LOOK AFTER YOURSELF!!!

It is your job to keep your body healthy…

Only by looking after yourself you can achieve happiness!

WHAT KIND OF BENEFITS CAPOEIRA BRINGS TO YOU?

The art of capoeira will bring to you health, happiness and fitness, in a personal level capoeira will build your confidence within each lesson, will give the right balance between mind and body, you will learn and increase your musicality and rhythm. Fatigue comes mainly through regular training, but there is an immediate boost to your daily energy levels, your stamina will improve very quickly and stress levels will reduce rapidly.

In a more physical way you will do a full body work out, including muscles that you never used before, you will increase agility and intense cardio work out. Capoeira also works as part of a social integration between people of different background, giving you the chance to meet so many different people and become a part of a big community that grows day by day.

Mestre Casquinha

“Be patient with yourself only like that you will be able to overcome your injury and enjoy the art of capoeira”

 Casquinha capoeira

Capoeira is very physically demanding and joint injuries can be the price a Capoeirista pays for not meeting those demands. The lack of training or physical abilities can also be a huge obstacle which prevents a Capoeirista from learning new moves or strengthening the old ones. Cross training is crucial in providing a well rounded program. This will not only help to improve your overall fitness level, but most importantly your game. 

A good Capoeirista understands the importance of incorporating a good fitness regimen to help overcome his/her physical limitations. It is not only about training Capoeira several times a week. Repetitive movements lead to increased risks of injuries if you neglect your muscle imbalances, flexibility, core strength and endurance. At a certain point, our technique and ability in the roda is dictated as much by our bodies as it is our training.

Remember, no one was born an expert. It takes a lot of hard work and dedication to overcome our weaknesses. 

In summary, all the Capoeira training will put you at risk of injury at one point or another. It's impossible to avoid all sprains, strains, knee injuries, groin pulls, fractures and dislocations, but you can certainly reduce your chances! Evaluate your weaknesses and craft a manageable routine to help maintain optimal level of fitness. Work on proper techniques to make sure you are not placing unnecessary stress on your joints. Increase your flexibility on your inflexible areas to prevent future injuries. Always make sure you warm-up properly to loosen up tight muscles to prevent ligament or muscle tears.  Be aware of your physical limitations so you don't overdo it! Give your body rest so you don't over train!

In the case you do sustain an injury, seek prompt and proper treatment to promote rapid healing. Consult with a physical therapist or physician if you are not sure what to do. It's better to be safe than sorry!

Most importantly of all, become a better Capoeirista by being a knowledgeable one!

SORE JOINTS

if you train frequently enough, you may experience some soreness or pain in your joints. It's essential to take the proper steps before, during and after training to reduce the chance of getting sore or pained joints.

Warm-up/Stretching extremely important to help loosen up muscles and joints in your body to make it easier and safer to train

Correct Technique the key is proper form so you don't hurt yourself! If it hurts, you're doing something wrong. How your shift your weight makes a huge impact on how a move can affect you!

Rest Listen to your body! You body needs time to recover and over-training may need to injury. You can benefit from a good day of rest and will come back even stronger!

Perform Alternate Movements If the soreness or pain is really noticeable, stop doing the same movements. Try to work on other techniques to give that part of your body a chance to rest and recover. Continuing to strain it will only make the situation worse.

Joint Supplements I'm not a doctor but glucosamine supplements may help. This is normally used by people with arthritis to rebuild joint tissue. Check with your doctor first!

Icing joints Using ice or cold packs on sore or pained joints works really well. The ice reduces any swelling or inflammation in the area and decreases pain.

Hot Water Soak Taking a hot bath, going to the sauna or steam room is a good way to relax the sore area and reduce stiffness and pain.

OTHER INJURIES

Other common issues that may affect your training can be wrist sprains or tendinitis, groin pulls, weak rotatory cuff and a weak core.  Are you cross training to balance your workouts? Are you working on your flexibility aside from the days you are training Capoeira? What exercises are you doing to strengthen your weak areas? There are always ways to improve you training and to prevent further injuries.

