Aruba Sports Medicine

La Medicina Natural y Tradicional, Alternativa Terapeutica de Multiples Patologias

La medicina tradicional y natural considera al hombre de manera holística, es decir, en su totalidad y dentro de un aspecto ecológico. Parte de que la falta de salud o la enfermedad proceden de un desequilibrio del hombre en su sistema ecológico total y no solo del agente causal y la evolución patógena. Para mantener una adecuada salud mental y física debe existir un equilibrio biológico, cuando este se rompe aparece la enfermedad.

La medicina natural y tradicional China es una ciencia milenaria, la práctica es tan antigua como la humanidad, las técnicas afines más frecuentes de esta ciencia son: acupuntura, moxibustión, ventosas, digitopuntura, masajes terapéuticos, fitoterapia, láserpuntura, electroacupuntura, analgesia acupuntural y farmacopuntura.

En la medicina natural se realizan diferentes diagnósticos siendo el principal el estilo de vida pues nos habla de cómo caminar, descansar, si hacemos o no ejercicio físico, hábitos y patrones de conducta como: manejar el estrés, los sentimientos, nuestras relaciones con los demás, con la naturaleza, todo esto nos da una idea donde se encuentra el problema del paciente y con un buen examen físico y la observación integral nos permite llegar a un adecuado diagnóstico y un mejor tratamiento.

Acupuntura

Acupuntura( acu del latín significa aguja y puntura punzar), el proceder terapéutico asiático consiste en aplicar agujas muy finas en determinados puntos del cuerpo estimulándolos para tratar diferentes enfermedades, regulando la energía de meridianos, los excesos o vacíos de energía, tanto en el meridiano como en los órganos, así propician su buen funcionamiento. La acupuntura y las otras técnicas afines como la moxibustión, ventosas etc… no solo se aplican en China y otros países de Asia como Japón, Vietnam y Mongolia, también fue difundido con posterioridad en Europa (Francia, Italia, España, Suiza, Alemania, Holanda, Rusia) y al continente americano muchos años después. En la medicina occidental también se aplica la acupuntura en diferentes especialidades. el método de anestesia con acupuntura se utiliza en operaciones ginecológicas, oftalmológicas, cirugía general y en la estomatología actúa en la remisión del dolor, regula la excitación de los nervios como en las neuralgias y en las parálisis estimulándolos para recuperar la motilidad ,ayuda a la recuperación acelerada de las enfermedades inflamatorias porque altera de manera favorable el número de leucocitos y refuerza la función de fagocitosis, regula también las funciones de excreción de hormonas ,actúa sobre el sistema inmunológico pues se aplica acupuntura para el dolor ,la hipertensión arterial ,las lumbalgias ,tendinitis, bursitis, artrosis, artritis y muchas enfermedades más .

Contraindicaciones de la acupuntura: no se debe aplicar en pacientes con cáncer y otras enfermedades malignas, pero sí en los efectos secundarios como: falta de sueño y depresión; no en enfermedades infecto contagiosas, no en lesiones de la piel como quemaduras, no se aplica en el embarazo, no en pacientes que consumen drogas, no en hemorragias, no en pacientes muy ancianos o personas muy débiles ni en niños menores de siete años.

Moxibustión

Moxibustión es un método de tratamiento en la medicina tradicional china con el cual se previene o se tratan las enfermedades mediante el calor que se produce con una moxa o tabaco de Artemisa en el punto de acupuntura indicado, puede aplicarse directo sobre la piel o indirectamente con sal, ajo, jengibre etc….

Se aplica para tratar enfermedades por insuficiencia debido al frío y en enfermedades crónicas, influye en el sistema inmunológico al regular la energía, expulsar el frío y la humedad, también se puede aplicar en dolores agudos, promueve el buen funcionamiento del sistema digestivo.

Contraindicaciones de moxibustión: no aplicar en personas con fiebre superior a 38 grados centígrados, hipertensión arterial grave, niños menores de siete años, personas con piel frágil (diabéticos, pacientes con lesiones en la piel).

Ventosas (cupping therapy)

Ventosas (cupping therapy), las ventosas es otra de las técnicas de la medicina tradicional china, es un método terapéutico heredado de nuestros ancestros, su objetivo principal es producir congestión local o extraer la sangre con previa succión en la zona de la piel aplicada.

