Sport Specific Injuries:
No matter the sport, injuries fall into two main categories, acute and overuse (repetitive strain).
High impact sports like soccer and basketball have a higher incidence of acute injuries while repetitive motion sports like running, cycling, and swimming have a higher incidence of overuse injuries.
Patient can usually recall the precise time at which the injury occurred.
An example is, "rolling" the ankle resulting in a sprain. Acute injury occurs when the force applied to skin, joint, muscle, ligament, or tendon, is beyond the anatomic limits of that tissue.
The pain of an acute injury is from tissue damage, bleeding, and inflammation.
The hallmark signs of inflammation are:
Loss of function
Repetitive strain (overuse):
This type of injury is more common in repetitive motion sports such as running or cycling. An example is plantar fasciitis.
Overuse injuries occur when the repetitive trauma/stress to soft tissue or bone occurs at a greater rate then healing.
The, "Terrible toos" are usually to blame:
Too little attention to pain
Treatent will vary based on the type and severity of the injury but the following should be included in the treatment plan.
I. Control pain and inflammation
Follow RICER: Rest -- Ice -- Compression -- Elevation -- Rehab
Rest- With the exception of fractures and significant soft tissue trauma, injuries rarely require absolute rest. Relative rest means that one should carry on with normal activities and exercises that do not provoke symptoms.
Ice- helps control inflammation and is analgesic
Compression- helps control swelling and pain.
Elevation- helps control excess fluid accumulation at the site of injury
Rehab-Early, appropriate, and safe rehabilitation can begin soon after injury.
II. Modify training
Don't play through pain that changes your gait or run or forces you to compromise your form. Be smart with your return to play plan. When a few weeks have been missed, returning to pre-injury play is a mistake. You should perform sport specific movements and skill work prior to return to play.
III. Address muscle imbalances
Not everyone needs the same stretches and strengthening exercises. It is important to receive a musculoskeletal assessment to determine what needs to be stretched and what needs to be strengthened.
IV. Core stabilization training
Core stabilization training allows us to control body movement and withstand the forces placed on the body by the surface and by external forces. Core stability training is more complex then performing crunches. A sports chiropractor or physical therapist can guide you through an appropriate routine.
V. Dynamic stretching
Dynamic stretching should be performed AFTER a brief warmup but BEFORE the activity. The motions of the dynamic stretch should mimic the activity you are about to perform. Static stretching, where one holds the stretch for 15-30 seconds should be used after the activity.
VI. Manual therapy to address scar tissue / adhesions / muscle tension
(ART) Active Release Technique providers are trained to detect and treat soft tissue adhesions common to repetitive strain injuries. These adhesions are often the culprit in slow or poorly healing injuries.
PREHABILITATION is a sports medicine concept of working to prevent injuries before they occur. This includes finding the appropriate balance between strengthening and flexibility, addressing old injuries, and being pro-active when symtpoms do arise. Making the right choices and working with the appropriate professional can literally keep you in the game.
MOST COMMON RUNNING INJURIES
tibial stress syndrome (shin splints)
itb friction syndrome
Most running injuries are repetitive strain in nature. All runners should be aware of the following stages of repetitive strain injuries.
Stages of repetitive strain injury:
I. Pain at beginning of run, goes away once warmed up.
II. Pain before run, goes away during run, may hurt following the run.
III. Pain felt throughout the run, altering gait and limiting run time.
IV. Pain during normal activities of daily living (Walking, stairs, etc.)
IT IS IMPORTANT TO CATCH THESE TYPES OF INJURIES IN THE EARLY STAGES!
Repetitive strain injuries in runners are due to a combination of intrinsic and extrinsic factors.
Intrinsic factors have to do with features of your individual body type and anatomy Examples include:
Anatomic leg length discrepancy
Previous injury with soft tissue changes
Extrinsic factors are modifiable factors, usually pertaining to training decisions.
Training errors-see," terrible too'"s
Poor training outside of running
Road surface problems- ex) road pitch
Addressing as many intrinsic and extrinsic factors as possible will be key to resolving (and preventing) repetitive strain injuries.
The two most common errors I see in runners are:
1- not adhering to a core stability and hip strengthening routine to supplement runs
2-not having a good return to run protocol following injury.
MOST COMMON CYCLING INJURIES
neck and back pain
wrist and hand pain or numbness
Cycling poses a unique challenge because of the flexed posture one assumes during a ride. Cyclists who spend alot of time at the computer can face additional challenges because the cycling posture can result in similar weak and tight muscle patterns one develops at the desk. This opens the door to neck and lower back pain.
One of the most common causes of knee pain in cyclists, especially beginners, is patella tracking dysfunction. The patella, a floating bone, tracks in a groove on the femur. Muscle weakness around the hip and knee may cause a mal-tracking of the patella which can lead to dull, aching and difficult to localize pain. Strengthening muscles around the knee as well as the lateral hip musculature can address this very common condition.
Tips for cyclists:
-Make sure your bicycle is fit for you by a professional.
-Perform exercises and stretches at home which counter the effects of the forward posture of cycling.
-As with other repetitive strain injuries, don't ignore pain that is causing you to compromise your form.
-Padded cycling gloves can prevent wrist and hand symptoms.
-Protect the knees with exercises to strengthen the lower back and lateral hip muscles in addition to the quadriceps, hamstrings, and calves.
MOST COMMON SWIMMING INJURIES
shoulder pain- most common
hip and knee pain
As with running, the most common types of swimming injuries are repetitive strain in nature.
Shoulder pain is the most common swimming injury.
Anatomy of the shoulder:
The shoulder is one of the most complex joints in the body. A healthy shoulder allows us to perform a wide range of movement, unlike any other joint. The success of the overhead swim stroke is dependent upon several anatomic components working together to ensure smooth, pain free motion.
A painful shoulder in a swimmer is often the result of cumulative trauma in the presence of weak or tight muscles. The soft tissues surrounding and supporting the shoulder are the most common culprits in a repetitive motion sport such as swimming.
The shoulder is comprised of three joints- the glenohumeral joint, AC joint, and SC joint. It also has a unique, "pseudo-joint" called the scapulothoracic joint.
These joints depend on more than a dozen muscles which keep it centered and stabilized through broad range of motion. A failure in this stability system leads to familiar diagnoses such as tendinitis, tendinosis, bursitis, and impingement syndromes.
All swimmers should be aware of what stretches to avoid and the proper stretching techniques. This article by physical therapist George Edelman should be used as a resource.
Tips for swimmers:
-Dry land training must include rotator cuff, scapulothoracic, and core strengthening.
-Learn the difference between dynamic and static stretching
-Don't ignore symptoms which cause you to modify your stroke.