Cori Seyhoon, D.C.
Whether you are a novice, or
a professional athlete, at
some point you are likely to
get injured doing what you
love. As a collegiate soccer
player, I learned the hard
way that not preparing my
body for training or
competition could have
disastrous results. However,
I also learned that proper
diagnosis and treatment is
critical to a speedy
recovery and getting back on
the field!
Participation in sports or
exercise is a vital
component to living a
healthier lifestyle and
maintaining proper physical
function. Exercise serves to
strengthen your heart,
bones, and joints and
reduces stress, among many
other benefits.
Unfortunately, many of us do
not know how to train
properly, thus resulting in
overuse injuries. Other
times, injuries result from
a weekend game of Flag
football, or Ultimate
frisbee when your friendly
opponent decides to check
you to the ground.
Frequently, sports injuries
occur in someone who is just
taking up sports as a form
of recreational activity,
doesn’t have proper safety
equipment, or becomes a
little too overzealous about
the exercise regimen (i.e.
my husband taking up
Motocross in his 30’s) .
Commonly injured areas of
the body are the shoulders,
elbows, ankles, knees and
spine. If you have ever
injured any of these areas,
please read on.
Strains and
Sprains
Although many of us think of
the horrendous sports
highlight reels showing
protruding bones and twisted
limbs during acute sports
injuries, the most commonly
injured structures are the
muscles, tendons, and
ligaments. The job of a
tendon is to attach muscles
to bones, and a ligament
attaches one bone to
another.
Many of you have seen a
teammate, friend, or
opponent plant his/her foot
wrong causing an acute
twisting or over-extension
of a lower extremity joint,
which may lead to tears of
muscles and tendons, called
“strains,” and tears of
ligaments resulting in
“sprains.” Muscle and
ligament tears range from
mild to severe, involving
bearable to excruciating
pain, that can be a
nuisance, or possibly even
debilitating. In mild
injuries, just a few fibers
are torn or stretched.
Severe injuries, involving a
tear through the full
thickness of the structure,
are most often considered
unstable and often require
surgical intervention. In
the spine, the
intervertebral disc, the
cartilage between the
vertebrae of the spine that
works as a shock absorber,
can also be torn, resulting
in a disc bulge and/or
herniation causing a world
of pain.
Holy Shmoly, I hurt
my....ankle sprains most
often involve tears of one
or more of the ligaments
along the outside of the
ankle. Knee ligaments,
including the larger
external supportive
collateral ligaments and the
smaller internal stabilizing
ligaments (anterior cruciate
ligament, posterior cruciate
ligament, or meniscus) can
also be torn. The cartilage
on the back of the patella
(knee-cap) can also become
eroded from overuse, leading
to a condition termed
chondromalacia patella.
Tendinitis
A common overuse injury
is tendinitis, also called
tendinosis. In this
condition, the tendon
becomes irritated or
inflamed from repetitive
use. For example, after
rediscovering your passion
for golf, you decide to
schedule a game, or impress
everyone at the driving
range every day for two
weeks. Unfortunately, your
body isn’t able to keep pace
with your eager desire to
improve and your muscles and
tendons in the shoulder and
elbow become overworked.
This often results in pain
and dysfunction in those
areas. In the shoulder, the
rotator cuff (a combination
of four muscles that
stabilizes and moves the
shoulder) becomes inflamed,
resulting in rotator cuff
tendinitis. Tennis elbow is
another form of tendinitis
that occurs along the
outside of the elbow, as the
name suggests, it is most
commonly found in tennis
players. In golfer’s elbow,
the tendons on the inside of
the elbow are affected.
Unilateral sports, such as
baseball, tennis, and golf,
where players consistently
use one side of their body
more than the other are at
risk for this condition.
Playing these kinds of
sports encourages the
over-development of one side
of the body, neglecting the
other side, creating
muscular imbalance. You can
reduce your risk by
following a proper strength
and exercise training
regimen tailored for these
activities.
Stress Fractures
Some athletes may
experience a stress
fracture, also called a
fatigue fracture. This type
of fracture occurs when an
abnormal amount of stress is
placed on a normal bone,
however underlying causes
such as muscular imbalance,
over training, and poor
nutrition can be the real
culprits. This type of
injury might occur in a
runner who rapidly increases
the amount of mileage while
training for a race, or
people who start running as
a form of exercise, but
progress too quickly. In
either case, the body needs
an appropriate amount of
time and the strength to
endure the increased
stresses on the body.
Another common injury is
shin splints. This overuse
injury is caused by
microfractures on the front
surface of the tibia (shin
bone). This is most often
seen in runners, although
other athletes can also be
affected, and the pain is
only felt when engaged in
high levels of activity.
Diagnosis
and Treatment
Sports injuries are most
often diagnosed from the
history of the activity that
brought on the pain, along
with a physical examination.
Orthopedic tests and range
of motion assessment will
likely reveal the problem.
In some cases, x-rays are
necessary to rule out a
fracture, and magnetic
resonance imaging (MRI) and
diagnostic ultrasound are
used to find soft-tissue
injuries, like tendinitis
and sprains. Fractures
typically require the
application of a stabilizing
device, such as a cast,
after the bone is put back
into position. Rarely,
surgical intervention is
required. There is a
relatively standard
treatment protocol for most
of the other overuse types
of injuries called “RICE”
(rest, ice, compression, and
elevation). This protocol
involves the following:
Rest
You just injured
yourself, so now is not the
time to run errands, exert
yourself, or lift heavy
objects. Please get some
REST! Resting the injured
limb or area allows the
healing process to take
affect and get you better
quicker. Generally no more
than 48 hours of rest and/or
immobilization is needed,
depending on the severity of
the injury. In fact, the
sooner you becomes active
after an injury, the more
rapid your recovery will be.
