Podiatrists are able to deal with many sports related problems affecting the foot, lower limb or even lower back (which can be a result of problems lower down the skeletal system) and Richard’s interest and training in Biomechanics and Sports massage make him well equipped in this discipline.
This blog is designed to give the reader a brief insight into the mechanics of a sports injury generally, the most common causes, the anatomy of a sports injury, how to try to avoid injury and the way to best recover from that injury.
A SPORTS INJURY is basically any form of stress inflicted on the body during physical activity that stops the musculoskeletal system (bones, muscles, ligaments, cartilage) from then being able to function properly. It usually results in pain, swelling, tenderness and limitations of use.
Injuries are classified as “ACUTE” which are the result of a sudden traumatic event e.g. fractured metatarsal, pulled hamstring, or “CHRONIC” which usually result from overuse and wear and tear over a period of time e.g. bursitis, tendinopathy.
COMMON CAUSES OF INJURY:
Repetition is a major cause of injury, as is using a poor technique or simply wearing inappropriate footwear. Other common causes can be:
* Failure to warm up making the muscles more prone to strain
* Excessive body loading i.e. applying forces to your body tissues which they are unprepared to deal with (lifting too heavy weights, running too far etc..)
*Overtraining increases the risk of chronic injury.
*Inappropriate equipment usage exposing the body to shock or inadequate support.
*Muscle weakness or imbalance which stresses opposing muscles and can lead to a loss of strength in the body.
*Accidents, often from impact or collision.
*Joint laxity e.g. hypermobility
*Lack of flexibility which limits the body’s capabilities due to limited joint range of motion.
*Genetic factors which are unique to all of us and influence the shape and structure of our musculoskeletal systems.
*Recurring injury which makes the body prone to other injuries.
ANATOMY OF A SPORTS INJURY:
The musculoskeletal components are listed here with their function and potential injuries:
*Skeletal muscles produce force and movement, the muscle fibres can be torn (“strained” or “pulled”) to various degrees of severity.
*Tendons connect muscles to bones and help produce movement. They can be strained or ruptured (complete tear) or suffer a tendinopathy which is pain caused by overuse or repetitive motion.
*Ligaments connect bone to bone and give joint stability by limiting joint movement. Prone to overstretching (sprain) or tears.
*Bursae: small fluid filled sacs that reduce friction. They allow muscles and tendons to glide over bone. Bursitis occurs from overuse or infection.
*Cartilage is a smooth fibrous covering over bone ends at the joints. It aids movement, shock absorption and impact. It can become torn or worn and heals slowly and poorly due to a poor blood supply.
*Joints are capsules (encompassing all of the above elements except muscles) which can become partially or fully dislocated.
*Bone fractures and breaks can damage surrounding soft tissues.
First and foremost age and the basic fitness level of any individual will influence their ability to enjoy energetic pass-times but the benefits of exercise to any off us is well known (reduces heart disease risk, reduces blood pressure, reduces cholesterol etc.) but we must make sure that we take any steps possible to reduce the risk of injury.
If an individual had an underlying health condition it would be necessary to visit e.g. their GP as a precaution before starting a new sport or regime. If a person is starting from a position of low general fitness and/or obesity it is vitally important that any new exercise is built up gradually to avoid injury but also so as not to kill the initial enthusiasm! “NO PAIN NO GAIN” is a great maxim but at what cost ? “SOFTLY- SOFTLY” is a better initial approach.
Any training regime should be formulated to meet the demands of the chosen sport e.g. distance running will require stamina training, weight training needs muscle strength.
*OVER-TRAINING prevents proper body recovery and increases likely injury.
CHOOSING THE RIGHT EQUIPMENT is a must: footwear must be sport specific and provide adequate support and cushioning, clothing should be suited to the purpose, equipment such as rackets, bikes etc. should be fitted to the individuals weight and body dimensions.
RESTING and refuelling are as important as the training itself, without these the body cannot repair from exercise and come back stronger and therefore if a person is injured often a complete break is the only way to guarantee no delay in recovery. Refuelling correctly is vital so diet must be tailored to the training programme: Glycogen is burnt by the body during exercise so pastas and wholemeal bread are great pre-exercise whilst nuts and dried fruit or energy bars are great during exercise. Post exercise protein and carbs are essential for body repair and should be eaten within 2 hours of exercise.
HYDRATION is also massively essential pre, during and post exercise.
A GOOD WARM UP prepares the body for exercise and reduces injury risk, it should be as sport specific stretch and movement wise as possible. It should include CARDIO WORK for approx. 10 mins. e.g. jogging/skipping to increase the heart rate and blood flow, LOOSENING EXERCISES e.g. hip, ankle, shoulder rotations etc. 5 – 10 mins, STRETCHING of various muscle groups e.g. hamstrings.
WARM DOWN post exercise is just as important in injury prevention as it restores the body gently to a pre-exercise state, aids repair and lessens muscle soreness. This should include gentle jogging and walking for 5 – 10 mins and static stretching to relax muscles and tendons, stretching each muscle group for 20 – 30 seconds.
RECOVERY FROM INJURY:
* Sharp pain: usually signifies an acute injury, Dull nagging pain usually signifies a chronic injury.
Soft Tissue Injuries (damage to muscles, tendons, ligaments, joints) will swell because of internal bleeding so the RICE (rest, ice, compression, elevation) protocol is essential initially.
* A break will take approx. 6 weeks to heal but soft tissue will take at least 12 weeks.
* Obvious Bone injuries would require immediate medical attention.
* Head injuries and other acute collision injuries, first aid or medical attention may be necessary.
Acute Injuries: Rest the injury, Ice the injury for 20 -30 mins every 2 hours for 1st 3 days, Compression should be applied e.g. tubigrip to reduce swelling, Elevation also reduces swelling.
Once the rice procedure has been administered, from about day 7 onwards or once swelling has subsided sufficiently, very gentle mobility exercise and stretching can begin on the affected area.
Advice from Podiatrists, Physios etc. can be useful (both in acute and chronic cases) especially with rehab and injury prevention going forwards and obviously sometimes further intervention via orthopaedic specialists etc. might be needed depending on injury severity. MRI scans, x-ray etc. can sometimes also be indicated.
Chronic Injuries: Rest and Ice are still good, but the treatment will involve a prolonged series of physical therapy and specific exercises to get mobility back to the affected part, sports massage breaks down scar tissue and aids repair. Often orthotics can be beneficial depending on the nature of the injury.
COMMON SPORTS INJURIES seen by Podiatrists are Shin Splints, Lower Back Injury, Tendonopathies (Achilles, Peroneals etc. ) Ankle Sprains, Runner’s Knee, Plantar Fasciitis, Metatarsal Fracture to name but a few !!