Taiobroshi wrote:So two weeks ago I was doing light newaza randori with a dan grade and after escaping a couple of attempts he caught me in a "belly-down" juji gatame. My hands were clasped and he cranked like hell and dropped his abdomen, then I heard my elbow pop twice while I yelled "tap tap!" Now every time I do a morote seoi nage or any kind of strong, slightly angled pull with my tsurite I have to stop to deal with the pain. I've also been waking up stiff. Usually I'm fine with injuries, but I graduate in 50 days and this is the last opportunity I'll get to travel on university's dime to big tournaments (Liberty Bell and Sr. National's). It's not fair that someone can visit a dojo and take away the next months worth of training and shiai, just to prove that he can armbar a 5'3" sankyu. Zero time to tap and even if I could I wouldn't have been able to tap his body so the unnecessary crank still would have gotten me regardless. What happened to taking care of your training partners?
I know complaining won't make my arm better, but I'm angry and upset so I thought I'd vent here since I know people can relate to the feeling of an injury holding you back. At least I don't have to make weight for a while. Other than RICE I don't know what else to do- any help in that department would be appreciated too.
Taiobroshi,
About 20 years ago I published a scholarly article entitled "The elbow joint of the judoka", which was about precisely these problems. I had reason to write this article as my own competitive career was significantly hampered by several severe elbow injuries. Unfortunately the article is not in English, and also, electronic publications started only in 1996. These problems were not well known among physicians due to unfamiliarity with the sport of judo. In order to optimally address certain injuries the mechanism that creates the injury is not without importance. Furthermore, in defining accurate rehab strategies, one needs to know to what kind of forces and movements the injured area will be subjected to.
There are certain things I can derive from your description, but there is other essential information which I can't. I would need to know if you were able to resist the armbar for some time, or if you were really caught off guard and the result was almost instantaneous instead. When a layperson describes a sound as "twice popped" it is insufficiently precise to determine what kind of structure it was that popped and exactly what kind of popping sound. I would need to hear it myself. However, in general jûji-gatame injuries affect the common insertion of the arm flexors. A number of muscles in the forearm, such as notably the palmaris longus, pronator teres unlike a muscle such as the biceps have no separate, nicely clear identified attachment or insertion on the bone. Instead, they merge at the location of insertion. That is also the reason that even when only one muscle is injured, its inflammation often spreads to the other, making the entire flexing movement problematic, which is what you experience.
If I would have heard the popping sound myself I might have been able to better determine where along the structure of your muscle the injury occurred. If it really was a consecutive "tchak-tchak-tchak" sound like how a big cable would snap then that would not be good at all, but usually, on a first injury it isn't that bad, because there is no scar tissue yet and thus the muscles still have a decent stretch factor. The popping sound in that case usually is a consequence of overstretching, with on a microscopic level a couple of fibers tearing. Particularly if you were forced to tap out while first substantially resisting the armbar, the consequence can be serious, because the injury is then of an eccentric nature; that means that your muscle is become longer as you are trying to make it shorter. After all your intent to flex your muscle and prevent the armbar is overcome by the greater force applied by your opponent thanks to the lever action he is applying. In this way forces are generated which exceed the integrity of the muscle and tendon itself. Because the muscle has a much higher elasticity than the tendon, in that case the injury will predominantly affect the tendon rather than the muscle. This is bad. In extreme cases the generated force may be so high that the tendon pulls its own attachment out of the bone. These injuries are extremely painful and take a long time to heal because tendons unlike muscles have poor blood circulation. Attempting to continue practicing judo at that point is stupid. Not only will it produce severe pain and hamper healing, but it will also stimulate the creation of tendinitis with potentially month-long or year-long problems.
The best treatment of this injury is longtime ice application straight on the skin for at least 40 minutes. The injury needs to be taped permanently for two to three weeks not with that narrow athletic tape that is so popular in the US, but with wide stretchable adhesive tape, no cast. You have to be very conservative when it comes to these injuries. The switch from cold to heat therapy is difficult to establish, with any miscalculation potentially provoking severe tendinitis. Oftentimes, weeks of cold therapy may be necessary, with heat therapy having to start much later than in many other types of injuries such as muscle injuries.
After that, we hit the same problem I have mentioned many times before on this forum. The FDA's very strange approach to this means that the ointments that exist for these injuries and that contain components such as diclofenac, ibuprofen, do no exist on the US pharmaceutical market. You would have to order from a Canadian, Mexican or European pharmacy unless you have a creative physician who is sufficiently familiar with world literature on this area that he orders the thing to be made at a compound pharmacy, which in the US unlike in Europe appears to be a service not provided by a standard pharmacy.
When it comes to judo, absolutely any impact exercises with that arm have to be prevented. The arm may not be used for fall breaking, and you need to switch sides during rehab. The arm may not be used as a tsurite, only as a hikite, which is far less heavy on the arm both during your own throws, as when resisting or reacting to an attack from your opponent.
Attempting morote-seoi-nage to the side that would require the injured arm to go in uke's armpit is about the most 'unwise' thing one can do. There are 40 throws in the gokyô and at least 27 standard others outside of that, giving you at least 66 other options variations not included.
Good luck !
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