Sports Injuries

Sports injuries usually fall into one of two categories: overuse or traumatic. The vast majority of sports injuries are due to overuse. An overuse injury implies that a tissue, usually bone, muscle or tendon, becomes painful when it is subjected to multiple repetitive stresses that it is not able to withstand. Eventually, the normal organization of that tissue’s structure is disrupted which will ultimately lead to inflammation and pain. Some of the more common overuse injuries in athletes include; bursitis, tendinopathy/tendinitis, and stress fractures. Overuse injuries in older athletes are almost expected because their tissues don’t have the ability to repair as well and degeneration as part of the aging process is occurring.

Bursitis

A bursa is a fluid filled sac that acts as a pressure reducer between two tissues; usually tendon and bone. The body has multiple bursa that are strategically located around all major joints. Bursitis results when a bursa is subjected to repetitive stresses that it is unable to properly handle. Eventually, the bursa becomes inflamed, painful and swollen. The two most common joints affected by bursitis are the shoulders and hips. Bursitis appears to be directly related to muscle weakness and tightness and thus treatment includes anti-inflammatory measures as well as the appropriate stretching and strengthening exercises.

Tendinopathy/Tendinitis

A tendon is usually a long rope or sheet-like structure that connects muscles to bones. Tendons enable muscles to move bones. Although tendon ruptures occur commonly in the older athlete, tendinitis or tendinopathy is the more common tendon injury seen. The suffix “itis” implies inflammation, which is the process by which the body attempts to heal an injured tissue. Inflammation is also the reason why the initial symptoms result, usually pain and swelling. When a condition becomes chronic, i.e. ongoing, inflammation becomes less prominent and tissue degeneration predominates. In this instance, the suffix “itis” is less appropriate with the suffix “opathy” more fitting, i.e. tendinopathy. Some of the more common tendinopathies involve the rotator cuff of the shoulder, the patellar tendon at the knee and the Achilles tendon at the ankle.

Treatment of tendinopathies includes relative rest, ice or heat to decrease the initial inflammation and pain, and eventually stretching and strengthening exercises of the involved muscles. Most overuse tendon injuries will require several months of treatment before becoming totally asymptomatic.

Some tissues have an abundant blood supply i.e. muscle and bone, thus, when injured, healing occurs quite quickly. Others tissues i.e. tendons or cartilage, have a limited blood supply and may take months to repair. Lack of symptoms does not necessarily mean lack of a problem and recurrences of overuse tendon injuries are common. In order to prevent a reappearance of the symptoms, an evaluation by a sports medicine specialist may be in order so that the athlete can be instructed on the proper stretching and strengthening exercises, as well as be evaluated biomechanically so that proper corrections can be made in his technique or equipment.

Stress Fracture

Stress or fatigue fractures occur when a bone is subjected to unaccustomed stresses for an extended period of time. Small microfractures begin to occur which eventually will lead to localized pain. Stress fractures occur most commonly in the lower limbs of runners, particularly when training for an event or when just starting a new program. Stress fractures are treated with rest, time and the appropriate strengthening exercises. If a stress fracture is suspected, the athlete should be evaluated by a sports medicine expert in order to prevent further sports injuries.

Macrotraumatic Injuries:

Macrotraumatic injuries result from a one time event in which the tissue is acutely overloaded and fails. Some examples of macrotraumatic injuries include; muscle strains, ligament, tendon and cartilage tears and bone fractures. Outside of most muscle injuries, macrotraumatic injuries usually should be evaluated by a sports medicine specialist and often require surgical treatment to repair the structure.

Injury Prevention

Training is an important component of sports participation especially if you expect to participate at a higher level. You should never hit the ground running when beginning an exercise program or start to participate in an unaccustomed sporting activity. Your musculoskeletal tissues need to adjust to these new stresses that are going to be placed on them. You should increase in a step wise, graduated fashion in order not to overload these susceptible tissues. Your body will adapt with repetitive exercises in moderation and you will eventually be able to participate in your sport at a higher level.