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Sports Related Injuries

Posted Jan 07 2009 12:29am

 American Chiropractic Association

Sports Injuries

July 2008

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


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.


In those who are training too much, overuse of a particular

joint or joints in the body can result in pain and dys


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 fracturesalso 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:


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



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 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 AboutPrevention

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. .

Common Signs and Symptoms

of Sports Injuries

Fractures can be recognized by acute pain and tenderness,

along with swelling and possible bruising

over the fracture site, often with visible deformity of

the affected bone. It is a myth that if someone can

move the joint near the pain, there is no fracture.

Stress fractures generally result in a slower onset of

pain that is made worse with activity.

Strains most commonly cause pain at the site of the

injured tendon, particularly where it inserts into the

muscle or bone. The muscle itself may also be painful.

There may be some weakness and even muscle

spasm. Pain is most severe with movement of the

affected muscle or tendon. The area is also tender to

the touch.

In sprains, pain and tenderness are felt over the

affected ligament. Swelling of the joint, along with

bruising, is also common, as is a reduced range of

joint motion. If there is excessive motion and/or a visible

deformity in the joint, this most often signifies a

more serious, full-thickness ligament tear.

Tendinitis causes pain, tenderness, and swelling over

the tendon, which is made worse by the motions that

stress the tendon. There is also generally restricted

range of motion, particularly in the direction of the

tendon itself.

Chondromalacia patella results in knee pain, particularly

behind the patella, along with a grinding or grating

sensation. The pain is most often felt when running

on an incline.

For more information on prevention

and wellness, or to find a doctor of chiropractic

near you, go to the Patient

Information section on ACA’s Web site at or call

703 276 8800.

Lawrence H. Wyatt, DC, DACBR, FICC, Writer

Nataliya Schetchikova, P hD,Editor

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