Sports Medicine

Athletes of every sport rely on stable ankles and feet for peak performance. An ankle sprain is a common injury for athletes, but other injuries such as a fracture or strain can occur during exercise or competition.

What causes a sprained ankle?

An ankle sprain is an injury to the ligaments around a joint. Ligaments are strong, flexible fibers that hold bones together. When a ligament is stretched too far or tears, the joint will become painful and may swell. Sprains are caused when a joint is forced to move into an unnatural position. This can happen due to joint weakness or an unnatural movement of the joint.

What are the symptoms of a sprain?

• Joint or muscle pain
• Swelling
• Joint stiffness
• Discoloration of the skin, especially bruising

What should you do if you have a sprained ankle?

1. Apply ice immediately to help reduce swelling. Ice the injury for 20 minutes on and 20 minutes off until swelling has subsided.
2. Limit movement of the injured area. To help, bandage the affected area firmly, but not too tightly. ACE bandages will work well. Use a splint if necessary. Keep the swollen joint elevated above the level of the heart, even while sleeping.
3. Rest the injured joint for several days.

Other useful tips for sprained ankles:

• Aspirin, ibuprofen or other pain relievers can help.
• Protect or keep pressure off the injured area until the pain subsides (usually up to seven-ten days for mild sprains and up to three-five weeks for severe sprains).
• You may require crutches when walking.
• Rehabilitation to regain the motion and strength of the joint may be necessary.

When should you contact a medical professional?

• You have swelling does not go down within two days
• You have symptoms of infection – the area becomes more red, more painful, warm to the touch, and you have a fever over 100˚ F
• If the pain does not go away after several weeks, see a foot/ankle specialist

How to prevent ankle sprains:

• Wear protective footwear for activities that place stress on your ankle and other joints.
• Make sure that shoes fit your feet properly.
• Always warm up and stretch before exercise and sports.
• Avoid sports and activities for which you are not conditioned if you have sustained an ankle sprain in the past, because your muscles will be weaker. Wearing a brace and doing strength exercises first can help when getting back into activities after an injury.

Elbow pain may be caused by a traumatic or overuse injury. People may report feeling an aching or other discomfort in the elbow that is not related to a direct injury.

What causes elbow pain?

Elbow tendonitis is an inflammation and injury to the tendons. Tendons are soft tissues attaching muscle to bone.

What is tennis elbow?

People who play racquet sports are more likely to injure the tendons on the outside of the elbow. Generally, this condition is called tennis elbow, or lateral epicondylitis.

Pain can be felt in the forearm and wrist. Although lateral epicondylitis is referred to as tennis elbow, a person can have this injury without ever playing a racquet sport.

What is golfer's elbow?

Golfers are more likely to injure the tendons on the inside of the elbow, and this is called golfer’s elbow, or medial epicondylitis.

Some people may also feel stiffness in their elbow or weakness in their hands or wrists. Nerves run through this part of the elbow, so people suffering from golfer’s elbow also may report tingling or a pins-and-needles sensation in their hands or fingers.

Although medial epicondylitis is often referred to as golfer’s elbow, anyone can develop this condition.

What can you do to help with elbow pain?

• Apply ice up to 15 minutes every hour for the first day. Continue to apply ice every three to four hours for up to three days.
• Wrap the elbow with a bandage to keep the elbow immobilized.
• Keep the elbow elevated above your heart.
• While you are resting the joint, take pain relievers such as acetaminophen, naproxen or ibuprofen.
• Activity modification is essential in the first few weeks following the injury.

What are common causes of elbow pain?

• Arthritis – narrowing of the joint space and loss of cartilage in the elbow
• Bursitis – inflammation of a fluid-filled cushion beneath the skin
• Elbow strains
• Infection of the elbow

How can I prevent elbow pain?

• Reduce the activity that causes the pain.
• Warm up slowly. Stretch the forearm before, during, and after exercise.
• Use an elbow sleeve to help keep your arm warm while playing.
• For tennis, use the correct grip size, a two-handed backhand, and proper tension racquet strings.
• Perform regular stretching and strengthening exercises.
• Use bracing to protect and support the elbow, as suggested by your physician or physical therapist.

When should you contact a medical professional for elbow pain?

• You have prolonged tendinitis that does not improve with home care.
• Pain is due to a traumatic elbow injury.
• There is obvious deformity in the joint.
• You are unable to use the elbow.
• You have a fever or swelling and redness of your elbow.

Hip pain can be caused by several factors, including traumatic injuries, overuse or repetitive motion, or underlying conditions like arthritis.

