Dr. Cindy Chang is a specialist in primary care sports medicine with almost 3 decades of experience. She has served as head team physician at UC Berkeley, chief medical officer for Team USA in 2008 & 2012 Olympics, and assisted in the WNBA COVID "Wubble." Chang takes an individualized approach to care, seeing athletes of all ages. She is Program Director of UCSF's Primary Care Sports Medicine Fellowship, board of trustees for the American College of Sports Medicine, chairs the Sports Medicine Advisory Committee for the California Interscholastic Federation & National Federation of State High School Associations, and past president of the American Medical Society for Sports Medicine. She earned her medical degree from Ohio State Univ. College of Medicine, followed by a residency in family medicine at UCLA Medical Center & a fellowship in sports medicine at Ohio State Univ. Medical Center.
Healing time for a strained muscle depends on the severity of the injury and the muscle affected, with grade I injuries taking 2-6 weeks, grade II 8-12 weeks, and grade III up to 6 months. Transcript: "This is a good question. How long does it take for a strained muscle to heal? I do want to point out, though a strain is the same as a pull, which is the same as a tear, it all means the same thing, which is that the muscle fibers have been disrupted, and there's been injury to the muscle fibers. The other thing to know is that the muscles attach to bones. And so for example, the biceps, a muscle, starts off and attaches at the bones, at the top of the shoulder, at the shoulder here. And then attaches all the way past the elbow, elbow crease at the radial head. But it's the muscle belly itself typically that we want to talk about in terms of if an injury happens in the muscle belly. Now if the injury happens at the tendon, would attaches on either side of the bone and the injury happens there. Then typically, a surgery may be needed. And that's a whole different situation. But let's talk about a strain to the muscle belly. It really depends on what muscle is injured as well as the degree. And we call it grade I, grade II, or grade III. Grade I, a few fibers. Grade II, more fibers. And grade III, a total tear. So grade I is typically around 2 to 4 to 6 weeks. Grade II can be up to 8 to 10 weeks, and even 12 weeks. And then a grade III injury, a complete tear, can sometimes be as long as six months before you have enough healing and scar tissue and remodeling for someone to return back to activity. OK, thanks."
To prevent common soccer injuries, athletes should alternate weight training and sprinting every other day and allow for recovery. They should also practice like they play to reduce the risk of injury. Transcript: "How can soccer players prevent common injuries? Well, let's talk about the most common injuries, and that's to the muscle tendon unit. For example, hamstrings, quadriceps or the thigh muscle, and the Achilles tendon or calf injuries. These are injuries to the muscles as they attach to the tendons, and this muscle tendon unit attaches to the bone. So let's talk about the concept of loading. Loading is where there is stress placed across that tendon, and that load can alter the mechanical properties and the actual physical properties of the tendon. So for example, if that tendon doesn't see enough load, then it gets relatively weaker. So for example, if you're sick or you're on vacation and then you go out try to sprint across the soccer pitch, that's too much low for that tendon and tendon may break down. For example, strain, you may pull that tendon, pull that muscle or rupture even the Achilles tendon. Let's say there's too much load on that tendon. So for example, you're loading that tendon too much and it breaks down because of that overload. And this can happen in youth sports, for example when they're practicing and training every day, or they have double games on the weekends. And that tendon will break down and cause a tendonitis. So the best thing to do to prevent these common injuries is to alternate weight training, and every other day and allow for recovery of that tendon. And also to practice like you play, practice and sprint, do those every other day. And cutting maneuvers, and hopefully you'll prevent these injuries."
