According to recent data from the US Department of Health and Human Services (HHS) roughly 8.6 million sports injuries occur each year. If your injury represents one of these statistics, you’re probably wondering what your treatment options might be. In this guide, Spine Technology and Rehabilitation in Fort Wayne Indiana is pleased to provide you with some basic guidelines. Guidelines which promise to ensure that you understand enough about proper treatment of sports injuries to be your own best advocate.
In this guide you will learn:
- When to seek medical advice for a sports injury,
- What your doctor should know to properly treat your sports injury,
- What a comprehensive sports injury evaluation consists of,
- What treatment you should expect from your sports medicine team.
- Some common types of sports injuries,
- Why each sport is prone to specific injuries,
- The basic factors which drive your doctor’s treatment decision
When should I seek medical attention for a sports injury?
Many common, acute sports injuries can initially be addressed by applying the PRICE method. Specifically:
- Protect the injured area from further damage (e.g. splint, tape, crutch)
- Restrict activity which is offensive to the injury
- Ice (20 minutes on 20 minutes off the injured area)
- Compression (this can be done manually by your physical therapist for fluid mobilization, by a mechanical device or by applying an elastic bandage)
Steps 3, 4, and 5 are combined to decrease swelling and inflammation.
You should seek medical attention if:
- there are any signs of bleeding or infection, including refractory drainage from a wound
- discoloration beyond mild bruising and excess swelling or pressure sensation
- loss of strength or loss of sensation
- impaired weight bearing on the affected limb
- deformity of the injured body part
- failure to respond to the PRICE method within a few days.
What should my doctor know about my sport in order to properly treat my sports injury?
Your doctor should at least know enough about your sport to establish the proper diagnosis or cause of your symptoms. 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 that causes the injury. Consider that the biomechanics of your sport inform the physician which areas of the body undergo the greatest stress concentration with each activity, as well as what the potential pitfalls are with faulty mechanics or movement patterns. In other words your doctors, trainers and physical therapists need to be familiar with the sports related mechanics and required movement patterns, in order to really understand your injury. That knowledge helps your team to provide you with the best possible treatment outcome, as well as to boost your performance and avoid re-injury. In addition to performance and prevention factors, sports medicine addresses other vital sports-specific issues such as scheduling demands, recovery time, equipment and nutritional requirements.
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? Case in point: a golfer, pitcher or boxer who doesn’t engage their hip musculature in proper sequence, is not only losing power but is susceptible to injury. Our spine mechanics warrant special attention because it is serves as the primary loadbearing axis of our body, as well 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. Keeping the spine strong and flexible in bending both front to back and side to side, as well as in rotation, is critical for peak sports performance and mitigating the risk of injury.
What kind of treatment should I expect from my sports medicine doctor?
Consider that a delay in diagnosis may often unnecessarily prolong treatment and recovery time, leading to a suboptimal outcome. Goal oriented sports medicine is focused on rapidly establishing a diagnosis to allow the best possible treatment results including resolution of pain, optimizing function and preventing reinjury. This combination ensures the quickest and safest return to play.
You should expect your sport medicine physician and healthcare team to:
- understand the mechanism leading to your injury
- do the necessary detective work to reveal the smoking gun, or anatomically specific diagnosis
- deliver targeted, expeditious treatment based on the precise diagnosis
- monitor your post treatment rehabilitation protocol to ensure a positive treatment outcome
- provide the best opportunity to boost your performance following the treatment protocol
- issue a prevention protocol to guard against re-injury
- evaluate any possible equipment related injury factors
- give customized nutritional and lifestyle advice
What are the some of most common types of sports injuries?
Let’s take a look at some well-known athletic injuries and share some treatment advice.
- Abrasions and lacerations - Minor scrapes and cuts usually only call for soap and water followed by the application of a protective barrier or band-aid. Larger lacerations may require antibiotic irrigation, special dressings and sutures. Tetanus shots may be necessary, absent an immunization history which includes 10-year boosters.
- Muscle spasms or cramps - Muscle cramps or “Charlie horses” often results from depletion of water and electrolytes or minerals with strenuous and/or prolonged athletic activity. Most often they can be treated with gentle stretching, hands-on trigger point therapy, as well as replenishing water with mineral and electrolyte supplements.
