As we near the end of winter, we look forward to warmer weather and outdoor activities. It is the time of year people take to the streets, playgrounds and fields – a time of year full of hope and renewed spirits – a time of early season injuries.
Injury is the main cause recreational athletes quit. Things like sprains, strains and tendonitis seem to run rampant.
A sprain is an injury where the ligament is overstretched, commonly seen with sudden twisting or wrenching of the joint beyond its normal range of motion. The most common sites for a sprain are the knee, ankle and wrist. Sprains come in different levels.
Grade 1 – Mild or first degree. This is a minor stretch and tear of the ligament. There may be some bruising, pain and swelling, but the joint is stable. You can still perform activities with only a moderate discomfort.
Grade 2 – Moderate or second degree. This is when the ligaments tear significantly enough to cause difficulty in resuming activity secondary to pain. Bruising, pain and swelling also occur, and there is a snapping sound at the time of injury, which causes the joint to “give way”.
Grade 3 – Severe or third degree. This is when the ligament is completely ruptured, or an avulsion fracture occurs. An avulsion fracture is when the bony attachment of the ligament is torn off while the ligament remains intact. A snapping occurs, and the joint gives way. Bruising, pain and swelling also occur, and activity is impossible secondary to pain and instability.
A strain is a trauma to the muscle or musculotendinous unit, consisting of the muscle, its tendons, the bony attachments and the junction between the muscles and tendons. It is commonly seen with violent contractions of the muscles or excessive force or stretch to the area.
Strains are graded much the same way as sprains. In fact, side effects are so similar, medical professionals often diagnose injury as a “sprain/strain”. One major difference is with grade three’s – often there is a visible “gap” at the injury site, and the muscles shorten and bunch up.
Tendonitis is an inflammation of the tendon, with some tearing due to tendon overload, or overuse. There are numerous types of tendonitis, such as “tennis elbow”, “little league elbow”, “jumper’s knee”, Achilles and rotator cuff tendinitis, to name a few. There are four levels of severity.
Grade 1 – This is where pain is experienced after activity.
Grade 2 – This is where pain is experienced at the beginning of activity, and, after activity. Pain usually disappears during activity.
Grade 3 – This is where pain restricts activity. Pain is evident during all phases of activity and post activity.
Grade 4 – This is where the pain interferes with daily activities, continuing to worsen with activity.
“Shin splints” is a non-specific term describing pain along the medial border of the tibia bone – your shin bone – occurring with exercise. Shin splints usually occur from a sprain in the muscle with inflammation of the bone. It commonly comes with anterior compartment syndrome, which is a painful condition caused by an interruption of blood flow to the area. Shin splints are common in runners, but any running activity increases risk. It is usually due to deconditioning, overtraining and poor technique.
A spasm is an involuntary, sustained muscle contraction, also commonly known as a cramp. The muscle spasm aids in splinting an injured area, reducing movement to prevent further injury.
But, there is hope. It’s a thing called conditioning. So, before you hit the ground running, follow these simple suggestions – it just may prevent you from getting sidelined.
1. Start out slowly – work your way up to a more rigorous routine. Don’t go out on the first day and think you can run five miles, after you’ve spent the winter honing your “couch potato” workout.
2. Conditioning. Don’t play sports to get into shape – get in shape to play sports. Start out a few weeks in advance with a well-rounded routine to decrease chances of injuries. It is recommended to begin a stretching routine. Stretching does not only reduce your chances of injuries, it can improve things like speed, agility, balance, endurance and strength. Stretch all the major muscle groups, especially those you will be working out the most.
After stretching, you should always warm up. Taking time to build up workout allows blood supply to increase to muscles so they can perform optimally. Warming up also allows the muscles to become warm to allow them to adjust to your workout more efficiently.
Begin an aerobic routine – one where you raise your heart rate, such as brisk walking on a treadmill, several times per week.
Avoid overtraining, or pushing your body to the limits.
Strengthening routines should also be a part of your preconditioning. The stronger you are, the less likely you are to become injured.
3. Safety. Make sure all gear is in proper working order, from you head right down to your toes. If you sneakers are falling apart, invest in a new pair. Make sure you check out the terrain and watch for pitfalls – uneven playing fields or uneven concrete – anything that could cause an injury.
4. Know your limits. Just because your running partner can handle five miles doesn’t necessarily mean you can – or should. Beware of signals that may signal some sort of injury, such as stiffness, localized pain, burning, tingling and numbness – even a discoloration of the skin or a change of contour in the muscles may be a warning to ease up.
And finally, if an injury does temporarily sideline you, don’t give up! Immediately after injury, use RICE – Rest, Ice, Compression and Elevation, to decrease pain and inflammation. Seek professional advise from qualified medical personnel to see when you may resume your activity. Healing times depend mostly on blood supply, which bring the necessary elements of healing to that specific area. Healing times do vary. For example, the average muscle strain will heal in three weeks. Tendons, on the other hand, require at least six weeks to heal solidly.
Regardless of the “average” times, some injuries heal more quickly for different people. For example, you heal faster if you are conditioned. Also, it depends of the severity of the injury – a grade 1 sprain may take you out for 4-5 days, whereas a grade 3 may take upwards of three weeks!
You should never resume an activity if you are still experiencing pain with rest. Once resting pain subsides, attempt some minimal exercising, gradually increasing intensity. If the pain resumes, stop activity. If all you feel is a dull ache, you can continue with caution – remember, pain is the body’s way of letting you know there is a problem. Now’s not the time to go overboard and make up for lost time!
Remember, one of the most difficult things to deal with when you have an injury is not the injury itself, it’s the feeling you let yourself or your teammates down – and the fear of it occurring again, perhaps next time being much worse!
If you are not fully healed, continue with a modified routine to keep the rest of your body in shape. Once you’re cleared, step cautiously at first – test the area, gradually working up to normal. And, always remember – if you return too early, you risk further, more debilitating injury. If there’s any doubt, check it out!