I chose medicine over law because I find joy in helping my patients solve their problems and get back to a quality of life they want and deserve. Transcript: "Thanks for that question, Aaron. It's totally all about my patients. I was deciding between law or medicine early in my career. And if I want to be a lawyer, I was going to be a DA. I was going to be a prosecutor. I was going to find out who'd done it. And that's a lot like medicine, is really what is the cause of my patients' illness or injury. And I get some really complex patients who have seen a lot of other doctors, and they come in. And I like to be able to-- that challenge of solving why they're having this issue, taking all that all the clues, all the MRI's, all the other tests had been done, but also really listening to my patients. Listening to them about their past medical history, their present illness, determining what the causes are of their symptoms. Is there something in their training? Is there something in terms of their equipment, in their technique? Something that's happening in terms of causing-- and their past injuries, which is causing them to come in with the issue they have. And then being able to help them solve this problem, sometimes, it's been going on for years. And getting them to be able to get back to their activity, whether or not it's running or playing pickleball or even being able to just pick up their grandchildren, that gives me great joy. And knowing that I have helped them get back to a quality of life that they want and deserve, that's what gets me going and keeps me going back to work day after day, even though it can be draining, and even though I stay up at night sometimes thinking about my patients a lot. That's why I do what I do."
Recent research has shown that exercising up to two hours before bedtime will not disturb your sleep, and is better than not exercising at all. It is suggested that you follow the exercise with stretching or yoga to help relax both your mind and body before bed. Transcript: "Do you think that running or exercising at night will disturb your sleep? That's what was thought in the past. Because if you exercise too late at night, with the expression of certain hormones, and with that rapid heart rate, that you would have a sense of wakefulness and that would disturb your sleep. Well, recent research has shown that exercise in the evening, up to two hours before bedtime, will not disturb your sleep. And therefore, I would suggest that you exercise if that's the only time that you can find to exercise. Because it's better to exercise than not exercise at all. And you can try it out yourself. Make sure though, that if you do exercise in the evening, that you follow that with stretching or yoga or some sense of cool down, so that both your mind and your body can relax, and get you prepared for a good night's sleep."
Parents should keep their children's developmental stages in mind when choosing activities for them. Encourage your child to play a variety of activities and make sure that it fits into your family life. Let your child take the lead in terms of what sports and activities they are interested in. Transcript: "What advice do you have for parents looking to find the right sports and activities for their children? It's important for parents to remember the developmental stages of their children. So, for example, they know-- when they're ready to catch a ball, right, when they're ready to walk, and run, and kick a ball. And so we sometimes see these soccer leagues for toddlers which are really a little bit crazy because you have these swarm of kids running after a ball. So while they can run and while they can kick, they don't understand the concept of soccer. Cognitively, they don't understand the rules, where their positions are, et cetera. So rather than being in that type of activity, parents can run with their kids. They can kick a ball with their kids. They can throw a ball with their kids. It's important for kids to see their parents be active, as well. And in terms of choosing the right activities for your child, really, it's going to be the activity that they have an interest towards. It's also going to be an activity that you can fit into your family life, your work schedule, your family schedule. You don't want your child's activities to, kind of, take over, that causes undue stress. And, again, remember, a lot of important things are important for your child's development, it's not just a sport. It can be any type of physical activity. And the last thing I want to say is encourage your child to play in a multitude of different activities because that will help their physical development, as well as their social and emotional development, too."
Make sure your child gets adequate rest and recovery time and check in with them to make sure they are mentally healthy and not feeling overwhelmed by expectations. Transcript: "What health factors should parents consider if their child is a competitive athlete? First and foremost, please make sure that your child is getting adequate rest and recovery time. You want to make sure that they're not being overtrained and that they actually have time in their lives, besides training for their sport, to also have time to spend with friends, family, and especially school as well. The other thing is check in on their mental health because people, adults around them, have expectations and demands. Make sure that your child who is competing at a high level in their sport is feeling secure, is feeling like they have a voice in their own activity level, have a voice in expressing whether or not they are tired, whether or not they feel that they're comfortable participating in that activity. People who have expectations on them, especially children, may start to feel symptoms of burnout. And from stress, they may start to have anxiety, performance anxiety, which can be helpful. But too much of it can definitely lead to depression, anxiety, difficulty sleeping, and then difficulty in school and in the relationships with others. So check in with your kids and make sure that they're good Thank you."