Existen diferentes tipos de ventosas, de bambú, cristal y plásticas. Se puede aplicar en combinación con la acupuntura. La forma de aplicar puede ser con fuego o con bomba de succión.

Su acción influye en la piel, dilatan las arterias y venas de la piel, activan la circulación de la sangre, elevan la temperatura de la piel acelerando el metabolismo, refuerzan la respiración cutánea y la nutrición, influyen en los músculos, en las articulaciones y en los nervios periféricos, influyen además en el sistema circulatorio y la sangre.

Aplicación en afecciones como: contusión, distorsión, neuralgias, parálisis periférica, ciatalgia, bronquitis, neumonía, tos, asma bronquial, litiasis renal y vesicular etc….

Contraindicaciones: no aplicar en pacientes con fiebre elevada, convulsiones, embarazo, trastornos de la coagulación, regiones del cuerpo con edemas y afecciones de la piel.

Lesión del Manguito Rotador

El manguito rotador es un grupo de músculos y tendones que rodea la articulación del hombro y mantiene firme la cabeza del húmero en la cavidad poco profunda de dicha articulación. Una lesión del manguito rotador puede provocar un dolor sordo en el hombro que empeora por la noche. 

Las lesiones del manguito rotador son frecuentes y aumentan con la edad. Sin embargo, pueden ocurrir antes en personas cuyos trabajos requieren realizar repetidamente movimientos por encima de la cabeza. 

Causas 

La mayoría de las veces, la causa de las lesiones del manguito rotador es el desgaste natural progresivo del tejido del tendón que se produce con el tiempo. La actividad repetitiva por encima de la cabeza o levantar objetos pesados durante un período prolongado puede irritar o dañar el tendón. El manguito rotador también se puede lesionar en un incidente en particular durante caídas o accidentes. 

Factores de Riesgo 

 Los siguientes factores pueden aumentar el riesgo de tener una lesión del manguito rotador: 

  • Edad. El riesgo de tener una lesión del manguito rotador aumenta con la edad. Los desgarros del manguito rotador son más frecuentes en personas mayores de 60 años. 
  • Algunos trabajos. Los trabajos que requieren movimientos de brazos repetitivos sobre la cabeza, como la carpintería o la pintura de casas, pueden dañar el manguito rotador con el tiempo. 
  • Determinados deportes. Algunos tipos de lesiones del manguito rotador son más frecuentes en personas que participan en deportes como béisbol, tenis y levantamiento de pesas. 
  • Antecedentes familiares. Puede haber un componente genético en las lesiones del manguito rotador, ya que estas lesiones suelen aparecer más frecuentemente en determinadas familias. 

 

 

Tratamiento 

 Los tratamientos conservadores, como el descanso, el hielo y la fisioterapia, a veces son lo único que se necesita para recuperarse de una lesión del manguito rotador, hoy dia se utilizan terapias como onda de choque con elevada efectividad en la resolucion de la lesion, y las terapias invasivas como la electrolisis percutanea tambien constituyen alternativas terapeuticas antes de llegar a necesitar cirugía. 

 Terapia 

 La fisioterapia suele ser uno de los primeros tratamientos que se recomiendan. Los ejercicios orientados a la ubicación específica de la lesión del manguito rotador pueden ayudar a recuperar la flexibilidad y fortalecer el hombro. La fisioterapia también es una parte importante del proceso de recuperación posterior a la cirugía del manguito rotador.

 

 

Hamstring Injury

Hamstring Injury

 

A hamstring injury is a strain or tear to the tendons or large muscles at the back of the thigh.

It’s a common injury in athletes and can occur in different severities. The 3 grades of hamstring injury are:

grade 1 – a mild muscle pull or straingrade

grade 2 – a partial muscle tear

grade 3 – a complete muscle tear

Natasha Barnes - Hamstring Injuries in Climbers - TrainingBeta

The length of time it takes to recover from a hamstring strain or tear will depend on how severe the injury is.

A minor muscle pull or strain (grade 1) may take a few days to heal, whereas it could take weeks or months to recover from a muscle tear (grade 2 or 3).

The hamstrings are tendons (strong bands of tissue) at the back of the thighs that attach the large thigh muscle to the bone.