WRIST TENDINITIS / SPRAINS

Wrist tendinitis is a common condition characterized by irritation and inflammation of the tendons around the wrist joint.  The tendon can be injured as a result of repetitive use, overuse, hyper-flexion, poor technique or weak wrists. Wrist sprain (injury to the ligament) can occur when you slip and break your fall with your hand - as I did when I was practicing my handstand years ago. This can stretch the ligaments that connect the wrist and hand bones a little too far. The result is tiny tears or a complete break to the ligament! This will limit your ability to perform au, bananeira, queda de rins and any weight bearing activities.

Signs and symptoms of a sprain may vary in intensity depending on the degree of the injury. You may experience swelling or tenderness in the wrist, bruising or discoloration of the skin, a pop or tear inside the wrist, a warm feverish feeling to the skin or persistent pain when the wrist is moved.

Severe sprains may require surgery to repair the fully torn ligament. This would be followed by a period of rehabilitation and exercises to strengthen the wrist and restore motion. A wrist sprain can take anywhere from 2 to 10 weeks to heal completely, depending on the severity of the sprain.

TREATMENT

Immobilize the Wrist The first treatment step is to place the wrist in a splint or a cast. Resting the tendon should help decrease inflammation.

Ice the Injury Ice is one of the most effective methods of reducing inflammation and swelling and promotes blood flow to the area. You should warp an ice pack in a towel and apply to the affected area sporadically throughout the day. Mild wrist sprain can be treated with the RICE protocol while moderate sprains may need to be immobilized with a wrist splint for 7 to 10 days.

Anti-Inflammatory Medications A pain reliever such as aspirin or ibuprofen may be helpful in the treatment of wrist tendinitis by decreasing swelling and inflammation of the soft tissues and symptoms of pain. If the pain and swelling persists more than 48 hours, you should probably see the doctor.

Natural Treatments / Acupuncture There are a number of vitamins and minerals which may ease pain and inflammation. Vitamins such as Calcium/Magnesium, Vitamin C and E can increase the body's resistance to developing tendinitis. Massage and ultrasound treatments can help encouraging blood flow and diminish numbness. However, acupuncture is the most successful method of treatment for tendinitis in the wrist.

Acupuncture needles are inserted at or near the pain source, along with other core chi points, such as the liver (significant for blood circulation), the stomach, neck, head or ankles. The treatment takes about 15 minutes. Between three and twelve treatments are often recommended over a period of a week or month. Acupuncture improves circulation, strengthens tendons and reduces swelling, thus lessening or curing pain.

GROIN STRAINS/ GROIN PULLS

the groin muscles (adductor muscle group) which run from the front of the hip bone to the inside of the thigh are the muscles which bring your legs together and stabilize the hip joint. A groin pull is an injury to the adductor muscles called a muscle strain. When a muscle is strained, it is stretched too far.

There are different grades of groin strain:

Grade I  -  mild discomfort and usually does not limit activity.

Grade II - moderate discomfort, can limit ability to run and jump, swelling and bruising may be apparent

Grade III - severe injury which can cause pain when walking and can be accompanied by swelling and bruising, muscle fibers may be torn.

TREATMENT AND PREVENTION

R.I.C.E Rest, Ice, Compression and Elevate. It is important to rest following the injury to allow the muscle to heal. Any activities that cause symptoms should be avoided. Apply ice to the injured area the first 48 hours after injury and after activities. Ice will help stimulate blood flow and bring down the inflammation.

Anti-Inflammatory Medications Anti-inflammatory medications can help reduce swelling and alleviate painful symptoms. These medications do have potential side effects, and you should check with your doctor prior to starting anti-inflammatory medications.

Gentle Stretching Stretching is helpful, but should not be painful. Excessive stretching can be harmful and slow down the healing process. Muscles that are stronger and more flexible are less likely to be injured. Once the injury has healed, you should focus on increasing the flexibility of the adductors (inner thighs).

