SPORTSSports Injury 101BY DR. PATRICE THOMPSON-SMITH DPTFor the average person, our image of sports therapy is limited to professional players or sports enthusiasts who consistently exercise, but this is not necessarily a complete picture. I would like to draw the attention of the individuals who generally have a love hate (on again, off again) relationship with exercise at best but desperately want to get healthy and maintain it. If you are one of those patients who plod on with determination despite your contused appendage hanging on by non-bony parts of the anatomy with no hope of winning, you will not be the focus of this article even if the information is still applicable.

This article is specifically referring to the people who usually start off with a BANG! Two sticks of carrots, four string beans and a shake all day. Then run 6 miles after doing 10 sets of this and 9 sets of that, six times per week!!

Usually there is a snap crackle or pop somewhere in the body and these patients end up in our offices with a slightly embarrassed apologetic smile while describing their injuries and we respond with a knowing yet understanding smile of our own, hoping that we can get them back up to speed before that modicum of motivation has faded into oblivion by the passage of time as their injury heals.

Therein lies the true test of a therapist. Can we get you back to your sporting activity in the quickest possible time with the ability to execute all prior activities at the same level or better while still minimizing the risk of re-injury? This of course is preceded by a thorough assessment and goal setting in order to determine if this is indeed possible.

So if you are a semi-permanent athlete planning to restart for the summer, I'd like to put you ahead of the game with a list of the four (4) most common injuries seen in our offices and how you can prevent them in order to achieve your goals with some efficiency.

1) Groin strains: This occurs when there is overstretching of the muscles leading to tears where the inner thigh meets the pubic bone or in the front of the hip. These tears generally occur in sports that require a forceful and sudden movement of the leg e.g. jumping or sprinting. In Bermuda we often see those injuries in football and rugby players.

Tip: Proper warm up and training will go a long way towards preventing injury. If it has been a few months since you last played, pretend you are new to the sport and spend some time re-training those muscles to get attune with the required movements before playing a game. We understand that in a previous life you could rival Pele, but we will certainly appreciate those moves after the warm-up.

2) Hamstring strains: This type of injury occurs when there is a complete or partial tear to 1 or more of the three muscles/tendons at the back of the thigh. This injury is seen in football/rugby players as well, but occurs just as frequently in track and field/ marathon runners. Persons who experience a hamstring strain are 2-6 times more likely to suffer a subsequent injury. So let’s try to avoid this injury in the first place.

Tip: Proper warm up with dynamic stretches helps to decrease the risk of injury. Also try to gradually increase the frequency and intensity of a new activity, taking care to listen to your body when it pleads for rest.

3) Low Back pain: There are a myriad of factors that can lead to back pain, improper form, muscle weakness, trauma and over-use, just to name a few. Usually these patients are seen in the physiotherapists’ offices about a month or so after renewing a membership at the gym. Most cases related to this etiology require a cessation of the offending activity for a short period accompanied by strengthening and stretching as tolerable.

Tip: The same applies with regards to gradually increasing activities over a period of time. However, proper form is paramount to preventing injuries of this nature and that form can only be maintained by having the required core strength.

4) Plantar Fasciitis: This is described as an inflammation to the thick band of tissue that supports the arch of your foot. This type of pathology in the foot is very common, but within the context of this article, patients present with this pain after attempting to run the same distance they ran 2-5 years ago after a 2-5 year break. This then leads to another break from running, walking and most fun activities in general.

Tip: Slow and steady is the name of the game with this one. A little at a time goes a long way. Gradually increase your distances, allowing your muscles to accommodate.
Please note the common thread throughout, too much and too soon. It behooves you to allow your body to slowly acclimatize to any new activity. If you are unsure of the pace, consult a trainer.

Rehab is a process. Depending on the severity of the injury, you may have to protect and offload for a period of time, then begin the process of protected reloading and conditioning along with sport specific training before even considering return to the scene of the crime.

May I suggest an alternative, instead of starting out with a bang, how about a few soft taps here and a tiny step there until you develop a rhythm you can really dance/play/run along to (nothing like moving to the beat of consistency).

There are other factors that can determine your risk of injury, your nutrition for instance, anatomical make-up specific to you, cardiovascular health etc.
Despite all precautions there is always a risk of injury, sometimes with no apparent indications or reasonable explanations as to the causative circumstances even after detailed research i.e. responsibly ‘Googling’!

See a therapist, you will receive personalized care that may not only give you some answers but may help to heal your injury faster and prevent further insult.
Till then, keep calm and sport on.

Dr. Patrice Thompson-Smith DPT
Physiotherapist
Ocean Rock Wellness