Sports Injuries

Sports injuries are all those aches, pains, and injuries caused from sports or exercise. Although, most sports injuries happen because of accidents, there are other reasons as well.
These include:

  • lack of warm up and stretching before exercise
  • improper use of equipment in sports or exercise
  • overdoing or exerting oneself or overuse from repetition – such as with racquet sports
  • lack of training or improper training

These injuries can affect any part of the body; however, it is mostly referred to in case of injuries which affect the bones, muscles, or adjoining ligaments and tissues.

Types of Sports Injuries

Sports injuries are categorized based on the part of the body it affects. Injuries include:

  • sprains, strains and spasms affecting muscles, ligaments, tendons
  • injury to ligaments (hip ligaments, knee ligaments, foot and ankle ligaments)
  • injury to tendons (e.g., Achilles tendon)
  • dislocation of joints (e.g., shoulder, knee)
  • bone fractures

The most common injuries:

Sprain
The connective tissues which joins the ends of bones in a joint are called ligaments. Muscles attach to bones with tendons. A sprain is when a ligament partially or completely tears in or around a joint. Sprains are described as first, second, or third degree. Commonly affected areas for sprains are ankles, knees, and wrists and cause by  a twist, fall or overstretching of the involved tissue. The signs of sprain include bruising, inflammation, swelling, pain, tenderness, instability, and immobility.
Strain
When there is excessive stretching of a muscle or tendon resulting in pain, soreness and inability to use normally it’s called a strain. Strains are described as first, second, or third degree. Signs of strain are pain, muscle contraction or tremor, and loss of strength. Causes of strain are excessive use, pull or stretch of tissue affected; strain may happen suddenly or over time from chronic use or overuse.
Fractures
A break in the bone is called a fracture. There are two types of fractures — acute and stress fractures. Acute fractures are caused by a one-time blow to the bone. Acute fractures can be simple or compound. A simple acute fracture is one with just one crack/break and very little damage to the surrounding tissues. A compound fracture is where there are multiple cracks and the broken bone sticks out through the skin. Compound fractures can be very dangerous because the risk of infection increases. Stress fractures occur mostly on legs and feet from repetitive stress on those areas from sports like sprints, hurdles, gymnastics etc., which requires constant running and jumping.
Dislocation
A dislocation is when the bones in a joint completely separate and caused by pressure severe enough to push or force a bone from a joint. Sports which involve lot of pushing, stretching, or falling, like football or basketball, can cause dislocations. The shoulder joint is the most prone to dislocation.
Knee injuries
Knee injuries vary from mild to severe and can affect the knee bones, ligaments, tendons or cartilage. Mild knee injuries include runner’s knee, which causes pain on the sides and below the knee; iliotibial band syndrome, which causes pain on the outer part of the knee; and tendinosis, which causes the tendons to wear out. More severe injuries involve damage to the cartilage, ligaments, or the bones. Knee injuries can be caused by jumping, running, and constant stress on the knee from twisting and turning, which are all a part of sports activities. Click here to learn more about knee anatomy and function or ACL ligament injuries.
Shin splints
Shin splints affects the shin or tibia, the front portion of the lower leg. However, shin splints is generally used to denote any type of leg pain. This  injury is caused by overuse or improper use of the lower leg like incorrect exercise techniques, over training, overstretching, and running or jumping on hard surfaces. It occurs with new runners  where the person may not aware of the correct warm up or running techniques or is not wearing shoes with proper padding for support.
Achilles tendon injuries
The tendon that attaches the calf muscles to the heel is the Achilles tendon. Any injury resulting in stretching or tearing of this tendon is an Achilles tendon injury. It mostly occurs with trauma when the tendon becomes weak due to aging or overuse. It occurs in football, basketball, or tennis if the player has not warmed up enough before the game or if the tendon has become weak from overuse.
Compartment syndrome
The muscles of the body along with the adjacent nerves and blood vessels are covered within a membrane called fascia. The fascia forms a “compartment.” With certain injuries, the muscle swells and causes pressure on the adjacent nerves and blood vessels within the compartment. This causes pain and the symptom is called compartment syndrome as it involves the compartment. It can occur in any kind of sport and caused either by a one-time injury, repeated overuse or repeated injuries to the same area.

Acute versus Chronic Sports Injuries

Sports injuries can be broadly classified into two categories — acute and chronic.

Acute injuries are those which occur suddenly, like a sprain, strain, fracture, etc. The symptoms of acute injuries are sudden excruciating pain, swelling, tenderness, weakness in the particular area, inability to bear weight, problems with in range of motion, or a visible fracture or dislocation.

Chronic injuries on the other hand are those which occur over time due to repeated use or overuse of that part of the body. Chronic injuries can happen while playing any sport or with regular exercise. The symptoms of chronic injuries include swelling, pain in the area with a particular movement, or constant dull pain even at rest. Chronic injuries can affect range of motion and strength in the joints.

Treating sports injuries at home

Minor sports injuries and ones without severe symptoms, can be treated at home with RICE therapy. Even some serious injuries can be first treated at home before seeing a doctor. The four steps in RICE therapy can be used to reduce the initial pain, inflammation, and swelling.

R – Rest is an essential factor in the healing process of any wound or injury. There should be limited or no weight bearing on the affected area. Activities should be stopped or at least reduced to rest the injured area.

I – Ice packs should be applied to the affected area to reduce bleeding or relieve the pain. Crushed ice wrapped in plastic bags and covered with towel make a good ice bag. Don’t apply ice directly to the skin. Ice packs should be limited to 20 minutes at a time. Heat should never be applied immediately after the injury as this can cause increased bleeding and swelling.

