Nutrition in Combat Sports

314 S.F. Martinez
17.9 Lacerations
Facial lacerations occur less frequently with use of head gear and occur more
frequently with contact competition than with Taolu weapons or two-person
forms. [10–12] Tournament regulations vary with respect to termination of the contest
depending on skill level (amateur or professional). [3] Protective rubber gloves should
be worn when evaluating cuts. Cuts overlying the facial vicinity of the following regions
require close observation or possible discontinuation of a bout: supraorbital or infraorbital
nerve regions, nasal lacrimal duct region (should be sutured only by subspecialist),
tarsal plate region of the upper eyelid, and nasal base adjacent to a nasal fracture.
Suturing or adhesive material can be used for wound closure; I prefer suturing, especially
in contact fighters. Although facial sutures are removed after several days, the
skin may take 6–12 months to reach full strength. Athletes usually return to fighting
soon after the stitches are removed regardless of recommendations.
17.10 Shoulder Conditions
Laxity of the glenohumeral joint frequently is considered advantageous by coaches
because both the open hands and weapons forms have ballistic maximal range-ofmotion
demands. However, if the flexibility is not balanced by good shoulder stabilizers,
injury may result. Once laxity causes symptoms, then a more practical
concern is the progression from laxity to clinical instability, which can be multidirectional
or single-plane. Instability can be caused by an acute injury or chronic
overuse. Anterior instability is more common than posterior instability in young
athletes and has a high rate of recurrence. Instability may lead to impingement,
recurrent subluxation, and rarely dislocation. The most frequent complaints are
anterior shoulder pain and arm fatigue with training.
Occasionally, the athlete reports feeling a “shift” occur at the glenohumeral
joint. Apprehension and relocation test usually are positive. Shoulder cuff weakness
may be present, along with dysynchrony in scapulothoracic muscle activation.
Palpatory tenderness frequently is noted along the glenohumeral joint line. Anterior
dislocation causes an obvious alteration in shoulder contour with the arm slightly
abducted and externally rotated. Posterior palpation reveals an abnormal absence of
the humeral head in its glenoid receptacle. Posterior dislocations are less frequent
and usually are caused by a forceful axial load. They may be difficult to appreciate
on standard radiographs. Radiographs should include anteroposterior, lateral, and
outlet Y views and should be evaluated for normal glenohumeral orientation.
Treatment of symptomatic laxity and instability is initially conservative rehabilitation:
rest (sling or shoulder immobilization) for 2–6 weeks depending on symptoms
and condition, limited range-of-motion exercises, shoulder stabilization exercises,
and limited pharmacologic support. Refinement of athletic movement mechanics
upon return to Wushu is imperative. Anterior shoulder dislocations usually can be