Strengthening After injuring the muscle, it is important to regain strength before returning to athletic activities. Both the injury itself and the rest period following the injury can reduce the strength of the muscle. Stronger muscles are less likely to sustain a re-injury. Of main focus should be the adductor and abductor muscles, pelvic stabilization and core stability.

Strengthening these muscles which help control the movement of the hips and pelvis should prevent future groin pulls from occurring.

Heat application Gentle heating with a heating pack or pad can be used before activities to help loosen the muscles and relax the injured area. Heat treatment is best for chronic conditions while ice is best for acute conditions (first 48 hours). As a general rule of thumb, remember to heat before and ice after

Physical Therapy Physical therapists can be helpful in guiding treatment that may speed your recovery. Some people find modalities such as ultrasound, therapeutic massage, and specific exercises particularly helpful. You should see your physician to determine if these would be appropriate for your condition.

What's in a Knee?

To understand knee injuries, first you have to understand the knee. The knee is a joint, which means it sits between the area where bones connect. It's actually the largest joint in the body. Your knees provide stability and flexibility for your body and allow your legs to bend, swivel, and straighten.

The knee is made up of several body parts like bones, cartilage, muscles, ligaments, and tendons, all working as one. So when we talk about a knee injury, it could be stress or damage to any of these parts.

Injuries to the knee can be one of the most frustrating hurdles to deal with in Capoeira training.  From the severe disability caused by an acute injury, to the gnawing, dull pain of a long-standing knee problem, knee injuries are notorious for bringing your training regimen to a grinding halt.  The focus of this month's article will be to discuss some of the common acute and chronic injuries to the knee that can occur in Capoeira.

Knee injuries are a huge topic.  I have chosen to focus on just a few that I believe are most relevant to the Capoeirista.  After a brief primer on knee anatomy, the first part of this discussion will focus on acute knee injuries, with special attention paid to those injuries that should prompt you to seek immediate medical attention. In these cases, long-term functional outcome is dependent on actions taken immediately after the injury. We'll also talk about some injuries you may see during a roda, and how your eyewitness account of the injury mechanism can help guide appropriate treatment.  The second part of this article will focus on chronic injuries as well as acute injuries that lead to sub acute problems, such as the notorious ACL tear.  I'll also discuss some basic treatment and stabilization methods, as well as when to seek medical care.

Basics of Knee Anatomy

The knee is a complex joint involving several bones, ligaments, and tendons with muscular attachments that provide strength and stability to the joint.  The femur (thigh bone) connects to the tibia (shin bone) which receives some additional support from the fibula (smaller lower leg bone).  A complex organization of ligaments on either side of the knee joint (the lateral and medial collateral ligaments) and internal to the joint (the anterior and posterior cruciate ligaments) help to stabilize the knee through its range of motion.  There are also cartilage cushion pads that sit atop the tibia, called the medial meniscus and lateral meniscus, that smoother movement of the joint.  The above figure details the anatomy of the bones and ligaments of the knee.  Not pictured in this figure is the patella, commonly referred to as the kneecap, which sits atop the joint. The patella is the bony connection between the quadriceps tendon (the connection point to the strong thigh muscles) and the patellar ligament, which attaches to the tibia.  These muscular attachments are shown in figure below.

The basic function of the knee is as a hinge, allowing flexion and extension of the lower leg.  However, as the knee flexes, the surrounding ligaments relax, which also allows some rotary motion. Direct and indirect forces applied to the knee while these ligaments are relaxed are the prime-time for injuries to occur. You know how your Mestre is always telling you to straighten your leg when you kick your meia lua de compasso? Well, it's not just for form and style-it's also for protection of your knee from injuries during a fast-paced roda. Kicking in a semi-flexed position makes your knee more vulnerable.

Acute Knee Injuries: Initial Treatment

As I've stated in previous articles, the immediate treatment of any acute muscular, joint, or skeletal injury is the same. We are so used to giving out this advice where I work in the Emergency Department, that we have adopted the mnemonic "RICE" therapy. 