C – Compression of the injured area can help reduce swelling and blood loss. Splints, elastic wraps (Ace bandage), or air casts can be used to compress the area.

E – Elevation of the injured area, like the elbow, ankle, knee, or wrist, helps reduce swelling. The affected area can be elevated by propping on pillows. The injured area should be elevated to a level higher than the level of your heart. In case of knee or foot injuries, you need to lie down to get the knee or foot higher than your heart.

When to call a doctor

If after the RICE treatments your symptoms don’t go away, you likely should see a doctor. You should call your doctor if the injury is so severe that nothing can be done at home. In cases where the patient is not able to bear any weight on the injured area or there is swelling or joint abnormality in an old injury, you need to see a doctor. For compound fractures, ligament or tendon tears, you should go to the emergency room for immediate treatment.

In most cases, the initial treatment of an injury is done by your regular doctor. Very serious injuries need to be taken to the emergency room. Then depending on the nature of the injury, you will either be referred to an orthopedist, who treats injuries to the musculoskeletal system; or a physiotherapist, who performs a rehabilitation program after the injury — or after surgery if surgery is needed.

Other treatment options

The RICE technique can used to treat the initial stage of the injury, but your doctor, after seeing the severity of the injury, can suggest one or more of the following treatment options.

Immobilization — This is used to stop the movement of the affected area to prevent further damage and speed the healing process (immobilization ensures proper blood supply to the affected area). Immobilization can be achieved using slings, casts, splints, and immobilizers.

Electrostimulation — In this method, mild electric current is applied to the injury which stops the nerve cells from sending pain impulses to the brain. It’s also used to reduce swelling and increase muscle strength by preventing muscle atrophy.

Cryotherapy — This reduces pain by applying ice packs to the affected area, which makes the area numb. It’s usually used in the first 48 hours after the injury.

Thermotherapy — Applying heat to the affected area, with heating pads or hot compresses, helps to reduce pain. It also increases the blood flow to the injured site whereby the healing nutrients reach the injured site and aid in the healing process. An important point to be noted here is that heat should not be applied in the first 48 hours of the injury. Also, heat can be used to warm up the injured area before rehab exercises.

Ultrasound — High-frequency sound waves are passed around the affected area which produces heat. Heat helps to increase the blood flow to the area and speed the healing process. Increased blood flow also helps bring medicine to the area.

Massage — Pressing and rubbing tense muscles manually increases the blood flow to the area and relieves pain. However, massage should be done in consultation with your doctor, as it can have a reverse effect in certain injuries, like fractures.

NSAIDs — Nonsteroidal anti inflammatory drugs are used to reduce inflammation and pain. NSAIDs like aspirin, ibuprofen, ketoprofen, naproxen sodium are easily available over the counter. Like any other medication, NSAIDs have side effects though they are not as severe as other medications. Side effects may include nausea, vomiting, or diarrhea. Any doubts about medicines should be approved by your doctor before taking them. Medications, other than NSAIDs, like acetaminophen are also prescribed for pain relief.

Surgery — Most sports injuries do not need surgery. But, when the injury is so severe that it cannot be repaired by any other method, surgery may be recommended. Surgery can be needed to repair torn ligaments or tendons and realign bones in a severe compound fracture. Surgery can include knee arthroscopy or shoulder arthroscopy.

Rehabilitation — For sports injuries, rehabilitation is a supervised exercise program that helps bring back normal function of the injured area. In most cases it starts with mobilization, since at the time of injury, the injured area has been immobilized. Movement is done gradually, beginning with simple range-of-motion exercises and building up to stretching and strengthening exercises. This is followed by adding weights or resistance to further strengthen the area. It is a very slow process and depends on how much time, effort and pain the patient is able to handle. Too much weight at one time may lead to setback re-injury. Slow and continuous stretching exercises should be done to maintain the flexibility, since healing forms scar tissues which tend to become stiff and tight. The goal is to increase flexibility, endurance, and strength to get back to full participation in the sport.

Preventing Sports Injuries

Any age group or fitness level who plays sports or exercises regularly is at a high risk of sports injuries. However, preventive measures should be taken depending on whether it’s a child or an adult. Children are at a higher risk of getting injured compared to adults. However, injuries to adults are more severe than those to children. Below are preventive measures based on age.

Children

Preventing injuries to children has to be a combined effort of parents, coaches, and the child. Children should follow these tips to prevent sports related injuries:

  • Warm up before any sport and cool down after.
  • Wear appropriate, well fitted protective gear wherever required.
  • Follow rules of the game.
  • Learn the right way to use of athletic equipment.
  • Be physically fit before the game. Don’t play if you are sick or tired, you’re more likely to get injured.

Tips for parents and coaches:

  • Groups should be formed according to size and skill levels — not according to age.
  • Kids should be allowed to play sports based on their ability and fitness level instead of pushing them to play beyond their capacity.
  • Put children in sports program, which have trained professionals who are well equipped to give immediate medical care to any sports injury and can teach ways to avoid injuries.
  • Children should have a complete physical examination before starting any sport.
  • Never let children push themselves by continuing to play while sick or hurt.
  • Children should be provided with safe fields and gyms to avoid serious injuries.

Adults

Adult athletes should follow these preventive measures:

  • Don’t over exert yourself. Maintain regular moderate activities. Increase your level gradually.
  • Learn the correct way of playing the sport or using exercise equipment.
  • Always wear appropriate and well fitting safety gear.
  • Work out the entire body with cardio, stretching, and flexibility exercises. This will not only prevent injuries but help your strength and endurance.

Women

In addition to the above, women should maintain proper body weight and avoid exercise that affects their normal menstrual cycle. Also, it’s important to work on both muscle strengthening and conditioning.