Injuries can be incredibly discouraging and are both physically and mentally difficult to recover from. More than just a slight ache, an injury often feels like you are at odds with your own body. On one hand, you feel and understand that circumstances beyond your control, as well as your own actions, led you to experience this pain.
On the other hand, you feel that your body can’t keep up with your desire to perform or play. And because injuries can take anywhere from weeks to months to completely heal and can leave lasting or even permanent damage (from recurring aches to nerve damage and pains to serious scar tissue), recovering from an injury requires patience.
Why Sports Injuries Are Common
Many people in the modern Western world struggle with conditions that are either exacerbated or caused by an excessively sedentary lifestyle. Getting people to move, then, becomes critical to prolonging their lifespan, as well as reducing the risk of heart disease, cancer, and chronic pain. Simple and consistent weekly exercise can greatly improve any person’s quality of life, even with a series of pre-existing conditions, including chronic fatigue and spinal problems.
But exercise, like any tool, can be constructive or destructive. Poor programming, lack of recovery, poor form, and several other issues can lead to a series of sports injuries, ranging from strains and sprains to tears, bruises, fractures, and more.
Injuries in adults often either occur due to a lack of exercise (followed by a particularly strenuous activity, or injury due to excess bodyweight), too much exercise within a short time frame (linked to ‘weekend warriors’), or sports. An estimated 8.6 million Americans receive treatment for injuries related to sports and recreational activities. Injuries are a risk to complete novices and amateurs as well as professional athletes. Certain athletes are at a much greater risk for developing injuries than other athletes depending on their sport, age, and other factors. While injuries can occur anywhere, most exercise-or sport-related injuries occur in the lower extremities, particularly in the knee.
Types of Adult Sports Injuries
Sports injuries can be typically divided into tendinopathy, sprains & strains, fasciitis, dislocations, and fractures. Understanding how and where sports injuries occur requires a basic understanding of how we use our bodies to move.
Fractures and dislocations are familiar to most people, and they involve partially or completely broken bones, as well as bones and joints that become misaligned due to external trauma.
Sprains, Strains and Tendinopathy
The points of attachment between muscles and bones are our tendons, while the points of attachment between two bones or a bone and a joint are our ligaments. Both are made of a different kind of material: fibrous collagen. While this material is incredibly tough, much of its toughness comes from the way it’s structured in the human body.
Tendons and ligaments are composed of collagen fibers that are closely packed together, running in parallel arrays to efficiently facilitate the transfer of force through a muscle to the bone. Taking the extension of the leg through the quadriceps muscles, force is generated through the contraction of the muscle and transferred through the tendon attaching to the kneecap, which attaches to the thigh and shin bone through a series of ligaments. This contraction in the muscle allows us to straighten our leg.
Muscular imbalances, poor form, and shearing forces all cause damage to these crucial tendons and ligaments. Because they’re arranged to transfer force in a certain way, any shearing force (cutting across the collagen fibers rather than transferring down the length of them) can cause excessive strain on the tendon, eventually leading to a partial or total tear. The same goes for the muscle, which can tear under excessive load (a very heavy bench press or deadlift may cause a pec or bicep tear, respectively).
Fascia is the fibrous connective tissue that covers our muscles and tendons, right underneath the skin. External trauma as well as overuse can cause inflammation in the fascia, which can become very painful. A common example is an inflammation of the fascia in the sole of the foot, just underneath the plantar fascia which runs from the heel all the way to the ball of the foot.
How Sports Injuries Are Treated
Different injuries require different treatments. Tears typically require direct medical intervention, sometimes including surgery. A fracture in the bone, if only partial, can be healed by giving the bone time to set and heal through a cast. A complete or ‘compound’ fracture will require resetting the bone back to its proper placement in the body.
Complete fractures may mean the bone has been broken but remains in the body, while a compound fracture involves pierced skin. Both require immediate treatment, and compound fractures must be taken care of right away to prevent infection.
Common places for cracked or broken bones in athletes include the wrists, ankles, ribs, hips, and hands/feet. Contact sports and combat sports may also include skull fractures. Once a bone has been set in place, a cast or rib belt may be used to help keep it in place. Healing time depends on the severity of the fracture, with some breaks taking anywhere from several weeks to a few months to heal. Rest is crucial. Any movement that might shift the bone can delay healing.
