Keeping the Hurt Out of Sports

Summer recreation can be a bruiser but there
are ways to prevent and repair injuries in
several popular seasonal sports.


July/August 2014

Run, Don’t Hobble

It happened four miles from Corey Parker’s Chicago home. She was in the middle of a training run last September, striding alongside the waves of Lake Michigan, when pain tore through her calf muscle.

It felt so intense she could no longer go on. She hobbled to the street and hailed a taxi. Parker, 34, had been training for a marathon, but the calf strain forced her to stop for three and a half weeks.
“That loss for me,” she said of not being able to run, “put in perspective that I have to keep my body healthy so I can keep doing what I love.”

Running may be one of the easiest sports to undertake—all that’s needed are workout clothes and a solid pair of running shoes—but runners, experienced and new alike, often stop because of injuries.
Most complaints from runners have a nonsurgical fix, says Joshua Harris, MD, an orthopedic surgeon at Houston Methodist specializing in sports medicine. “If you look at just the foot, the biggest things are just breaking in new shoes or running in shoes that are too old.” Harris adds that shin splints, also known as medial tibial stress syndrome, often happen when there’s a big change in running intensity, distance or topography. “That’s why kind of listening to your body is the best piece of advice I give to new runners.”

New runners who have no history with sports should start with low-mileage and low-intensity runs three times a week. Combining intervals of walking with running will also help those new to the sport, says Harris, the founder of Houston Methodist’s Endurance Medicine Program for athletes who train and compete at long distances. “You just want to get experience being on your feet,” he adds.

In addition to making sure you have the right pair of shoes—ask personnel at a running store about proper fit and selection—injury prevention lies with effective recovery efforts.

Parker has incorporated recovery into her training regimen, becoming a member of the Chicago Recovery Room, which has compression boots, foam rollers, electrical stimulation equipment and an ice bath to help amateur athletes bounce back from workouts.

Liz Yerly, physical therapist and owner of the Chicago Recovery Room, says, “Recovery is basically the time when your body is repairing itself. With runners, the pounding they’re putting on their bodies is huge.”

Ice and compression are particularly important, Harris said, because they help contract muscles and blood vessels that swell during running.

Parker says the recovery methods she uses have cut by half the time she can go back to training after a lengthy run. Parker has also incorporated a strength-training regimen; Yerly says strengthening the body’s core muscles helps with stability.

Anne Palmer, a 54-year-old runner from Scituate, Massachusetts, does 200 crunches each run to help her core and stretches for 10 minutes. In two decades of running she has never had a running-related injury.

In addition to the cardiovascular and endurance benefits, “running definitely gives me energy,” Palmer says. “I get to think without the distractions.”
—Erin Chan Ding

 

Goal: Soccer Field Wellness

On a beautiful weekend you go play soccer with your buddies. It sounds innocent enough, but without proper preparation, you—or your child—could do real damage.

“Especially with youth athletes, coaches and parents need to not let them do too much too soon, make sure there’s proper conditioning and make sure that the athlete is trained so he or she is not doing the same motions over and over again,” says John Gallucci, PT, DPT, MS, ATC, medical coordinator for Major League Soccer and author of Soccer Injury Prevention and Treatment (Demos Health).

Besides eating properly and getting enough rest, Gallucci says soccer players need to focus on hydration. “A tremendous amount of lower extremity strain can be decreased just by keeping the body hydrated appropriately,” he says.

Sean Rush, president of the Pipeline Soccer Club in Maryland and a former pro player, says, “The most important thing is really learning how to properly stretch. If you don’t stretch right, danger lies ahead.” He adds that stretching isn’t stressed enough, especially with younger athletes.
Suppose you do everything right, but you still get hurt. What now?

Gallucci says soccer injuries often affect the lower extremities. If this is the case, see if you can bearweight on the leg. If so, he recommends the RICE protocol: rest, ice, compression and elevation. If you can’t, get help immediately. “It’s very important to get to a doctor or physical therapist as soon as possible,” says Gallucci.

Rush agrees: “I’ve seen so many people wait, and the first thing a doctor says is, ‘You really should have come in yesterday. We could have avoided certain things like this.’ Too many people wait. So get it checked out immediately and don’t try to tough it out.” Likewise, if you’re using the RICE method and you’re still having problems a day or two later, see a professional.

After getting a diagnosis “you’ve got to figure out the right rehab,” says Rush. “Rehab could take months if you’re not doing things the right way or seeing the right people.”
—Michele Wojciechowski

 

Cycling for Safety

Participating in cycling is as easy as riding a bike, right? Not exactly. Safe cycling means preventing injuries.

