Sports Injury Treatment & Prevention
[ Most common injuries for all types of athletes ]
The rotator cuff is the name for the four tendons that surround and help control the shoulder joint. The rotator cuff surrounds the ligaments of the shoulder and control the movement of the joint throughout its range of motion. Rotator cuff injury is the most common shoulder affliction. People with rotator cuff conditions often have pain with many common activities such as reaching and lifting. Rotator cuff tears and tendinitis can interfere with sleep and become very frustrating.
Treatment of a rotator cuff injury depends upon the degree of damage to the tendons. Most conditions involving the rotator cuff respond readily to conservative measures such as a period of rest, anti-inflammatory medicines, modification of activities and injury therapy. Once pain subsides, exercises are important to restore blood flow and continue the healing process. In more severe cases, injections and sometimes surgery help to alleviate the problem.
Ankle sprains not treated correctly or an ankle that has sustained multiple injuries may result in chronic instability. This may produce an ankle that feels “weak”, “unstable”, or “buckles” frequently. An orthopaedic surgeon can perform a physical exam to determine the amount of joint “laxity”. Initial treatment includes bracing to protect the joint, but most important is correct rehabilitation of the ankle. This often requires the aid of a physical therapy to improve strength and balance. Severe sprains also result in loss of nerve fibers within the ligaments that help us tell where the foot is in space. The therapist can also help to restore this proprioception, or “position sense” of the ankle.
Sprains are injuries to the ligaments of the ankle causing them to partially or completely tear as a result of sudden stretching. They can occur on either the inner and outer portions of the ankle joint. The typical injury occurs when the ankle is suddenly “twisted” in a sports activity or by stepping off an uneven surface. The pain is initially severe and can be associated with a “popping” sensation. Immediate swelling and bruising over the area of injury often occurs as the injured blood vessels leak fluid into the local tissue. Examination of the area may be quite tender to touch and painful with weight bearing. Ligament injuries may be graded from I to III, ranging from partial to complete tears. Partial tears retain some ankle stability, whereas complete tears result in decreased stability.
Acute ankle sprains are initially treated with RICE (Rest, Ice, Compression, Elevation). Anti-inflammatory medications can be given to reduce local inflammation. Frequently, an x-ray is required to rule out the possibility of a fracture. Many sprains are under treated, which may result in chronic instability of the ankle. Certain severe sprains require a period of immobilization in an orthopaedic boot or cast so that the ligaments will heal in the correct, tight position. An ankle sprain that remains painful may indicate other injuries to bone, cartilage, or tendon. Occasionally, additional imaging such as an MRI may be required to investigate these associated problems. A “high ankle sprain” may be diagnosed as well which takes significantly longer to heal.
Plantar Fasciitis is the most common condition of heel pain. This condition occurs when the long fibrous plantar fascia ligament along the bottom of the foot develops tears in the tissue resulting in pain and inflammation. The pain of plantar fasciitis is usually located close to where the fascia attaches to the calcaneous, also known as the heel bone.
The most common complaint from plantar fasciitis is a burning, stabbing, or aching pain in the heel of the foot. Most sufferers will be able to feel it in the morning because the fascia ligament tightens up during the night while we sleep, causing pain to diminish. However, when we climb out of bed and place pressure on the ligament, it becomes taut and pain is particularly acute. Pain usually decreases as the tissue warms up, but may easily return again after long periods of standing or weight bearing, physical activity, or after getting up after long periods of lethargy or sitting down.
In most cases, plantar fasciitis does not require surgery or invasive procedures to stop pain and reverse damage. Conservative treatments are usually all that is required. However, every person's body responds to plantar fasciitis treatment differently and recovery times may vary.
What is Achilles tendinitis?
Achilles tendinitis is an inflammation (swelling) of the tendon, which usually occurs as a result of overuse injury. Anyone can have Achilles tendonitis. Athletics involving frequent jumping is the classic cause, but certainly not the only one. Any activity requiring a constant pushing off the foot, such as running or dancing, may result in swelling of the tendon.
Symptoms and treatment for Achilles tendinitis
People with Achilles tendinitis may experience pain during and after exercising. Running and jumping activities become painful and difficult. Symptoms include stiffness and pain in the back of the ankle when pushing off the ball of the foot. For patients with chronic tendinitis (longer than six weeks), x-rays may reveal calcification (hardening of the tissue) in the tendon. Chronic tendinitis can result in a breakdown of the tendon, or tendinosis, which weakens the tendon and may cause a rupture. The recommended treatment for Achilles tendinitis consists of icing, gentle stretching, and modifying or limiting activity. Nonsteroidal anti-inflammatory medications (NSAIDs), such as ibuprofen or naprosyn, can reduce pain and swelling. Physical therapy and the use of an orthosis (heel lift) can also be helpful.
What is an Achilles tendon tear or rupture?
Achilles tendon rupture is a severe and disabling injury. A rupture usually takes place a couple of inches above the joining of the tendon and the heel bone. This typically occurs when someone contracts, or tightens, the calf muscle and suddenly pushes off the foot, such as in basketball or racquet sports. The injured person experiences pain, swelling, and an inability to stand on their tiptoes. The person may feel as if they were “kicked in the back of the heel.”
What exactly is the ACL, and what role does it play in sports?
The ACL is one of the four main ligaments in the knee and is the primary stabilizer. It’s the smallest of the four, but it serves the most important function: It stabilizes the knee for rotational movement. When you cut to change direction, that’s when the ACL comes into play. For most straightforward activities, such as jogging, the ACL isn’t involved. The most common sports in which ACL tears include soccer, basketball, football, and tennis. Back in the old days, before we really understood the function of the ACL, having an ACL injury used to be called a “trick knee.” The reason a knee without an intact ACL gives out occasionally is that it’s lost that stabilizer, and although it does not give out every single time, you never know when it will and when it won’t.
This injury is rampant. There are between 250,000 and 300,000 ACL injuries per year, and they’re almost exclusively happening to athletes. The chances of a nonathlete suffering an ACL injury are 1,000 to 1. The most common mechanism of injury is non-contact and caused by cutting. You’re running along, you plant to change direction, and your knee buckles. The next most common is a contact injury such as being clipped from behind in football and hockey. A skier can also tear an ACL when the ski catches awkwardly in the snow or the carving of the ski twists the leg.
Shin Splints
Shin splints is the common name for the medical condition called medial tibial stress syndrome in which pain occurs along the tibia (shin bone) in the front of the lower leg. The pain is a result of small tears in the area the lower leg muscles’ attachment to the tibia. Shin splints are typically caused from intense or vigorous athletic activity and can be resolved with adequate rest, stretching, deep tissue muscle release and modifying your exercise routine.
Sciatica
Sciatica is a symptom of a problem with the sciatic nerve, a large nerve that runs from the lower back down the back of each leg. It controls muscles in the back of your knee and lower leg and provides feeling to the back of your thigh, part of your lower leg and the sole of your foot. When you have sciatica, you have pain, weakness, numbness or tingling. It can start in the lower back and extend down your leg to your calf, foot, or even your toes. It’s usually on only one side of your body.