Rest:  Do whatever you can to keep pressure off the injury.  For lower extremity injuries, you can use crutches, which can be purchased or rented at local pharmacies or medical supply stores.  This will prevent continued, recurrent trauma to the injured joint.Ice: Get an ice pack, and apply it to the injured area for 20 minutes every 1-2 hours for the first day. Continue using ice packs 3-4 times per day for the next two days. This will cause local blood vessels to constrict, thus decreasing swelling.Compression: Get an ACE wrap or other elastic bandage, and wrap the injured area. This will prevent movement of the area, which will decrease pain. This also decreases swelling.Elevation:  Keep the injured area elevated.  If possible, the goal should be to have an injured joint above the level of your heart when sitting or lying down.  This will decrease blood flow to the area and thus decrease swelling from any bleeding that may be occurring in the joint or muscle tissue.

Meanwhile, using a non-steroidal anti-inflammatory medication (NSAIDs), such as ibuprofen or naproxen, will decrease pain and also promote healing. Note that these medications are different than acetaminophen (Tylenol) and aspirin, which are also over-the-counter pain killers, but lack the anti-inflammatory effect.  I usually recommend ibuprofen at a dose of 600 mg (3 over-the-counter 200 mg tablets) for the average female (50-60 kg) or 800 mg (4 over-the-counter 200 mg tablets) for the average male (60-80 kg) every 8 hours around the clock for the first 2-3 days after an injury occurs. After this, they can be taken on an "as needed" basis.  These medications can be hard on the stomach, causing stomach inflammation and less commonly stomach ulcers.  Don't take these medicines until you've spoken to your doctor if you have a history of stomach problems. 

All of the above measures serve to decrease immediate swelling and inflammation, which will limit pain and help you get back in action sooner.

Subacute Knee Injuries 

That nagging knee problem can be one the most difficult to deal with in Capoeira. Though the pain may not prevent you from training, the apprehension you feel about turning a sort-of-stable injury into a more serious one can prevent you from putting 100% into your game.  In this second part of the article, we'll discuss some less acute injuries that may occur in Capoeira, how to treat them, and when to seek medical treatment.  Please note, this is not meant to be a comprehensive discussion of knee injuries-here I will focus on injuries I believe are most likely to afflict the Capoeirista.

Ligament Injuries

As discussed in part one of this article, there are a number of ligaments that provide stabilization to the knee. Though injuries to any of these ligaments alone and in combination may occur, there are some predictable patterns of injury based on mechanism that we often see and diagnose in the hospital.

The most common injury/mechanism pattern is a valgus stress on the knee.  The classic mechanism we think of is when an American football player gets clipped from the blind side across the knee joint.  In Capoeira, an aggressive forquilha (the movement when you enter under a meia lua, grab the person's ankle and block their knee to take them down) counter-attack to an opponent's meia lua de compasso would be a similar at-risk mechanism.  When this happens, the first injured ligament is the medial collateral ligament (MCL).  As the force increases, the anterior cruciate ligament (ACL) and medial meniscus will be torn as well.  These ligament structures are often referred to as the "unhappy triad" in medicine because they are so commonly injured together.  A varus stress is another common pathway to a ligament injury.  In Capoeira, a tesoura de frente is an at-risk movement, as it may cause a bowing of the knee inwards, tearing the lateral collateral ligament (LCL), followed by the ACL and the posterior cruciate ligament (PCL). 

It's important to note that direct, violent force by another person is not required to sustain one of these injuries. In fact, many ACL tears I have seen have been in patients who torque their knee suddenly with a planted foot while just warming up. It's well known that this injury mechanism may produce an ACL tear, and it's most common in young females-even healthy ones in great physical condition.

Think you may have torn an ACL? Here are some of the common features of the diagnosis.  If you hear a "pop" or "snap" in your knee at the time of injury, and if you develop a swollen knee within 2 hours of the injury (as opposed to 12 hours or more later-almost all knee injuries will get swollen later), there is a high likelihood that you do have an ACL injury.  Absence of pain does not mean you are in the clear; in fact, complete tears are not very painful, though partial ones will be.  Notably, weight-bearing does not rule out an ACL tear either.  Actually, three-quarters of people with ACL injuries can walk unassisted.  Thus, the diagnosis may be delayed by weeks or months.

