
The first-line treatment for a muscular strain in the acute phrase include five steps commonly known as P.R.I.C.E
• Protection: Apply soft padding to minimize impact with objects.
• Rest: Rest is necessary to accelerate healing and reduce the potential for reinjury.
• Ice: Apply ice to reduce swelling by reducing blood flow to the injury site. Never ice for more than 20 minutes at a time.
• Compression: Wrap the strained area to reduce swelling with an ACE soft-wrapped bandage.
• Elevation: Keep the strained area as close to the level of the heart as is conveniently possible to keep blood from pooling in the injured area.
When tissue is injured (surgically or otherwise), the oxygen supply to the tissue is reduced, while the oxygen needs of the tissue increase. The ensuing oxygen deficit causes secondary hypoxic injury, or additional tissue injury, tissue death, and swelling. Proper treatment reduces the metabolic needs of the injured tissue, thereby reducing the secondary hypoxic injury, and accelerating the wound healing process.
I would like to share how I treated myself and how I made sparring after one week rest>
Ice Massage:
Icing injuries can be one of the most important immediate treatment steps for strained muscle. Applying ice to a soft tissue injury can help reduce swelling and inflammation by reducing blood flow to the injured area. Ice also provides temporary pain relief after an acute or traumatic injury. In order to get the best result, it's important to ice the injury during the 48 hours after the injury, before the swelling becomes advanced. Ice therapy that reduces the temperature of the injured tissues by 10 to 15 degrees for short, repeated periods of time also appear to have the best results. I strongly recommend applying ice massage more than icing compression if you know where the injury is. I strongly felt that my deep tissue and injured part got iced very well.
Acupuncture:
acupuncture works by strategically placing needles on pressure points to regulate blood flow to trouble spots via major pathways in the body, thus resulting in relaxed muscles with less swelling, tension and pain. Each needle is connected to an Electrostem valve to deliver currents from one point to another, which increases oxygen flow and delivers white blood cells to the injury. Fortunately, there are some Japanese acupuncturists in Boston area and that was right decision that I went to see him at the day of injury.
Anti-inflammation:
Acetominophen is useful for relieving mild forms of arthritis, headaches and general aches and pains. While it does not relieve redness, swelling or stiffness related to inflammation, it is well tolerated and rarely causes stomach problems. It is the pain relief medication of choice that can be used safely in pregnancy and breastfeeding. The main caution to take when using acetominophen is that it can lead to liver damage if taken in high doses or if taken in high doses (>4grams) for long period of time (>10days). Acetominophen is metabolized through the liver, so if you have an underlying liver condition such as hepatitis or alcohol-related damage - it is important to limit the amount taken. If this is the case, discuss with your doctor or pharmacist to adjust the dose safely.
Ibuprofen is a non-steroidal anti-inflammatory medication that is effective at decreasing inflammation from acute injuries such as strained muscles and joints. It is also very effective for menstrual cramps, headaches and arthritis pain. Caution should be taken when using Ibuprofen because it can affect platelet function (responsible for clotting) which can prolong bleeding time. For this reason, if you have had an injury which causes bleeding, you are taking medication that can thin the blood (e.g. Warfarin, Plavix), or if you are over 60 (higher risk of bleeding) - it would be prudent to use caution with ibuprofen. Ibuprofen can affect the lining of the stomach causing gastrointestinal upset and it can increase blood pressure, so if you suffer from heartburn, stomach ulcers or high blood pressure - use caution and discuss with your doctor to safely adjust dosing.
Choosing between Acetominophen and Ibuprofen is ultimately dependent upon your personal preference but consider your health risks, the potential side effects of each and what symptoms you are trying to relieve.Ultrasound therapy is performed by using an ultrasound machine that generates sound waves to the location of the injury. A gel is applied to the affected skin area. A probe from the ultrasound machine is then gently rubbed on the skin in circular motions, producing sound waves that penetrate muscle tissues. The sound waves create a gentle heat and stimulate healing in damaged muscles.
Ultrasound:
Ultrasound therapy is performed by using an ultrasound machine that generates sound waves to the location of the injuries. A gel is applied to the affected skin area. a Probe from the ultrasound machine is then gently rubbed on the skin in circular motions, producing sound waves that penetrate muscle tissues. The sound waves create a gentle heat and stimulate healing in damaged muscles. I really felt that this machine worked very well. I used this one as pre worm up session and made my hamstring very warm.
Kinesio-Tape:
There is little scientific evidence that elastic therapeutic taping produces clinically significant benefits. A 2012 systematic review found that the efficacy of elastic therapeutic tape in pain relief was trivial given that no studies found clinically important results. The tape "may have a small beneficial role in improving strength, range of motion in certain injured cohorts and force sense error compared with other elastic tapes, but further studies are needed to confirm these findings". Actually, this tape is originally from Japan. I used tape for stability and protection. I couldn't make it without those.
Thigh-Supporter:
I used thigh supporter for not compression, but protection. Some doctors and Athletic trainers say those who got injured should not compress right after you got. I mostly used it when I train because it keeps me warm and help stability well.
I can't believe that I come back to sparring after 1 week rest. I couldn't even walk first 3 days. Needless to say, I was so nervous and worried about fight coming up. However, I did whatever I could do and made it thorough.
I don't know how much this review helps you guys, but I would love to help other athletes who experience same situation I was.
Lastly, I really appreciate those who supported me financially. Those equipment and treatment fee were covered by sponsors. Without them, I couldn't even fight. My next job is still protecting my injured part, strengthen them, and work on flexibility for next hard training.
Such a long blog....gotta go to bed now! zzz