Can a muscle injury cause hip pain?

A common cause of hip pain in adults is muscular weakness, strains, or overuse, especially in the hip flexor, groin, and lower abdominal muscles.

Hip flexor strains usually cause pain in the front of the hip and thigh, sometimes up into the lower abdominal region. These happen when you overstretch or tear the muscles responsible for lifting your leg and bending the waist. Cyclists, runners, and soccer players often suffer these injuries.

Groin strains cause pain in the inside (medial) portion of the thigh and can be mild to severe. These occur when you overstretch or tear the muscles on the inside of the thigh, called adductors

Lower abdominal strains are sometimes mistaken for hip flexor strains because the pain can be in the same location.

What can I do if I have hip pain?

Treatment for all types of hip pain is similar.

The RICE Method:

Additional ways to treat hip pain:

• Anti-inflammatory medications, such as ibuprofen or naproxen
• Gentle muscle stretching

These injuries can be prevented by warming up before exercise and cooling down after exercise. For cyclists, make sure the bike seat is at an appropriate height to help reduce these muscular injuries.

What is sciatica?

Sciatica is pain in the lower back that radiates down through the buttocks, hip, and lower extremities. Several underlying factors cause sciatic nerve pain, including muscle tightness, disc herniation, arthritis of the spine, or spinal stenosis. A sports medicine specialist can determine if your pain comes from the sciatic nerve. Sciatic nerve pain can happen with activity or at rest, and can sometimes cause numbness and paresthesia (pins and needles sensation).

Treatment for sciatic nerve pain typically depends on the underlying cause but can include anti-inflammatory medication, physical therapy, and ice.

What is arthritis?

Arthritis in the hip is most common in people 50+ years of age, but it can occur in young people as well.

Arthritis occurs when the cartilage in the hip wears down over time. People with arthritis may complain of joint stiffness, cracking, swelling, tenderness, and sometimes deformities in the joint.

Arthritis is diagnosed after an X-ray shows degeneration of the cartilage in the hip joint. Treatment can include physical therapy, weight loss, ice, heat, medications, or joint replacement.

Knee pain may be caused by a traumatic or overuse injury. People may report feeling an ache or other discomfort.

Sports injuries to the knee are very common and can range from mild to severe. The complex motions that athletes perform involving the knee joint - repeated twisting or pivoting, frequent stopping and starting, or swift directional changes - can cause damage to both cartilage and ligaments.

What is a ligament injury?

The knee is made up of four major ligaments: the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), and lateral collateral ligament (LCL).

What is an interior cruciate ligament (ACL)?

The anterior cruciate ligament (ACL) is located inside the front of the knee. It’s responsible for stabilizing the knee joint from front to back. ACL injury frequently occurs in athletes that stop and start suddenly or change direction in mid-motion.

What is a posterior cruciate ligament (PCL)?

The posterior cruciate ligament (PCL) is located inside the back of the knee and stabilizes the joint, keeping the tibia from moving too far backwards. Damage to the PCL requires extreme force, such as a direct hit to the knee. A PCL injury is generally not as severe as an ACL injury, and often will heal on its own.

What is a medial collateral ligament (MCL)?

The medial collateral ligament (MCL) is located along the inside of the knee, connecting the femur and tibia bones of the leg to stabilize and limit sideways movement at the joint. The MCL is one of the most common ligament injuries and occurs when the knee joint takes a direct hit from the outside of the knee.

What is a lateral collateral ligament (LCL)?

The lateral collateral ligament (LCL) is located along the outside of the knee, connecting the femur and fibula (lower leg bone on the outside of the leg) to limit and stabilize sideways movement of the knee joint. An LCL injury usually happens along with another injury in the knee, and in sports with a direct hit or during movement with a sudden change of direction.

What are the symptoms of a ligament injury?

A tear of any of these ligaments may be accompanied by a “pop,” knee swelling, pain when bearing weight, and a “giving way” sensation when walking.

What are treatment options for ligament injuries?

A full tear or partial tear of these ligaments is reason to seek medical attention for further evaluation. Surgical intervention may be needed when these ligaments fully tear.

What is a meniscal tear?

The meniscus is a thick layer of cartilage that acts as a shock-absorber between the femur and tibia bones in the knee. It protects the harder layer of cartilage that lines the ends of the bones. In severe injuries such as a direct hit to the knee, or excessive twisting, the meniscus can tear and cause severe pain and swelling.

Knee pain or tenderness may be caused by a sudden, traumatic injury, overuse, or an underlying condition like arthritis. Knee pain can range anywhere from dull and achy to sharp and stabbing, depending on the cause.