The term “hamstring” also refers to the group of 3 muscles that run along the back of your thigh, from your hip to just below your knee.

The hamstring muscles aren’t used much while standing or walking, but they’re very active during activities that involve bending the knee, such as running, jumping and climbing.

Hamstring Muscle Tendinopathy | Orthopedics Sports Medicine

What causes hamstring injuries?

A hamstring injury can occur if any of the tendons or muscles are stretched beyond their limit.

They often occur during sudden, explosive movements, such as sprinting, lunging or jumping. But they can also occur more gradually, or during slower movements that overstretch your hamstring.

Recurring injury is common in athletes and sportsmen, as you’re more likely to injure your hamstring if you’ve injured it before.

Regularly doing stretching and strengthening exercises, and warming up before exercise, may help reduce the risk of injuring your hamstring.

How do I know if I’ve injured my hamstring?

Mild hamstring strains (grade 1) will usually cause sudden pain and tenderness the back of your thigh. It may be painful to move your leg, but the strength of the muscle shouldn’t be affected.

Partial hamstring tears (grade 2) are usually more painful and tender. There may also be some swelling and bruising at the back of your thigh and you may have lost some strength in your leg.

Severe hamstring tears (grade 3) will usually be very painful, tender, swollen and bruised. There may have been a “popping” sensation at the time of the injury and you’ll be unable to use the affected leg.

Rest and recovery

Recovering from a hamstring injury may take days, weeks or months, depending on how severe the strain or tear is.

A completely torn hamstring (grade 3) may take several months to heal and you’ll be unable to resume training or play sport during this time.

Initial treatment

During the first 2 or 3 days, you should care for your injury using RICE therapy:

Rest – keep your leg as still as you possibly can and avoid physical activity. Your GP may recommend using crutches in more severe cases.

Ice – apply cold packs (a bag of frozen peas wrapped in a tea towel will also work) to your hamstring for up to 20 minutes every 2 to 3 hours during the day. Don’t apply ice directly to your skin.

Compression – compress or bandage the thigh to limit any swelling and movement that could cause further damage. You can use a simple elastic bandage or elasticated tubular bandage available from a pharmacy.

 Elevation – keep your leg raised and supported on a pillow as much as possible, to help reduce any swelling.

Regular painkillers, such as paracetamol or a non-steroidal anti-inflammatory drug (NSAID) cream or gel, may also help relieve the pain.

Short-term use of oral NSAIDs, such as ibuprofen tablets, can also help reduce swelling and inflammation. However, these aren’t suitable for everyone. Check the leaflet that comes with your medication to see if you can take it.

Gentle exercises and stretches

Returning to strenuous exercise too quickly could make your injury worse, but avoiding exercise for too long can cause your hamstring muscles to shrink and scar tissue to form around the tear.

To avoid this, you should start doing gentle hamstring stretches after a few days, when the pain has started to subside.

This should be followed by a programme of gentle exercise, such as walking and cycling, and hamstring strengthening exercises.

 

 

Therapeutic ultrasound

 

Therapeutic ultrasound is used to treat generally muscle, joint or tendon injuries; It works through the emission of sound waves generated by means of a transducer, promoting the release of heat towards the affected area and the stimulation of blood flow, achieving the reduction of pain and inflammation, this type of treatment is very effective, not it causes no pain or has any side effects.

General indications of therapeutic ultrasound.

Utility of Musculoskeletal Ultrasound in Sports Medicine

Nowadays, musculoskeletal ultrasound has become a necessary and very useful tool for the diagnosis and prognosis of sports injuries, its use is increasingly established in the world of sports and has multiple advantages over other modalities.

It is fast, cheap and, in addition, it allows interaction with the patient, which has led to an exponential growth in their employment.

Therefore, in the field of Sports Medicine and Traumatology, in the event of an injury it is necessary to reach an exact diagnosis in the shortest possible time, to be able to establish an immediate treatment, which allows to shorten the recovery. This is where ultrasound is a basic tool for the study of all injuries, which limit the athlete’s performance so much. In addition, ultrasound allows a rigorous and detailed evolutionary control to be carried out, assessing the day-to-day of the injury.

