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Treating Sports Injuries: Part 1

Posted Aug 24 2008 1:49pm
DAVID FOLK THOMAS: Welcome to our webcast. I'm David Folk Thomas. Are you like me? Do you like to keep in shape and workout, and hope you don't hurt yourself when you're doing it? Well, there are a lot of right ways to work out. There are certainly a lot of wrong ways to work out. Even if you're doing it the right way, there is no guarantee you're not going to get injured in the process, and if you're doing it the wrong way, there is a pretty good chance you will get injured.

We're going to tell you what to do if you do get an injury while working out, whether it be playing tennis, playing basketball or working out at the gym with weights.

Joining me are a couple of experts on the subject. On my left is Jim Ramsay. He's the Athletic Trainer for the New York Rangers hockey team.

Next to Jim is Dr. Jonathan Glashow. He's a sport medicine orthopedic surgeon at Lennox Hill Hospital in New York City. He's also a consultant for the New York Rangers, as well as numerous Olympic athletes. Gentlemen, thanks for joining us here on the webcast.

Let's start with you Jonathan. Injuries. What's the first thing to do? Give us a common injury that can come from working out?

JONATHAN GLASHOW, MD: Injuries are an inevitable part of exercising and working out. We just try to minimize them in both frequency and intensity. A very common injury is a knee pain brought on, for instance, after a leg workout exercise.

DAVID FOLK THOMAS: You're feeling a strain or something?

JONATHAN GLASHOW, MD: After working out you have pain, you have trouble going down the stairs, you have trouble sitting in a movie for any extended period of time. When you sit at the restaurant, when you get up the knee creaks and it's painful. You don't know what to do.

DAVID FOLK THOMAS: You know when a cold front is coming in, so to speak. You can predict the weather.

JONATHAN GLASHOW, MD: Right.

DAVID FOLK THOMAS: So whatever kind of injuries are there? You are with the Rangers, so what other kind of injuries, outside the ones where they're getting clocked into the boards by a member of the Philadelphia Flyers. What kind of injuries are you seeing from working out?

JIM RAMSAY: What we'll commonly see is a muscle strain. What it involves basically there is that the muscle becomes damaged. You overload the muscle by using improper form or technique. That's when you commonly hear the pop sound, or you basically feel something that tears in the muscle. Later on you'll notice some swelling or maybe some discoloration in that. Muscle strains a very common injury in weight training or riding the bike. Anything in terms of the fitness facility.

DAVID FOLK THOMAS: The difference again between a sprain and a strain, Jonathan?

JONATHAN GLASHOW, MD: It's semantic terminology. We like to keep things in little boxes to make us feel better. A sprain generally refers to a stretched ligament, whereas a strain refers to a stretched muscle. We grade them. A grade one sprain, for instance, of the ligament is that the fibers are stretched, but not really beyond their elastic length. In other words, they stretch and go back. Grade two is a partial tear. In other words, the ligament is partially disrupted, but still intact. A grade three sprain is a complete disruption of that ligament.

DAVID FOLK THOMAS: Are sprains generally harder to heal from than a strain, or does it depend?

JONATHAN GLASHOW, MD: I guess it's hard to say. You'd have to identify which ligament. Some sprains never heal without surgery, and therefore never heal. Most strains of a muscle refer to a partial tear of a muscle. Muscle by definition has a better blood supply and healing ability than a nonvascular tissue or less vascular tissue like a ligament.

So in general, I guess to answer that question you would have to say that a muscle has more ability to heal, therefore, a strain is more easily healed. But you could have a sprain that gets better much more quickly than a very significant muscle strain, like a bad hamstring or Achilles or calf strain. Sometimes they take a long time, as I'm sure Jim could attest to in getting somebody back to a sport.

DAVID FOLK THOMAS: Just very quickly, tendonitis also. You hear a lot about that. What's the difference between tendonitis?

JIM RAMSAY: Muscle strains and sprains are more what we call an acute injury. Basically, it's an injury that occurs right away. There is definitely a trauma that has damaged that muscle.

DAVID FOLK THOMAS: You know how you did it. You're like, "I just sprained my ankle."

JIM RAMSAY: Exactly. Whereas tendonitis comes on more gradually. It's an overuse type of injury. There is some inflammation. Jonathan might be able to give you more of a structured definition, but there is definitely an inflammation of a tendinous part of a muscle. That comes from microtrauma, small little traumas that occur at the area where it inserts on the bone or some point along the tendon. Over time, those traumas just accumulate and cause a chronic inflammation of that tendon.

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