What is tendonitis?

Tendonitis is inflammation of the tendons, usually from overuse. Tendons are the soft tissues attaching muscle to bone. In the knee, the patellar tendon is an extension of the quadriceps muscle group, and it connects the kneecap (patella) to the shin bone (tibia).

People who have patellar tendonitis often report pain and/or tenderness in the front of the knee, sometimes accompanied by swelling, just below the kneecap.

What is iliotibial (IT) band syndrome?

The iliotibial (IT) band is a thick, fibrous band that runs from the outside of the hip to the outside of the knee. IT band syndrome is common in distance runners. IT band syndrome can cause pain in the outside (lateral) aspects of the hip, knee, or upper leg that is sometimes accompanied by swelling.

Treatment options for iliotibial (IT) band syndrome:

• RICE Method - Rest, ice, compression, elevation
• Non-steroidal anti-inflammatory drugs (like ibuprofen and naproxen)
• Physical therapy
• Foam rolling and massage
• Stretching before and after exercise and activity

What is a meniscus injury?

One of the most common injuries in the knee is a meniscal tear. The menisci are the two pieces of cartilage in the knee between the thighbone (femur) and the shinbone (tibia). The menisci provide cushion between the two bones. When the knee is forcibly twisted or rotated, these pieces of cartilage can tear. If a meniscal tear is suspected, it is important to see an orthopedic surgeon to determine the most appropriate treatment.

Signs and symptoms of meniscus injuries?

• Pain in the knee joint – this can be on the inside or outside of the knee
• Swelling in the knee joint
• Stiffness
• A “clicking” or “popping” sensation when walking

What is arthritis

Arthritis is a common cause of knee pain in people 50+ years of age, although it can affect younger people as well too. Arthritis occurs when cartilage in the knees wear down over time. People with arthritis may complain of joint stiffness, cracking, swelling, tenderness and sometimes deformities in the joint. Arthritis is diagnosed after an X-ray shows degeneration of the cartilage in the joint. Treatment can include physical therapy, weight loss, ice, heat, medication, and joint replacement.

Shoulder pain may be caused by a traumatic injury or by overuse of the arm with repetitive motion. People may report feeling an aching or other discomfort when moving or using the arm.

What is a shoulder dislocation/labral tear?

The shoulder joint can dislocate from the socket with an injury or repetitive overuse. The injury weakens the muscles holding the shoulder in place. The extent of the dislocation, whether the ball is moved partially or fully out of the socket, affects the amount of pain you may experience, especially if a tear occurs in the muscle and soft tissues surrounding the socket.

What is a shoulder fracture?

A fracture, or break, of one of the bones in the shoulder usually occurs from a fall or collision. While some fractures are obvious, some are not.

What is a rotator cuff tear?

A torn rotator cuff causes pain, weakness, and an inability to move the arm freely during full range of motion. It also tends to be painful when you try to lift and turn your arm during overhead activity.

Your rotator cuff is made up of the muscles and tendons in your shoulder, which connect your upper arm bone (humerus) with your shoulder blade (scapula). The rotator cuff holds the ball of the humerus firmly in the shoulder socket.

A rotator cuff injury includes any type of irritation or damage to your rotator cuff muscles or tendons. About half the time, a rotator cuff injury can heal with the help of physical therapy.

What causes a rotator cuff tear?

Four major muscles (subscapularis, supraspinatus, infraspinatus, and teres minor) make up the rotator cuff.

Rotator cuff injuries can be acute (traumatic) or chronic injuries that happen over time. These injuries include:

• General wear and tear as you get older or participate in repetitive movement activities.
• Tendonitis – tendons in your rotator cuff can be come inflamed due to overuse or overload.
• Bursitis – the fluid-filled sac (bursa) between your shoulder joint and rotator cuff tendons can become irritated and inflamed.
• Strain or tear – left untreated, tendonitis can weaken a tendon and lead to chronic tendon degeneration or to a tendon tear.

What should I do if I have shoulder pain from a rotator cuff injury?

Most of the time, rest and physical therapy are the best treatment. Your doctor or a physical therapist will talk with you about specific exercises designed to help heal your injury, improve the flexibility of your rotator cuff and shoulder muscles, and provide balanced shoulder muscle strength. Depending on the severity of your injury, physical therapy may take from several weeks to several months.

