Sprains, strains Many times, athletes’ injuries preventable, expert says
STORY AND PHOTOS BY BILL BURRUS
If you’ve ever played sports in high school or college, there’s a good chance you’ve had to deal with at least one of the common injuries that hamper athletes.
A couple of the biggest problems athletes may incur are sprains and muscle strains, according to veteran athletic trainer Brian Anderson of the Greenwood Leflore Hospital Outpatient Rehab and Wellness Center.
Sprains are injuries to ligaments, the tough bands connecting bones in a joint. Suddenly stretching ligaments past their limits deforms or tears them. Strains are injuries to muscle fibers or tendons, which anchor muscles to bones. He said strains are called “pulled muscles” for a reason: Over-stretching or overusing a muscle causes tears in the muscle fibers or tendons.
Anderson has 15 years’ experience as an athletic trainer, and on Friday nights, he can always be found on the sidelines of high school football games in Leflore, Carroll or Montgomery county. He also helps out area schools in other sports as part of the center’s outreach program.
In terms of muscle strains, Anderson sees more problems in the hamstring, which is made up of three muscles in the back of the thigh. The hamstring can be over-stretched by movements such as hurdling or kicking the leg out sharply when running.
He says hamstring injuries can be slow to heal because of the constant stress applied to the injured tissue from walking.
“You kind of have to let pain be your guide before you are back to full activity,” Anderson explained.
Greenwood’s Michael Nix, a registered physical therapist for Professional Physical Therapy and Wellness Center in Belzoni, has helped the Pillow Academy football team in years past. He says the most common sports sprain occurs in the ankle.
Ankle sprains, according to Nix, typically occur when the foot turns inward. This turning stretches or tears the ligaments on the outside of the ankle, which are relatively weak. Nix says for immediate relief, follow the R.I.C.E. treatment plan: rest, ice, compression and elevation. Many of the problems resulting from sprains are due to blood and edema in and around the ankle; therefore it is important to minimize swelling. After applying the ice, wrap the ankle in an ACE bandage or wrap to keep it supported and compressed. An anti-inflammatory can be helpful to reduce pain and inflammation for the first seven to 10 days after the injury.
Try to not place ice directly on skin.
Anderson said one common mistake made when icing sprains is keeping the injured area under ice for longer than 25 minutes at a time.
“The body will signal hypothermia, and, as a self-defense mechanism, will send more blood to that area,” Anderson said. “And that’s not what you want when you’re trying to reduce swelling.”
A high ankle sprain is slower to heal, Nix said, and a doctor should probably examine it to make sure the bones in the lower leg did not separate.
“Sometimes preventing common sports injuries is beyond our control, but many times sports injuries are preventable,” Nix said. “We can bring on injury ourselves because we’re not conditioned for the activity. A good stretching and strength training program can help fight off some injuries.”
Here’s a look at some other common sports injuries and how they can occur:
nGroin pull: Pushing off in a side-to-side motion causes strain of the inner thigh muscles or groin.
nShin splints: Pains down the front of the lower legs. They are most often brought on by running — especially when starting a more strenuous training program such as long runs on paved roads or hard surfaces.
nACL knee tear: The anterior cruciate ligament (ACL) holds the leg bone to the knee. Sudden cuts or stops or getting hit from the side can strain or tear the ACL. This is potentially the most severe of the common sports injuries.
Always, if you suspect an ACL injury, see a doctor immediately because a completely torn ACL usually will require surgery.
nTennis elbow: Caused mainly in racket sports due to, overuse of the forearm extensor muscles, along with repeated impact.Other factors that may contribute to tennis elbow include lack of strength, poor technique, and increases in duration or intensity of play.
The injury causes pain on the outside of the elbow, usually during or after intense use. In some cases, lifting or grasping objects may be difficult, and some have pain that radiates down the arm.
Treating sports injuries
For immediate relief for pulls and strains, follow the R.I.C.E. (Rest, Ice, Compression and Elevation) treatment plan. Because many problems resulting from sprains are due to blood and edema in and around the ankle, it is important to minimize swelling.
After applying the ice, wrap the ankle in an ACE bandage or wrap to keep it supported and compressed. An anti-inflammatory can be helpful to reduce pain and inflammation for the first seven to 10 days after the injury.
- Rest. Avoid weight bearing for 24 hours or longer for a severe sprain.
- Ice. Apply ice (bagged, crushed ice wrapped in a thin towel) to the ankle joint. To avoid frostbite, ice should not be left on the area longer than 20 minutes at a time. Ice 20 minutes every two hours for the first 24 hours to control swelling.
- Compression. Wrap the ankle with an elastic bandage (start at the toes and wrap up to the calf) to help prevent swelling and edema.
- Elevation. Raise the ankle above the hip or heart to reduce swelling.
- If swelling doesn’t subside in 48 to 72 hours, seek medical treatment for a complete evaluation.
- If unable to bear weight within 48 hours, seek medical treatment.
Treatment for hamstring injuries depends upon the severity of the injury. Due to the pain and limited ability to use the muscle, a third-degree strain usually results in a visit to a physician for evaluation and treatment. Less severe hamstring strains may be treated at home. These general treatment steps are commonly recommended for mild or moderate hamstring injuries.
nAfter an injury it’s important to rest the injured muscle, sometimes for up to two or three weeks, before you can return to sports.
R.I.C.E: Rest, apply ice and compression and elevate the leg if possible.
- An anti-inflammatory can help reduce pain and inflammation.
- A stretching program can be started as soon as the pain and swelling subsides.
- Use a strengthening program to rebuild the strength of the injured muscle in order to prevent re-injury. Make sure you increase this gradually.
- A thigh wrap can be applied to provide support as the muscle heals.
Rest is the best treatment for shin splints. For immediate relief use the R.I.C.E. treatment method for controlling pain and inflammation. Return to activity gradually with non-weight-bearing activity (cycling, swimming) in your workouts until pain-free.
- Strengthening and stretching exercises are helpful. The ankle injury rehab program can also be used for shin splint rehab.
- Tape your shins to reduce stress.
- Wear proper footwear.
- Replace shoes as needed.
Rest is the first treatment for tennis elbow. Stop all activities that cause the pain and use the RICE treatment method to reduce pain and swelling. Conservative treatments are often all that is needed for a full recovery of a tendinitis, which usually resolves itself in a few days to a few weeks.
If tennis elbow pain is due to a deterioration of the tendon (tendinopathy), it can take two to six months to fully recover. Many cases of lateral epicondylitis become chronic problems that progressively get worse if the athlete continues activity despite nagging elbow pain.
If elbow pain lasts more than a few days despite rest and conservative treatment, you should see a physician for an evaluation and a referral to physical therapy.
A physical therapist may use ultrasound or other modalities to help heal tendinopathy. The specific rehab depends upon the exact cause of the injury and the diagnosis; however, the most common rehab methods include ultrasound, medications, massage, braces or splints.