Among the many advantages that this diagnostic technique provides over other study techniques, especially in the assessment of tissues such as muscle, ligament and tendon, the following should be noted:

– It allows dynamic studies to be carried out, which accurately determine the diagnosis of small lesions, which may go unnoticed, when the structures remain at rest. In the case of complex joint unions such as the scapulo-humeral joint, from dynamic maneuvers, the existence of entrapment syndromes can be demonstrated.

– It allows the carrying out of repeated studies that facilitate an evolutionary control in the day-to-day of the injured athlete. As there are no contraindications, this rapid technique allows a comparative examination with the healthy side to determine the extent and characteristics of the lesion area.

– At present, the use of compact equipment facilitates the use of this technique in the field, thanks to the ease of application, safety, its non-radiant character and its accessibility.

– New technological advances such as three-dimensional study, elastography, high-resolution Doppler or Doppler quantification, are making it possible to complete the examination of the musculoskeletal lesion so that small lesions are now easily diagnosed.

On the other hand, some drawbacks of ultrasound must be considered in comparison with other diagnostic techniques, such as the limited independence of the explorer, interobservative variability, poor visualization of the bone, and intra-articular structures as well as that of certain muscles.

Ecografía - Ángel Troncoso Fisioterapia Ecografía musculoesquelética: ¿es una herramienta válida en el razonamiento clínico en fisioterapia?

Usefulness of Ultrasound in injuries that appear as a result of sports activity :

  • Epicondylitis or “tennis elbow”
  • Epitrocleitis or “golfer’s elbow”
  • Painful shoulder from rotator cuff tendon injuries, bursitis, etc.
  • Biceps brachii tendinitis
  • Wrist sprain
  • Finger tendonitis
  • Painful hip from injury to the adductors or pubalgia
  • Bruising on the thigh from contusions or ruptured rectum
  • Hamstring muscle rupture with posterior thigh pain
  • Knee sprain with involvement of lateral ligaments
  • Quadriceps or patellar tendinopathy (“jumper’s knee”)
  • “Goose foot” tendinopathy (pain on the inside of the knee)
  • Tennis leg
  • Ankle sprains or strains
  • Achilles tendon tendinopathies
  • Plantar fasciitis or pain in the sole of the foot
  • Tears or strains of the rectus abdominis

 

Laser Therapy

What are the effects of using lasers?

The use of laser in physiotherapy, if it has these characteristics, increases metabolic activity by acting on the mitochondria, which can reduce healing times. In addition, it produces an increase in vasodilation, improves lymphatic drainage, reduces inflammation and increases the pain threshold. Photomechanical stimulation inhibits pain sensation and provides immediate relief.

Toral points out that laser therapy “has no absolute contraindications.” Laser therapy is painless, and although it increases the temperature of the treated area, it is not invasive. The laser acts on the cell membrane generating a photochemical effect, which facilitates tissue regeneration, pain reduction and remodeling of inflammatory effects.

All these characteristics allow to obtain a series of effects that were not achieved with the low-power laser.

  • The biostimulant effect accelerates the production of fibroblasts with the consequent production of collagen in order to rebalance the extracellular matrix and to remodel the tissues. This is only achieved by long pulse continuous or pulsed emission.
  • The anti-inflammatory effect is the result of biological stimulation of the tissues, which triggers vasodilation.
  • Stimulation also produces a neoangiogenesis phenomenon that has an anti- edema effect .
  • High-powered laser therapy also has relaxation effects by modulating the release of oxygen.
  • Finally, the analgesic effect allows to reduce pain without collateral effects, optimizing the interaction with the peripheral nervous system.

 

What can laser be used for in physiotherapy?

With these functionalities, the laser covers a wide spectrum of applications.