Strained muscles and ligaments generally heal the same way, simply requiring dedicated off-time. Since swelling can increase discomfort and pain, keeping the affected muscle or tendon elevated can slow circulation and reduce pain. Icing the area may also remove the pain. Over-the-counter pain medication may be prescribed to help a patient sleep and relax. Muscle and tendon strains can take up to several months to fully heal, although some cases only require a few weeks. Recovery depends entirely on how severe the injury is.
Much like a bone, a tendon is permanently changed after a strain or partial tear. Athletes and adults who experience pain due to tendon or ligament damage are more likely to experience recurring pain after recovery and must be conscious of how they move and warm up for their sport.
A total tendon tear is more complicated, and in some cases, tendon repair surgery may be needed to help the tendons reattach. As a tendon approach a total tear, it becomes harder and harder to support weight and move the bone the tendon is attached to, causing seriously limited mobility.
Much like inflamed tendons, fasciitis is caused by overuse of the affected area or an underlying condition (unrelated to sports and exercise). Rest is critical. The most common type of fasciitis is plantar fasciitis seen in joggers and runners, caused by overuse of the foot, improper footwear, and improper running technique. Taking a few weeks rest until the pain subsides, wearing shoes with better cushioning and adjusting one’s running style to strike with the mid-foot rather than the heel can greatly reduce both fasciitis and knee problems.
Preventing Sports Injuries
While some sports injuries cannot be prevented and are a part of the risk of playing a sport, there’s a lot a person can do to minimize their chance of injury. A few specific tips include:
- Warmup properly. A quick 3-5-minute cardio session to get the heart pumping is one thing, but if you’re doing any form of explosive or load-bearing exercises, it’s important to properly prepare and warm up your muscles and joints. Start with low weights and work your way up to a working weight, foam roll and employ dynamic stretches to increase your range of motion, and so on.
- Pay attention to form – Injuries can happen out on the field and in the training room. Paying attention to how you exercise can help you avoid muscle imbalances and shearing forces. Pay attention to your elbows and knees when lifting, be deliberate in your stance and stride when running or jumping and learn to isolate and activate muscles that are otherwise often left to grow weak, including the glutes, adductors, and rear deltoids.
- Slow progressive overload – don’t make massive jumps when training with weight. Stick to small increases for compound lifts and use machines and dumbbells to isolate specific muscles rather than lifting as much as you can. Advanced trainees can benefit from overloading and utilizing expressly heavy weight during exercises such as cheat rows, farmer walks, and rack pulls, but most individuals should refrain from such exercises until they’ve built stronger muscles and resilient tendons.
- Proper recovery – both after and before an injury, it’s critical to be religious about your two main forms of recovery: sleep and food. Eat enough, sleep enough, and don’t skimp out on either. When eating, focus on nutritious food and healthy fats. Avoid seed oils or cooking oils and load up on sources of omega 3. Avoid refined sugars and other foods associated with increased inflammation, and eat complex carbs, lean protein, and plenty of colorful vegetables.
- Address muscle imbalance – A physical therapist can help you identify and address muscle imbalances, often caused by weakness, poor habits, or asymmetry in the skeleton. Mitigating the effects of these imbalances can greatly reduce the load on certain tendons and muscles, decreasing injuries. Examples of conditions caused by imbalances include valgus knee, knee pain due to quad/hamstring dominance, flat feet, back pain caused by scoliosis, and more.
- Train flexibility – more than an afterthought, regularly and consistently stretching the muscles both with resistance (weight) and without resistance can improve mobility, lengthen the tendons, and strengthen them. Most static and dynamic stretches only introduce temporary changes in the tendons, so consistency is key.
Don’t Stop Exercising
Muscles, tendons, and bones require rest to heal, but they can only get back to their former levels of strength and resilience through careful and constant exercise. Proper physical therapy, nutrition, adequate blood flow and resistance can increase tendon strength even after an injury. Athletes have recovered from total knee blowouts and have continued to make strides in their sport, even without the use of illicit substances such as anabolic and corticosteroids for injury recovery.
The key is to approach exercise carefully and deliberately, making small steps to prevent pain and improve strength. Don’t jump right back into your old level of training. Walk slowly before you walk briskly and walk briskly before you jog.