Secrets To Treating Martial Arts Injuries

By Mark A. Caselli, DPM, and Edward C. Rzonca, DPM

A Guide To Treating Fractures

   As a result of blunt force trauma, the martial arts student may suffer a fracture, a contusion or a laceration. Fractures require early diagnosis and immobilization to expedite healing. The most common foot fractures occur as spiral oblique injuries of either the digits or the metatarsals. They are usually the result of the torsion generated by the impact of the moving foot hitting a fixed object such as an opponent.    If one suspects a fracture, do not allow the athlete to continue the competition. Further trauma from competition can convert a simple non-displaced fracture into a displaced, comminuted fracture or even a compound fracture.    If a martial arts athlete sustains an acute injury, instruct him or her not to move from the fallen position on the mat. It usually takes at least a few minutes until the initial shock of the injury wears off before even a cursory examination has any real value in determining the extent of the injury. If one suspects a fracture, immobilize the injured part or at least move the athlete without moving the injured area. Apply ice and elevate the limb after achieving initial immobilization.    Do not permit athletes to resume any martial arts activity that may subject them to blunt force trauma until the fracture is completely healed, which is usually eight weeks. The athlete should engage in appropriate exercises to maintain strength and flexibility during the bone healing process.

Addressing Common Contusions

   Contusions, which are usually less severe than fractures, are a common result of sparring or board breaking. While sparring, the student wears a chest protector, a helmet and a mouth guard as well as pads on the arm, hand, foot and lower leg. During sparring, one must perform each kick and punch in a fraction of a second to be effective. From a tactical standpoint, when students see an opening in the opponent’s defense, they will usually execute three to four moves sequentially to further reduce the opponent’s defenses. However, the opponent will also counter the attack. Both participants are vulnerable when each is trying to anticipate the other’s move.    Advancing opponents often cut short well-intentioned kicks, which land in an unintended area. A kick meant for the opponent’s torso might land on a non-padded upper thigh area, resulting in a thigh contusion. Any non-padded area such as the thigh or knees can now be a vulnerable target. Accordingly, the common areas to receive contusions are:    • the lateral aspect of the foot when one performs a sidekick (driving the lateral portion of the foot into the board);    • the plantar metatarsal heads when one performs a forward snap kick (kicking the plantar forefoot forward and upward); and    • the plantar calcaneus when one performs a turn kick.    If the student misses the center of the board or does not deliver enough force with the kick, the end result will be pain. If the error is large enough, the martial artist will have a significant contusion or fracture. Contusion injuries may have symptoms for up to six weeks although one can usually recommend an early return to martial arts activities.

How To Handle Nail Bed Lacerations

   Lacerations need immediate attention in order to stop any bleeding and assess the level of severity. A common laceration is the result of the nail plate impacting the distal tuft of the digit. Another laceration is the result of the nail plate being forcibly lifted off the nail bed.    Both of these lacerations commonly occur when athletes kick the sparring bag or while they are sparring. While these lacerations usually do not result in any permanent disability, both these injuries are very painful and require podiatric intervention to excise the damaged nail plate. The athlete must also learn to dress the involved toe and apply protective padding to the toe to promote both healing and the ability to resume martial arts activities.

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