  • In traumatology it is used for post-trauma recovery , because it allows the possibility of modeling the emission according to the desired physiological effect.
  • In pain therapy, because it is capable of generating a rapid decrease in joint and muscle pain through the stochastic emission patented by Mectronic, which acts on the peripheral nervous system.
  • In the prevention of accidents, because if they undergo laser therapy treatments before the sporting event, the musculoskeletal structures will be vascularized and perfectly oxygenated, reducing the risk of micro-injuries.
  • To speed up recovery , because the multi-modal emission allows the therapy to be personalized according to the need.
  • To quickly eliminate edema, because it allows you to customize the therapy according to the somatic characteristics of the patient and their pathological state.
  • To heal muscle injuries, because it allows the metabolic activation of all microbiological processes that return the intracellular and extracellular balance to the cell, in order to rapidly rebuild muscle tissue.
  • To treat acute pathologies, because it modulates, in the water phase of the pathology, the inflammatory effects through a stimulating action of the deep tissues.
  • To treat tendinopathies, because it exerts a biostimulant action and rebalances the correct balance of muscle forces through deep and complete oxygenation of the muscle fasciae.
  • As a physiological accelerator , because it allows the correct biostimulant therapy to be applied by defining the energy dose and the mode of emission depending on the pathological condition of the patient.

Most common applications

  • Deep tissue penetration with power up to 12 W in continuous mode
  • Pulsating mode for immediate pain relief
  • Painful shoulder
  • Hip arthrosis
  • Epicondylitis
  • Carpal tunnel syndrome
  • Patellar tendonitis
  • Lumbar pain
  • Achilles tendonitis
  • Back pain

 

Physical exercise all ages

CEMEDAR Center for Sports Medicine in Aruba

Aruba, despite being a small island, has a sports medical center, which offers its services to all practitioners of physical activity and sports, has high-tech equipment and highly experienced professionals who offer their services in various branches of sports medicine, athletes and practitioners of physical activity throughout the island.

Sports medicine is the medical specialty that studies the effects of competitive exercise and physical activity in general, on the human body, focusing on the prevention, treatment and rehabilitation of diseases and injuries that occur in practitioners, also in the evaluation of the physical conditions and performance of the athletes
Every day it has a greater role in both high performance and recreational sports, offering scientific support for the achievement of high results in elite athletes, and at a recreational level promoting the level of health and well-being of the population, offering care and guidance so that The practice of sport is always a means to raise the standard of living and the health of the population, at all ages, starting from an early age to the elderly.
The main tasks of sports medicine are:
• Preventive mission.
• Guiding mission.
• Healing mission.

Ejercicio Fisico todas las edades

Services offered:

  • Sports Traumatology
  • Sports medicine
  • Physiotherapy
  • Sports Psychology
  • Sports Massage
  • Athlete Functional Assessment

 

The services offered by the Arubano CEMEDAR sports medical center are available to the entire population of Aruba, both high-performance athletes and the general population, we have professionals in medicine and sports sciences willing to offer their services for well-being of the entire population, the practice of physical exercise has in CEMEDAR a center of high scientific level that everyone can use and benefit from its services.

Core Concept and Assessment Training

The core is based on a set of clinical biomechanical osteoarticular muscle groups, especially the central part of the body, including dorsal lumbar rachis, pelvis, and hips, which allows us stability in the spine coordinated by the motor control system; when it is subjected to external and internal forces for its training it is of useful importance since the trunk and the extremities participate

The assessment of the Core applies different kinematic and dynamometric techniques, it is important to highlight that its operation depends on maximum strength, resistance strength, intra and intermuscular coordination, motor control, and proprioceptive control.

The objective is to prevent lumbopelvic injuries, optimization of performance in order to improve the stability of the athlete with precision and agility, the ideal is to perform exercises that exercise the flexors, extensors, lateralizers and rotators, the most effective safe are sample dog, bug Dead and planks, taking into account the frequency, intensity and equal volume through the iliolumbar proprioceptive exercise program and waist dissociation, the upper and lower limbs are necessary for coordination of the Core stability of the same in the sports field.

Pointer Dead bug Iron

Bibliography

Borghuis, J; Hof, A and Lemmink, K. (2008) The importance of sensory motor control in provide stability core stability. Sports medicine, 38, 11, 893-916.

McGill SM (2007) Low back disorders: evidence-based prevention and rehabilitation, 2nd.ed. champaing: Human Kinetic.

Van Dieen, JH; Luger, T and Van der Eb, J. (2012) Effects of fatigue on trunk stability in elite gymnasts. Eur J Appl Physiol. 112 (4): 1307–13 .:

Vera-García, FJ; Elvira, JL; Brown, SH and McGill, SM. (2007) Effects of abdominal stabilization maneuvers on the control of spine motion and stability against sudden trunk perturbations. J Electromyogr Kinesiol. 17 (5): 556–67

Vera-García, FJ; Barbado, D; Moreno-Pérez, V; Hernández-Sánchez, S; Juan-Recio, C and Elvira, JLL. (2015) Core stability: Evaluation and training criteria. Rev Andal Med Sport, 8 (2): 79-85.