Other rotator cuff injury treatments may include:

• Steroid injections – depending on the severity of your pain, your doctor may use a corticosteroid injection to relieve inflammation and pain.
• Surgery – if you have a large tear in your rotator cuff, you may need surgery to repair the tear. Sometimes during this kind of surgery, doctors may remove a bone spur or calcium deposits.
• Arthroplasty – some long-standing rotator cuff tears over time may contribute to the development of rotator cuff arthropathy, which can include severe arthritis. In such cases, your doctor may discuss with you more extensive surgical options, including partial shoulder replacement (hemiarthroplasty) or total shoulder replacement (arthroplasty)

What is a sprain?

A sprain occurs when your ligaments are stretched too far which can result in tear or loss of elasticity in the ligament. Oftentimes, you will feel a sharp pain and may hear or feel a pop.

How can I prevent a sprain?

Wear proper equipment and protective gear, such as an ankle brace, to help prevent sprains if you know a joint is weakened.

Making sure that the muscles surrounding your ligaments are strong is also crucial in preventing sprains.

What is a muscle strain?

A strain occurs when a tendon or muscle is stretched too far and either tears or loses elasticity. Oftentimes, you may feel a sharp pain when it initially occurs and you may hear or feel a pop.

How can I prevent a strain?

• Stretch your muscles properly in warmups to prevent strains.
• Make sure you are not bouncing when you stretch.
• The best technique for post-exercise is the stretch-and-hold method. Hold the stretch for 20-30 seconds, rest, and then repeat approximately three times.

A dynamic or active warm-up is also important in preventing strains. When performing a dynamic warm-up, you go through motions that you use while playing your sport. For example: high knees, high kicks, lunges, grapevines, etc.

What is tendonitis?

Tendonitis usually occurs as a result of overuse, so it is important to do a variety of exercises or activities to prevent tendonitis from occurring.

How can I prevent a tendonitis?

Tendonitis usually occurs as a result of overuse, so it is important to do a variety of exercises or activities to prevent tendonitis from occurring.

Proper technique and body mechanics for your specific activity also can reduce your risk of tendonitis.

If pain does not resolve, see one of the SSM Health orthopedic specialists for the following:

• Foot or ankle pain
• Hand or wrist pain
• Hip or knee pain
• Shoulder or elbow pain

How can I treat a sprain, strain, or tendonitis at home?

The best way to treat a sprain, strain, or tendonitis at home is by using the PRICE formula:

The wrist, hand, and fingers are vulnerable to injury in many competitive and contact sports, and injuries occur even when using protective gear. Many injuries can be treated with the RICE method, but if the pain continues, SSM Health Orthopedics specialists are here to help.

The most common wrist and hand injuries seen in athletes include:

• Fractures
• Wrist or finger sprains
• Wrist tendonitis
• UCL of the thumb injuries
• Carpal tunnel syndrome
• De Quervain's tenosynovitis

What can I do to help with wrist or hand pain?

Initial treatment for most types of hand pain is similar, the RICE method:

The symptoms of concussion may be subtle and don’t always show up immediately. This makes it especially important to pay attention to your body and note any symptoms you experience in the days following a head injury. If you’re experiencing any of the below following a blow to the head, you should be evaluated by a physician:

• Balance issues or dizziness
• Concentration or memory problems
• Confusion
• Double or blurry vision
• Headache
• Feeling sluggish or "in a fog"
• Loss of consciousness (even briefly)
• Mood, personality or behavior changes
• Nausea or vomiting
• Sensitivity to light and noise
• Sleeping more or less than usual

If you experience any of the following symptoms during your recovery, seek immediate emergency or urgent care.

• Headaches that worsen
• Look of being very drowsy or can’t be awakened
• Inability to recognize people or places
• Neck pain
• Seizures
• Repeated vomiting
• Increasing confusion or irritability
• Unusual behavioral change
• Slurred speech
• Weakness or numbness in arms and/or legs
• Change in state of consciousness

Following a concussion, complete rest - both physical and mental - is the most critical part of recovery. Once a concussion is identified, there are several guidelines to follow to promote healing:

• No activity or exercise until cleared by physician
• Limited or no texting, computer or video games
• Driving may be restricted
• Avoid over stimulating activity (theme parks, movie theaters, concerts, etc.)
• Don't take headache medications unless advised by a physician
• Modify school or work attendance and activities as needed

Most people recover from a concussion within 7-10 days. When returning to work or school don’t put excessive strain on your brain. Take breaks as needed in a quiet place and ask to be excused from non-essential work. When your signs and symptoms are gone, you can return to normal activities. If you’re an athlete, speak with your SSM Health provider about when and how it’s safe to return to the field.