Sports Medicine

How To Tell If Your Injury Is Serious

There are some common tip-offs you should recognize as warning signs that you have an injury that needs your attention. While some sports injuries are immediately evident, others can creep up slowly and progressively get worse. If you don't pay attention to both types of injuries, chronic problems can develop. The following list of six injury tip-offs comes from Anybody's Sports Medicine Book, written by James Garrick, M.D. and Peter Radetsky, Ph.D.

Joint Pain
Joint pain, particularly in the joints of the knee, ankle, elbow and wrist, should never be ignored. Because these joints are not covered by muscle, there is rarely a muscular origin. Joint pain that lasts more than 48 hours requires a physician diagnosis.
Tenderness At A Specific Point
If you can elicit pain at a specific point in a bone, muscle or joint, by pressing your finger into it, you may have a significant injury. If the same spot on the other side of the body does not produce the same pain, you should probably see a physician.
Swelling
Swelling is usually quite obvious, and can be seen, but occasionally you may feel swollen without outward signs. Swelling is always a sign of a sports injury and should never be ignored. Often, swelling within a joint will cause pain, stiffness, or may produce a clicking sound as the tendons snap over one another because they have been pushed into a new position due to swelling.
Reduced Range Of Motion
If swelling isn't obvious, you can usually find it by checking for a reduced range of motion in a joint. If there is significant swelling within a joint, you will lose range of motion; the limb will only go so far in each direction. Again, compare one side of the body with the other to identify major differences. If there are any, you have an injury that needs attention.
Comparative Weakness
Comparing one side to the other for weakness is often hard to do, but can be a good clue to identify significant injury. One way to tell is to left the same weight with the right and left side and look at the result. Often therapists will test comparative weakness manually or with special equipment.
Numbness and Tingling
Never ignore numbness or tingling. Often related to nerve compression, these warning signs may indicate serious injury and should always be seen by a physician.

I Have One Of The Warning Signs of Injury - What Next?

If you recognize any of the above warning signs of injury the goal is to prevent further damage. Don't let the problem get any worse and don't let the swelling continue. Look for an obvious cause of the injury such as poorly fitting equipment or a missed step while sprinting. If you can locate the source of the injury, you can begin to remedy the situation. If you have any of the above warning signs, do not continue your activity. Begin treatment immediately.

The first treatment indicated for any acute injury is reducing any swelling. Swelling causes pain and loss of motion, which in turn will limit use of the muscles. If you don't use the muscles, they will weaken, and shorten and resist repair. The primary treatment for acute sports injury is R.I.C.E.: Rest, ice, compression and elevation. Rest in this case simply means to stop the activity that caused the injury. Compression for an acute injury is the most important immediate treatment. Wrapping the injured body part with an ACE bandage can keep swelling to a minimum.

Never apply heat to an injury. Heat will increase circulation and increases swelling.

Immediate Treatment For Injury
As a recap, here is what you should do immediately when you sustain a sports injury:

Stop the activity immediately.
Wrap the injured part in a compression bandage.
Apply ice to the injured part (use a bag of crushed ice or a bag of frozen vegetables) for no more than 15 minutes at a time. Let the area warm completely before applying ice again, in order to prevent frostbite.
Elevate the injured part to reduce swelling.
Get to a physician for a proper diagnosis of any serious injury.

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'Prehab' to Avoid Rehab

Athletes of all levels can avoid many sports injuries with Prehabilitation

What is Prehab?

Prehab is a personalized exercise program that continually evolves. It provides sports specific focused exercises and activities for athlete's needs. The philosophy is simple. Prevent injuries. The development and execution of an effective program can be complex. The practice of prehab and its success relies greatly on an athlete's ability to commit to prevention. The development of the program needs to be progressive and periodically re-evaluated to change with the athlete's needs.

Who Should Prehab?
Athletes of all levels should include a prehab program in their training. The more advanced the athlete, the greater the need for a prehab program. As an athlete's body matures within a sport, their body adapts to the physical demands of training. Too often repetitive movements and the daily stresses of training cause negative effects within their bodies. This limited training technique may cause tightness of muscle groups, imbalances of strength, coordination or muscle stabilization. These imbalances occur naturally with activity and are reinforced with each workout. These imbalances are often the root of many training injuries and may predispose athletes to greater risk of injury during training and competition
How to Prehab
A personalized Prehab program should address total body balance and consider sports specific needs. It balances the range of motion, strength, coordination and stabilization. Comparing left to right, front to back, upper to lower body is the basic premise. Exercises and sports specific skills and drills are focused on an athlete's weaknesses. The majority of prehab programs should focus on coordination and stabilization of the hips, stomach and back "core". Core instability is common and is often due to the lack of a proper training program. Many athletes and coaches use traditional protocols of upper and lower body lifting or basic sprinting and lifting routines, outside of regular practice drills. This leaves the core without a direct focus or training routine.
Continual Progress
A Prehab program should be constantly updated to match the athlete's progress. Activities in a prehab routine can be a subtle focused exercise or a complex sequence of movements designed for dynamic stabilization or to improve an athlete's skill. Adding dimensions of skill, 1 on 1 competition or scoring values can stimulate an athlete's focus and improve the success of a program. Using tools from traditional sports and physical therapy programs can add options. Tools like a foam roll, balance boards, weighted and exercise balls can also make a program unlimited in design.
When to Prehab
As indicated, Prehab should be practiced before an injury. Unfortunately, it often takes an athlete and staff many injuries to decide to initiate a prehab program. Depending on an athlete's training cycle, prehab can be done within a practice session or as an independent workout. Three or four exercises in a warm up or cool down, a few exercises while resting or waiting a turn in practice, or a detailed tedious workout focusing on an athlete's weaknesses. Full workouts can be designed for off days or active rest days. Mini prehab workouts are great for team travel and recovery days. In any case, a prehab program should be a regular part of an athlete's training routine.
Where to Get Help with Prehab Program Design
Athletes should be screened for imbalances. Objective measurements of active range of motion and strength, biomechanical observations, past medical history, present health status and input from support staff should all be considered when designing a program. Such screenings can be performed by the following professionals:
- Athletic Trainer
- Athletic Therapist
- Sports Therapist
- Physical Therapist with additional sports training
Successful Prehab
The ability to challenge and motivate an athlete is the difference between success and failure with respect to a tailored prehab program. Knowledge of the chosen sport, the athlete's needs and open communication are the keys to success with prehabilitation.

Author Information
Kenneth L. Johnson LATC/PTA
Team 2002 Sports Therapist
Specialist of Sports Injury prevention, management, evaluation and prehabilitation.

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