“The biggest thing that we see with cyclists from children to adults is that the bike is not fitted properly, which ends up leading to injury,” says Gallucci, who is also president of JAG Physical Therapy. “Any bike shop can fit you; if it’s not fitted properly, you’re going to have hip, knee and ankle issues.”

Elizabeth Harlow, a cyclist for 20 years, agrees. “Even if the bike is the correct size for you frame-wise, there are other components on that bike that need to be fitted,” she says. “You would not buy a pair of running shoes off the shelf without trying them on. It’s the same thing with a bike.”
Gallucci says to wear an appropriate helmet that fits correctly. “If there’s an accident, you want to make sure that your brain is protected,” he says.

And stay hydrated. “A lot of people who ride in the colder months figure that they’re not sweating as much, so they don’t need as much hydration,” says Gallucci. “The body has to warm itself and actually dehydrates quicker when it’s cold. So you do need to hydrate in the cooler months as well.”
Of course, any serious injury should be examined by a medical professional immediately. But you might be able to deal with lesser ailments on your own. Gallucci says strains can be treated with the RICE protocol.

If you ever hit your face or any part of your head, however, go to a doctor or hospital. “Any injury sustained to the head should be evaluated by a physician as soon as possible to rule out the individual being concussed,” says Gallucci.

After an accident that left her with knee damage and a cracked tibia—which led to surgeries and rehab—Harlow advises cyclists recovering from injuries to be patient. She wanted to get back to riding immediately, but it took her almost a year to do so. There was one upside, though. “Since I’ve come back, I’ve had more of a renewed passion for the sport.”
—Michele Wojciechowski

 

America’s Pastime Done Right

No sport says summer quite like baseball. If you’re at a stadium watching your favorite team, the biggest threats to your health are an errant foul ball and consuming too many hot dogs.

If you’re playing baseball or softball yourself, there are additional hazards. These include stress on the shoulders, elbows and hands as well as repetitive strain injuries that could develop from swinging a bat, according to the editors of Everyday Sports Injuries (DK).

You should also beware of the risk of head injuries if you’re hit with a pitch while batting, Everyday Sports Injuries cautions. And abrupt spinal twists can cause disk degeneration, lower back pain and damage to nerves in the neck, while frequent rotation of the hip can bring about wear and tear.

Rotator cuff injuries, shoulder bursitis and fractures to the thumb are among other possible hazards.
Using proper technique can minimize injuries. Warming up with dynamic stretches can help improve performance and cut injury risk, as can a training regimen focused on shoring up the stabilizing muscles in the shoulder, the DK editors note. Chest stretches can help prevent shoulder pain that comes from repeated throwing or swinging.

As for the elbow injuries that pitchers can sustain, the conventional wisdom that pitchers should rest for a few days after pitching may need some revising. Jim Kaat, who pitched more than 4,500 innings and 180 complete games in his career, tossed a ball around every day. Kaat didn’t heavily exert himself by pitching daily, he said in a MLB Network roundtable discussion, but threw enough to get some exercise.
—Tom Elmore

 

Serving Up Tennis health

Racket-based sports such as tennis can put you at risk of injury from head to toe. The upper limbs can endure serious strain from repeatedly moving your arms overhead during serves and smashes, according to Everyday Sports Injuries, while knees and ankles can suffer from sudden accelerations and quick changes of direction.

Other risk factors linked to tennis include over-training, inadequate strength and endurance, inflexibility, improper equipment and poor aerobic fitness level, say officials of the United States Tennis Association Sport Science Committee.

But the most crucial element in injury prevention is employing proper stroke mechanics, according to the USTA. It’s particularly important to understand the “kinetic chain” principle, which describes the energy or force generated by one part of the body and how it is transferred to the next link.

The association says that up to 54% of the power generated during a tennis serve, for example, is produced by the legs and trunk. Unseasoned players may not use their legs and trunk adequately to generate this power, and mistakenly put more demands on the smaller muscles in the kinetic chain. The result: injury.

When it comes to protecting shoulders and elbows, the USTA says “proper timing and coordination of the kinetic chain is critical for avoiding the types of injuries that can occur in the upper body when hitting an open-stance forehand. Additionally, having adequate strength in the rotator cuff and upper back can help stabilize the shoulder and prevent injury.”

Among exercises that can help prevent such injuries are the low-to-high pull, in which a cable column weight is pulled from about a foot off the ground up and across the body. Straight-arm rowing, which trains the muscles that stabilize the shoulder blades to help protect the rotator cuff from injury, can also help. (Full descriptions of these exercises and others can be found at USTA.org under Sport Science.)
—Tom Elmore

 

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