Miserable: The Agony Of Workout Injuries

If you are a regular at the gym, fitness class, yoga studio, avid runner or walker, you have probably twisted an ankle or pulled a muscle at some point. Unfortunately, I’m all too familiar with knee, foot, ankle and shoulder injuries and more recently – an injured hamstring. Not only can injuries temporarily side-line you from your favorite activities – some grow into what feels like never-ending misery.

In many cases, injuries are due to overuse of a part of the body when participating in a certain sport — runner’s knee or tennis elbow, for example. Other types of injuries are caused by trauma — hard contact with something, perhaps resulting in a broken bone or torn ligament or tendon.

At a recent meeting of the American College of Sports in Medicine in Austin, Texas, Edward G. McFarland, MD, spoke about sprains, strains, tears, and other types of sports injuries: What they are, how to avoid them, and how to treat them.

McFarland is the Wayne H. Lewis Professor of Orthopedics and Shoulder Surgery at Johns Hopkins Medicine in Baltimore and a team physician for the Baltimore Orioles baseball team.

What are the most common types of sports injuries?

We usually divide them into two groups: traumatic injuries and overuse injuries.

First, traumatic [injuries]. In the lower extremities, the most common would be knee ligament injuries and fractures. In the upper extremities it would be fractures, rotator cuff injuries, and instability of the shoulder.

Overuse in lower extremities would be patellar [knee cap area] tendinitis or Achilles [heel area] tendinitis. In the upper extremities, it would be … biceps and rotator cuff [shoulder muscle and tendon] problems.

With either type of injury, any type of musculoskeletal tissue can be involved: bone, ligament, tendon, muscle, or nerve.

What are the most common causes of these injuries and how can you prevent them?

Traumatic injuries are, of course, very unpredictable. Sometimes they’re due to poor conditioning, poor surfaces, or poor equipment. Oftentimes, they are just bad luck.

Overuse injuries are almost always due to increasing the stress on the tissues too rapidly. So we see them very often in people who are out of shape and do things they are not used to doing or not conditioned for doing.

The other place we see them is in people who are fairly well-conditioned and try to bump up their level of fitness or level of expertise too rapidly.

I think that as you get more mature, you realize that it takes less and less to get your tissues aggravated.

I always tell people when you are starting out, do about one tenth of what you think you can do and try not to overdo it. We often see people who haven’t done a sport in months or years and try to go out full-gun or full-bore. Suddenly they are hurting all over, or get tendinitis, or irritation of their tendons or ligaments or knees or their joints. The biggest issue is a large increase in physical stress too rapidly.

But still, it is very unpredictable, which is what makes it so frustrating.

Expert advice from Edward McFarland, MD, on how to cope with these common sports injuries.


What are the treatments for these different injuries?

With traumatic injuries, if you have bruising or swelling or can’t move something, you of course need to see a health provider to make sure that you didn’t break something.

For overuse injuries, there is a litany of things you can do. We usually recommend relative rest. In other words, you don’t have to completely stop your sport, but you should back off a little bit. Maybe not exercise five days a week but go to three, or maybe don’t exercise for two hours, but for 45 minutes.

You may want to do some cross training, exercising joints other than those that are irritated.

Also, use ice on places that hurt.  Ice, not heat — the old adage about ice for 24 hours followed by heat is really not believed anymore. Ice is better for pain and swelling and for getting range of motion back. You can ice after any exercise; you can even ice at night in bed. Heat is good for stretching and before exercise, but ice is always better afterward.

You can also take some acetaminophen in a low dose if you are so inclined, but it’s a little trickier if you try to use anti-inflammatories [such as aspirin, ibuprofen, or naproxen] because there are lots of side effects associated with them. But if you don’t have trouble with those, then small doses are probably OK.  It’s always a good idea to check with your doctor before taking medication!


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