For as long as there has been the desire to win, there has been sports related injuries. Whether one is a highly-trained athlete or a weekend warrior, injuries have plagued us all. It is virtually impossible to prevent all sports related injuries; however, one can at least reduce some injuries by following a few simple techniques. An overview of some of the more common injuries will be discussed followed by preventive techniques and finally treatment options.
One simple classification is to categorize injuries as traumatic or repetitive. Traumatic injuries include contusion (bruise), strain, sprain, concussion, and fractures. Overuse injuries mainly involve epicondylitis (tennis/golf elbow) and runner’s knee (pain behind the kneecap).
The most common injuries in competitive sports involve sprains and strains. Sprains are injuries to ligaments, which are a short band of flexible, yet strong fibrous connective tissue that attach two bones together. Over stretching of ligaments past their maximum capacity can cause tears or deformity, which leads to damage and subsequent injury. Strains on the other hand affect muscle fibers and/or tendons. Tendons are a tough band of connective tissue that connect muscle to bone. Excessive extending or overuse of a muscle can lead to tears in the muscle fibers or tendons, which can cause injury.
Some of the more common injuries include joint injuries and pulled muscles. Knee injuries are among the most common injuries. The injuries vary from patellofemoral syndrome or runner’s knee (pain behind the kneecap) to damage to ligaments such as the Anterior Cruciate Ligament (ACL). Another common injury is the ankle sprain where the foot turns inward. This motion can stretch or even tear the ligaments on the outside of the ankle. This can lead to pain, swelling, and bruising. In severe cases, one will not be able to apply weight to the joint. Several muscle groups are typically affected with pulled muscle injuries. Groin pull occurs with a side-to-side motion causing strain of the inner thigh muscles. Hamstring strain can be quite painful and take a long time to heal. Shin splints typically affects the inner side of the tibia (shinbone) secondary to inflammation of the muscle surrounding the tibia. Finally, elbow injury secondary to repetitive motion as seen with tennis or golf. Tennis elbow tends to be more on the outside of the elbow while golf elbow affects the inside more than then outside.
There are several simple techniques that will reduce the incidence of sports related injuries. Warm-up and stretching exercises are utilized to prepare for a subsequent strenuous workout. Preparatory warm-up increases body temperature. The increase in body temperature causes several physiological responses. An elevation in body temperature allows easier release of oxygen from hemoglobin and myoglobin, the oxygen carrying proteins in the blood and muscles, respectively; increase blood flow to muscles, which enhances delivery of substrates and removal of metabolic byproducts; reduction in muscle viscosity (muscles contract and relax faster thus improving power output efficiency); lowers the critical level at which metabolic reactions occur (acceleration of the metabolic rate); increase in the sensitivity of nerve receptors (augmentation of the nervous system); and increase in velocity of nerve impulses (helps with coordination of rapidly moving body parts). All these physiological changes reduce the incidence of musculoskeletal sports related injuries. Furthermore, warming-up the specific muscles that will be utilized subsequently during the strenuous exercise, will also reduce chances of injury since this type of warm-up provides a rehearsal of the physical activity to come. How does warming up prevent injury? Muscle elasticity is dependent on blood saturation. Thus, cold muscles with a low blood saturation are more susceptible to injury or damage than muscles at higher temperatures and higher blood flow. Higher temperatures increase the capability of ligaments and tendons to stretch which increases joint range of motion.
The benefits of stretching are a bit more controversial. Some studies assert stretching is beneficial, others claim it does not provide any advantage, and some conclude it can cause some harm. Consensus is that stretching improves flexibility which can lead to improved physical performance. Flexibility can also help reduce injuries to the musculoskeletal system.
If an injury occurs what can be done? Primarily, serious injuries need to be evaluated by a physician. If an injury appears deformed, there is excessive swelling or bruising, or extreme pain, then an evaluation is warranted. For most other injuries, during the first 48 hours, apply ice. Ice is typically placed in an insulating material and applied for 20 minutes of each hour. Over the counter medications such as non-steroidal anti-inflammatory drugs (NSAIDs) tend to help with the acute inflammatory process that occurs immediately after an injury. Compression with elastic bandage and elevation of the injured site can reduce swelling. For continued persistent pain and disability, one should consult with a physician.
Physical therapy can aid in recovery from an injury. Through physical therapy one can reduce pain secondary to soft tissue injury such as muscles, ligaments, and tendons; improve range of motion; build muscle strength; improve flexibility and function. A physical therapist can evaluate how one performs an activity and make suggestions to improve how the activity is performed and help lessen the likelihood of an injury. For certain injuries, muscle relaxants may be prescribed. Opioids are not typically prescribed unless there is severe injury such as a fracture.
Sports are the most common activities people engage in. To continue a lifelong relationship with sports, a few simple exercises such as warming up and stretching can help reduce the incidence of injury.