- Contusions - The telltale sign of a contusion is a black and blue mark. When severe these can be dangerous, particularly in certain areas such as the calf which are prone to compartment syndrome. Compartment syndrome is caused by intense, sustained swelling; causing tissue damaging pressure to build. Surgery can be avoided in mild cases with ice, elevation and fluid mobilization. Moderate cases require oral or IV steroids and severe cases call for surgical decompression to alleviate the mounting pressure. Any injury where pain and swelling persists, particularly when accompanied by weakness, inability to bear weight, or loss of sensation warrants immediate medical attention.
- Strains - Commonly referred to as muscle pulls, strains are caused by tearing of muscular fibers or tearing of the tendons that attach the muscle to bone. Depending on the extent of trauma they range from partial to full thickness tears. It’s important to note that while this injury can be caused by a single traumatic event, it is often the result of repetitive overloading to failure. Proper therapeutic exercise to prevent the muscle imbalance which leads to muscular fatigue and eventual failure is essential. Taping and splinting to offset loadbearing across the injury site is another consideration.
- Tendinitis - Tendons are the fibrous tissue which connect muscles to bones. Tendons get angry and become inflamed as a result of faulty movement patterns and muscle imbalance. While redness and swelling may be evident along the pathway of the tendon, the most characteristic symptom is pain at the beginning of an exercise routine (stressing the tendon) which then temporarily eases -- only to return. Some tendons like those of the rotator cuff have watershed zones, which are relatively devoid of blood supply, leading to throbbing pain as the patient lies down to rest in the evening. Complete tears may necessitate surgical intervention, but mild to moderate tears often respond to conservative care and regenerative medicine.
- Sprains - Ligaments are the connective tissue bands that attach one bone to another. When the elastic limits of these fibers are exceeded by trauma they tear, producing weakness, limited joint mobility and bruising. Similar to strains and tendon injuries, mild to moderate sprains often respond to conservative care (physical therapy, taping and splinting) and regenerative medicine. Surgery is reserved for full thickness tears.
- Bursitis - A bursae is a fluid filled sac that allows tendons (attaching muscles to bones) to glide smoothly over bony prominences. Muscle imbalances may lead to abnormal slipping of the tendon over the bursae creating inflammation. Conservative care consists of topical anti-inflammatories, physical therapy and taping. Some cases require an image guided anti-inflammatory injection.
- Fractures and dislocations - Any traumatic event followed by deformity, marked swelling, discoloration and pain warrants immediate skilled medical management. Leave it to your doctors to decide if your injury simply requires some splinting and rest or necessitates surgery.
- Arthritis - Arthritis is inflammation of a joint. Symptoms of arthritis include pain, swelling, redness, popping, clicking, giving way, locking or difficulty bearing weight. Topical anti-inflammatory medication, splinting, activity modifications and therapeutic exercise are usually adequate treatment. Other medications, injections, regenerative medicine (stem cell treatment) or surgery may be advisable in some presentations.
- Plantar fasciitis - The plantar fascia is the fibrous connective tissue across the bottom of our foot, which maintains the arch and helps to control the storage and release of elastic energy while we are walking or running. If the bottom of your foot feels stiff and achy, particularly when your feet first hit the floor in the morning, you may have plantar fasciitis. Don’t delay treatment, because far too often it becomes a chronic, nagging problem. Treatment generally consists of therapeutic massage, anti-inflammatory agents, taping, orthotics and in long-standing cases injections.
Are people in my sport prone to certain types of injuries?
Yes. The innate movement patterns of your sport determine which areas of your body are most prone to injury. That’s one of the reasons why it helps for your doctor to know the basics of what your sport involves. Let’s take a look at a few examples of the role various sports activities play in determining which areas are most vulnerable:
- 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 injuries 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 linemen 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 which is 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 linemen, 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 factors drive treatment decisions?
Treatment options may range from conservative (e.g. splints, meds and rehab) to minimally invasive procedures (e.g. image-guided injections or arthroscopic surgery), as well as major surgical interventions. 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 address performance mechanics to prevent further stress concentration at the injury site. A good sports medicine team understands that each sport has its own nuances. In other words, they don’t simply see your injury as another sprain, strain or broken bone. They place your injury and treatment protocol in the overall context of the individual needs of your sport and lifestyle. Spine Technology and Rehabilitation in Fort Wayne, Indiana applies all of the factors referenced in this blog when evaluating sports injuries. Contact our office today to learn more or set up an evaluation.