Whether you are a novice, or a professional athlete, at some point you are likely to get injured doing what you love. A 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.
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.
- Tears of muscles and tendons are called “strains”
- Tears of ligaments are called “sprains”
- Muscle and ligament tears range from mild to severe, involving bearable to excruciating pain
- 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.
- Upper extremities (shoulders, elbows, wrists, hands and fingers) can suffer sprain/trains injuries as well.
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.
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.
- 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:
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.
- 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.
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.
Elevating the injured extremity (arm or leg) above the level of the heart will also help to reduce swelling.
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.
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.
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.
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.