In some cases, long-term
immobilization can sometimes
be harmful to recovery
because scar tissue and
adhesions set in. Your
chiropractor will guide this
process and aid your process
of recovery. Please ask
him/her what activities are
safe and which activities to
stay away from during the
acute phases of healing.
Returning to activity too
early, choosing the wrong
types of activity/exercises,
or excessive activity can be
detrimental.
Ice (a.k.a. Cryotherapy)
Ice can be helpful with
pain reduction and tissue
healing. Please see notes on
proper icing and heat
strategies, To ICE or To
Heat, that is the Question!
Compression
Another important
component of the RICE
protocol is compression!
Many people forget that
compressing the area of pain
will help reduce the amount
of swelling from the injury.
In most cases, wrapping your
ankle, knee, elbow, or
shoulder (or whichever area
is affected) with an ace
bandage or bracing sleeve
will suffice. If you use
compression and ICE at the
same time you can get double
for your money! If you have
any questions, your
chiropractor will determine
if this will be beneficial
in your case.
Elevation
Elevating the injured
extremity (arm or leg) above
the level of the heart will
also help to reduce
swelling.
Pain relievers
Recent research
demonstrates that some
nonsteroidal
anti-inflammatory (NSAIDS)
drugs may actually slow the
healing process by
restricting the body’s
natural healing mechanisms,
so they should be used
sparingly. In other words,
if you can tolerate the
discomfort, do so.
Joint manipulation
Research also shows that,
in some cases, joint
manipulation can be helpful
with pain reduction and a
quicker recovery.
Introducing motion into an
injured joint in a
controlled manner (provided
by your chiropractor), the
healing process can be
ameliorated. This treatment
encourages proper joint
motion and scar tissue to
lay down more appropriately.
Your chiropractor will
determine if this procedure
will be helpful in your
case.
Electrical modalities and
myofascial release
In many sports injuries, the
integrity of the
soft-tissues is compromised
and often needs to be
addressed with modalities
such as ultrasound,
electrical muscle
stimulation, cold laser, or
interferential current.
Another therapy that also
helps reduce swelling,
decrease fascial adhesions,
and muscle repair is
instrument assisted
myofascial release
technique. Your doctor will
help determine if these
procedures will be helpful
in your case.
KinesioŽ Taping
Kinesio® Taping Method is a great therapeutic tool that can help while you are recovering from a sports injury and get you back in the game quicker. Kinesio® Tex Tape provides support for muscles and tendons, helps to prevent over-contraction of muscles, and also helps to reduce inflammation and swelling. For more information about Kinesio® Taping, click here.
Prevention
What can you do to
prevent sports injuries? In
most cases, proper
conditioning (gradual
progression workouts),
warm-up and cool-down
(stretching) procedures, and
appropriate safety equipment
can substantially reduce
injuries. Understanding
proper techniques can also
go a long way toward
preventing injuries,
remember quality is better
than quantity! Sufficient
water intake is also an
important preventive
measure.
Keep these tips in mind:
- Don’t wait too long
to seek treatment! If an
ache or pain persists
for more than 48 hours,
get someone to evaluate
it. The quicker you come
in, the quicker we can
get you better!
- When choosing
between heat and ice, if
there is any doubt ice
it up! ICE will only
help, whereas heat can
have some adverse
reactions.
- Gradually increase
your training intensity.
The recommended
progression is 10% per
week. Track your
progress in minutes
rather than miles. Avoid
increasing the number of
workouts and their
intensity in the same
week. If you typically
train 3 days per week,
the first week of
progression increase the
number of training
sessions to 4 times. The
next week, instead of
adding another session,
increase the intensity
of those 4 sessions.
- Hydrate before,
during, and after
exercise! Here’s how to
figure out the amount of
water you should be
drinking: divide your
body weight in half and
drink that many ounces
of water per day.
- Give your body time
to recover and proper
rest! Proper rest allows
your body to acclimate
to increased physical
stress demands (i.e.
more activity, running,
tennis, soccer, etc.).
Have you ever gotten
sick after you increase
your workouts, take more
on at work, or feel
stressed about managing
your children’s life?
Stress manifests in your
body in many different
ways, peace of mind
oftentimes means peace
of body. If you are
feeling overwhelmed by
your workouts or
training schedule, take
a day or two off and
regroup. You will
advance your fitness
level faster and safer
by doing this rather
than breaking your body
down more but choosing
to power through and
train. In other words,
know your limits and
don’t push yourself
beyond what is
reasonable.
- Stretch your muscles
when they are warm. It
does you no good to
stretch cold muscles.
The muscles will not
hold the stretch and you
won’t get the most of
your time. Make sure you
warm up for 5-10 minutes
with light exercise
(i.e. jogging), then
take your time to
stretch your arms and
legs. Yoga and Pilates
are great ways to
increase your
flexibility and
stability.
- Novices beware! When
you are deciding to take
up a sport or activity
for the first time,
please have the proper
gear. For example, I
decided to try
snowboarding this year
and you can be sure that
I was equipped with the
necessary gear to keep
me safe on the mountain.
I had waterproof and
padded outerwear, wrist
guards, and kneepads to
reduce the risk of
injury from the
inevitable falling I was
going to do. I probably
should have had a helmet
as well, but the point
is don’t take risks with
extreme sports when you
can really get injured
by not wearing the right
gear.
Copyright, Cori Seyhoon, D.C. All rights reserved.