If you suspect an ACL tear, or any other ligament injury of the knee, you should see a family physician, orthopedic surgeon, or sports medicine specialist to confirm the diagnosis. The physician will likely perform stress tests of the knee, which means he/she will push/pull your knee in different directions to determine where the instability lies, and what degree of instability is present.  Initial treatment for a partial tear may involve joint stabilization with a special device called a knee immobilizer.  If a more severe injury is diagnosed, you may need an operation to fix the ligament. 

Subacute Injuries: Iliotibial Band Syndrome

The repetitive flexion and extension of the knee required in every esquiva predisposes the Capoeirista to a problem known as iliotibial (IT) band syndrome.  The IT band is a strap of muscle fibers and connective tissue that passes along the lateral thigh and connects just past the knee, on the lateral tibia.  As the knee is flexed and extended, it can rub across the lateral part of the end of the femur, causing irritation (as shown in the above figure). Symptoms of IT band syndrome may include lateral knee pain that seems to travel up and down the side of the leg, and movements like esquiva na frente (stressing the front knee) or negativa (stressing the back knee) will tend to worsen symptoms.  Initial treatments include use of NSAIDs, ice, and stretching of the IT band.

Subacute Injuries: Patella-Femoral Syndrome

Finally, a reason for that deep, aching pain that you have in your knee that no one seems to be able to explain... When other more serious diagnoses have been ruled out by your doctor, but you find your knee is still hurting, ask your doctor to consider patella-femoral syndrome.  This condition, due to misalignment of the patella, occurs in young adults.  Pain usually localizes to the anterior or medial part of the knee.  Range of motion of the knee is normal, but strenuous exercise involving the knee will tend to worsen symptoms.  The diagnosis can be made through physical examination. Your physician can measure your Q angle, which determines patellar alignment. A patellar inhibition test is another physical exam finding used to make the diagnosis. 

Treatment of this condition involves strengthening of the quadriceps muscles.  Isometric exercises (muscle contraction without changes in length) are a good way to start. Try lying flat on your back, then lifting your leg off the ground in full extension.  Hold this position for 5 seconds.  Repeat 3 sets of 10, and perform these exercises 3 times daily. The same exercise should be performed with the knee semi-flexed. As these become easier, add isotonic exercises such as leg extensions against resistance to further build up the quadriceps tendon. 

Conclusion

I hope this discussion of knee injuries gives you some ideas about what to watch out for the next time you experience or witness an acute knee injury in the roda, and some ideas about what may be causing any chronic/recurrent knee pain you are experiencing.  As mentioned in the introduction, there are a large number of knee injuries which I did not cover in this article, so if you have a knee injury and feel like your symptoms don't quite fit any of the descriptions above, there may still be an injury that requires diagnosis and treatment.  It's always a good idea to make an appointment with your family doctor, a sports medicine specialist, or an orthopaedic surgeon to begin evaluation if you feel something is wrong.  Healthy knees are the foundation of a good ginga, so make sure to take care of them!

My disclaimer: without a hands-on exam of your injury by a qualified medical professional, such as a physician or nurse with orthopaedics training, you won't know exactly what's wrong, and the advice above may not apply to you.  If you have any questions, make an appointment to see your doctor.

A Warrior of Light needs patience and speed at the same time.

The two biggest mistakes of a strategy are

a: to act prematurely

b: to let the opportunity pass by.

To avoid making these mistakes, the warrior copes with each situation as if it was unique, and applies no formulas, prescriptions or the opinions of others.

Caliph Moauiy at asked Omar Ben Al-A as what was the secret of his great political skill:

“I have never gotten involved in any matter without first studying the way out;

“on the other hand, I have never become involved and wanted to get out right away,” was his answer.

Paulo Coelho

This are some research I did on capoeira injury, from the internet

(sites like Roda magazine.com and some books!