Participation in sports or exercise is an important step
in maintaining your health. Exercise strengthens your
heart, bones, and joints and reduces stress, among
many other benefits. Unfortunately, however, injuries
during participation in sports are all too common. Often,
these injuries occur in someone who is just taking up
sports as a form of activity, doesn’t use proper safety
equipment, or becomes overzealous about the exercise
regimen.
The more commonly injured areas of the body are the
ankles, knees, shoulders, elbows, and spine.
Remember that you should discuss any exercise program
with your doctor of chiropractic before undertaking
such activities.
Strains and Sprains
Although bones can sometimes be fractured with acute
sports injuries, the most commonly injured structures
are the muscles, tendons, and ligaments. Tendons
attach muscles to bones, and ligaments attach one
bone to another.
An acute twisting or overextension of a joint can lead to
tears of muscles and tendons, called “strains,” and
tears of ligaments result in “sprains.” These tears range
from mild to severe. In mild injuries, just a few fibers are
torn or stretched. Severe injuries, where there is a tear
through the full thickness of the structure, are most
often considered unstable injuries and frequently require
surgical intervention. The intervertebral disc, a ligament
between the vertebrae of the spine that works as a
shock absorber, can also be torn, resulting in a disc
bulge and/or herniation.
Ankle sprains most often involve tears of one or more of
the ligaments along the outside of the ankle. Knee ligaments,
including the larger external supportive ligaments
and the smaller internal stabilizing ligaments, can
also be torn. The cartilage on the back of the patella
(knee-cap) can also become eroded from overuse, leading
to a condition termed chondromalacia patella.
Tendinosis
In those who are training too much, overuse of a particular
joint or joints in the body can result in pain and dysfunction.
These injuries are called “overuse syndromes.”
A common overuse injury is tendinosis, also called tendinitis.
In this condition, the tendon becomes inflamed
from repetitive use. In the shoulder, the rotator cuff (a
complex of muscles that stabilizes and moves the
shoulder) becomes inflamed, resulting in rotator cuff
tendinitis. Tennis elbow is another form of tendinitis that
occurs along the outside of the elbow, most commonly
in tennis players. In golfer’s elbow, the tendons on the
inside of the elbow are affected.
Stress Fractures
Some athletes may experience a stress fracture, also
called a fatigue fracture. This type of fracture occurs
when an abnormal amount of stress is placed on a normal
bone. This might occur in a runner who rapidly
increases the amount of mileage while training for a
race. Stress fractures also occur in people who begin
running as a form of exercise but overdo it from the
start, rather than gradually progress to longer distances.
One final common injury is worth mentioning, and that
is shin splints. This overuse injury is caused by
microfractures on the front surface of the tibia (shin
bone). This is most often seen in runners, although other
athletes can also be affected.
Diagnosis and Treatment
Sports injuries are most often diagnosed from the history
of the activity that brought on the pain, along with a
physical examination. In some cases, x-rays are necessary
to rule out a fracture. Magnetic resonance imaging
(MRI) and diagnostic ultrasound are also used in finding
soft-tissue injuries, like tendinitis and sprains.
Fractures require the application of some stabilizing
device, such as a cast, after the bone is put back into
position. Rarely, surgical intervention is required. There
is a relatively standard treatment protocol for most of
the other overuse types of injuries. This protocol
involves the following:
Rest
Generally no more than 48 hours of rest and/or immobilization
is needed, depending on the severity of the
injury. In most cases, the sooner the person becomes
active after an injury, the more rapid is the recovery. In
fact, long-term immobilization can sometimes be harmful
to recovery. Your doctor of chiropractic will guide this
process, as too early a return to activity, choosing the
wrong type of activity, or excessive activity can be detrimental.
Ice or heat
Ice or heat can be helpful with pain reduction and tissue
healing.
Compression
Compression of the area may reduce the amount of
swelling from the injury. Your doctor of chiropractic will
determine if this will be beneficial in your case.
Elevation
Elevation of the injured arm or leg above the level of the
heart is thought to be helpful in reducing swelling.
Pain relievers
Recent research has demonstrated that some nonsteroidal
anti-inflammatory drugs may actually slow the
healing process by restricting the body’s natural healing
mechanisms, so they should be used sparingly.
Joint manipulation
Recent research has shown us that, in some cases, joint
manipulation can be helpful with pain reduction and
more rapid recovery. Your doctor of chiropractic will
determine if this procedure will be helpful in your case.
A Word About Prevention
In many cases, sports injuries can be prevented. Proper
conditioning and warm-up and cool-down procedures,
as well as appropriate safety equipment, can substantially
reduce injuries. Understanding proper techniques
can also go a long way toward preventing injuries.
Sufficient water intake is also an important preventive measure.