Athlete Functional Assessment.

Sports practice requires fit and healthy individuals to face the challenges imposed by the performance of physical exercises, whether they are exercises for healthy and recreational purposes or in competitive sports, where the demands reach their maximum expression.

It is essential first of all at the beginning and during sports practice, an evaluation of the physical capacities and the condition of the practitioner is carried out, without knowing the functional state of the athlete there are great risks of damage to health, or in the worst of cases. cases can cause even death; there are many reports of sudden death during intense exercise that have occurred in recent years

Functional assessments have the following purposes:

  • Know the physical and mental health status of the exercise practitioner
  • Determine the level of development of the general and specific physical capacities of the sport (Strength, speed, Endurance, flexibility, etc.)
  • Morphological and somatotype evaluation
  • Prescription of exercises appropriate to the level found in the evaluations
  • Evaluate the Training process throughout its preparation journey.
  • Evaluation of energy systems and devices (Cardiovascular, respiratory, metabolic, neuromuscular)
  • Nutritional assessment
  • Psychological evaluation
  • Hematological and biochemical evaluation (Hb, glycemia, lactate, urea, hormones, etc.)
  • Know the level of tolerance to Training loads, together with the fatigue indicators.

The functional evaluation is carried out through laboratory and field tests, and through standardized and validated tests the integral evaluation of the athlete is carried out, offering information on the initial and developmental level during the performance of physical exercises.

The tests carried out take into account the sex, age, sport and level of condition of the practitioner.

It is important in the functional evaluation to have technology that allows the precision of the evaluations, the reliability and objectivity of the results are extremely important to establish training programs and physical exercises, which achieve improvement in the performance of the practitioner

Cupping Therapy

What exactly is cupping in the context of massage?

A treatment for cupping that is therapeutic includes warming and placing cups, usually made of glass, on the skin. In the process of warming the air in the cup, a vacuum is created, and when it is applied to the skin tissues are drawn to the cup. This promotes healing, increases blood flow, and also reduces the tension in connective tissue. It is similar to deep tissue massage, which can help reduce pain and to break down scar tissue. Cupping is commonly applied to areas of pain, such as the back, neck, and shoulders. The cups can cause temporary soreness or bruise dependent on the strength of suction created by vacuum as well as the degree of internal stagnation. This would indicate that the treatment has eliminated stagnation and toxins, according to TCM. The cups are removed by lifting one edge and allowing air to enter and breaking the seal and vacuum.

What exactly is cupping therapy??
TCM believes that stagnation in blood or qi is what is the cause of the disease. Cupping stimulates the local circulation of blood and qi around the area of treatment. This helps to relieve the swelling, tension, and discomfort. It draws impurities to the surface and removes toxic substances. According to Western science, cupping improves the flow of blood and relaxes connective tissue. Cupping stimulates tissue relaxation and better cell-to-cell communication. The work of U.S. physiologist and acupuncturist Helene Langevin has documented cell-level changes using an ultrasound camera. She has proven the effects of cupping, acupuncture, and massage relax tissue and reducing markers of inflammation. Inflammatory cytokines (chemical messengers) are reduced, while the cytokines that aid in healing and relaxation are increased.

What are the benefits of cupping?

The advantages of cupping include local pain relief and relaxing muscles. Cupping helps improve overall health by removing the blockages in energy that TCM practitioners consider to be obstacles in the flow of energy or Qi. In the case of athletes, cupping may assist in increasing the flow of blood to a specific muscle region or help reduce discomfort. Cupping was used by a variety of athletes during the Rio Olympics 2016. This can be seen in circular markings on some members of the U.S. swim team members.

How long will the cupping of bumps require?

The bruises that result from cupping last from a few days to a couple of weeks. According to TCM practitioner Casco, it is expected that after several weeks of repeated cupping treatments the bruises will reduce as the stagnation is eliminated. This is an indication of a successful cupping protocol.