Sports Injuries: How the Experts Assess Them

Ankle Injury | Spine Technology and Rehabilitation

What should my doctor know about my sport in order to properly treat my sports injury?

Each sport has its own unique demands upon our body’s structural integrity. One key to evaluating a given sports injury lies in understanding the sport and the sport-specific mechanics causing the injury.

Sports like powerlifting, football and golf impose tremendous loads on the spine, creating a high incidence of low back injuries. Others such as Olympic weightlifting, swimming and gymnastics subject the shoulder to great torsional strain; explaining the associated high incidence of shoulder injuries in these sports. Overuse injury resulting in hip flexor strains, groin pulls, and hamstring strains are especially prevalent in sports involving jumping, kicking and sprinting; including figure skating, dance, martial arts, cycling, soccer and track and field. Tight hip flexors combined with weakness of the opposing muscles and improper rotation through the spine and pelvis are typical predisposing factors. Tearing of the muscular and or tendinous fibers usually presents as groin pain and soreness which is worsened with lifting the thigh or bending at the waist.

Burners or stingers are nerve injuries that occur when the head and neck are forcefully rotated or bent; stretching or compressing the nerves which run from the neck to the fingers. This explains the resultant burning or stinging sensation radiating into the arm. To no surprise, burners or stingers occur most frequently in contact sports as football, hockey or wrestling. Offensive and defensive lineman are the most at risk group, owing to the tremendous forces imparted on the neck during blocking and tackling. This same group are also at risk for developing sciatica; back pain radiating down the back of the leg toward the foot. In young to middle age athletes sciatica most often results from a bulging disk in the back compressing the adjacent nerve root (connecting to the sciatic nerve in the leg). Athletes whose sport requires prolonged positioning in a flexed forward posture, combined with trunk rotation seem to be most vulnerable. That’s why in addition to lineman, it also presents in cyclists, golfers, hockey and tennis players. Figure skaters represent an at-risk group, because of the imbalanced, torsional loading of the spine, upon landing their jumps repeatedly on the same leg. Again, your doctors, trainers and physical therapists need to be familiar with the sports related mechanisms of injury in order to understand how to approach and treat them.

What does a sport specific evaluation entail?

Assessment of sports injuries begins with a careful history and physical.

Historically the sports medicine team document training routines, the nature and frequency of events and competitions. Lifestyle is also an important consideration. For example, is the athlete consuming enough nutrient dense food to compensate for the intense demands, build-up of toxins and microtrauma imposed by their sport? Do they enjoy enough restorative sleep and stress relieving activities to properly heal? What is their warm-up ritual before workouts, events and competitions? Proper warm-up routines may enhance blood flow and aid flexibility. Our blood and cardiovascular system is literally our life force, delivering oxygen and nutrients, while removing harmful waste and toxins. Consequently, activities which promote blood flow can both help prevent and treat injuries. What type of cross training are they involved in? Could improper cross training mechanics be implicated as an injury mechanism?

A comprehensive physical examination must include a thorough analysis of general and sport specific movement patterns. For example, any gait deviation (faulty walking mechanics) is generally magnified by sports participation. Are there deficiencies in the athlete’s sport mechanics? For example a golfer, pitcher or boxer who doesn’t engage their hip musculature in proper sequence, is not only losing power but inviting injury. Our spine mechanics warrant special attention, as it is serves not only as the primary loadbearing axis of our body, but also as the locomotive engine. Consequently, if the spine is not functioning properly not only is it vulnerable, but it renders the arms and legs prone to injury occurrence. Keeping the spine strong and flexible in bending both front to back and side to side, as well as in rotation, is critical for optimizing sports performance and mitigating the risk of injury.

What factors drive treatment decisions?

Treatment options may range from conservative to minimally invasive procedures, as well as surgical intervention. Treatment decisions will be based on the injury type/location, severity, demands of a given sport, the options available, potential risks associated with a proposed procedure, recovery protocols and lifestyle choices. Whatever treatment options are ultimately chosen, understanding the sport specific biomechanics is paramount for prescribing a rehabilitation protocol geared toward long-term success. Once the body is injured it becomes imperative to optimize performance mechanics to prevent further stress concentration at the injury site and recidivism.

Learn More About Dr. Fortin

Dr. Joseph Fortin, DO Dr. Joseph Fortin is the Medical Director at Spine Technology and Rehabilitation and a Clinical Professor at Indiana University School of Medicine.

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