Sports injuries: causes, symptoms, diagnosis, treatment

Regular exercise improves health and provides a sense of satisfaction, but people who exercise regularly are at risk of injury, particularly from overuse.

Participation in sports competitions always involves the risk of injury. Most injuries occur not only among athletes, but can also occur in everyday life.

In most cases, depending on the mechanism of injury, a distinction is made between overexertion trauma, blunt trauma, and acute ruptures (sprains) of soft tissues.

Overuse injuries are the most common cause of sports-related injuries and can involve any combination of muscles, ligaments, cartilage, tendons, bursae, fascia, and bone. The risk of overuse injury depends on complex interactions between human and environmental factors. Human factors include muscle weakness and stiffness, joint laxity, previous injuries, bone weakness, and limb asymmetry. Environmental factors include training errors (e.g., exercising without adequate rest, loading too heavily, training one muscle group without training the opposing muscles, doing too many of the same movements), environmental conditions (e.g., running too long on treadmills or outdoors), and equipment characteristics (e.g., unusual or unfamiliar movements, such as on an elliptical machine). Runners are most likely to be injured by increasing the intensity or duration of a run too quickly. Swimmers are not prone to overuse injuries, but there is a specific risk of injury to the shoulder joints, which provide the main movement.

Blunt athletic trauma causes contusions, fractures, and other injuries. The mechanism of injury typically involves forceful collisions with other athletes or objects (such as being kicked in football or thrown overboard in hockey), falls, and direct blows (such as in boxing and martial arts).

Strains and strains (extensions) usually occur with accidental forceful exertion, most often when running, especially with a sudden change in direction. Such injuries are also common in strength training, when a person quickly drops or lifts a load instead of moving smoothly and slowly.

Symptoms and diagnosis of sports injuries

Trauma always causes pain of varying intensity. Signs may be absent or include any combination of soft tissue swelling, hyperemia, increased local temperature, some tenderness, ecchymosis, and loss of mobility.

The diagnosis is made based on the history and physical examination. The circumstances of the injury should describe movements and physical exertion during activity preceding the injury, establish the time of onset of pain, its degree and duration before, during and after physical activity. Patients may undergo additional examinations (e.g., radiography, CT, MRI, bone scan) and may also undergo consultations with specialized specialists.

Treatment of sports injuries

Immediate treatment for most acute sports injuries includes rest, ice, compression, and elevation. Rest prevents the injury from becoming larger. Ice (or ice packs, which must be used properly because they can damage the skin) causes vasoconstriction and reduces swelling, inflammation, and tenderness in the soft tissues. Compression and elevation reduce tenderness and swelling. An elastic bandage can be placed around a sealed ice pack to hold it in place. The bandage should not be so tight that it cuts off circulation. Ice and elevation should be used periodically for 24 hours after an acute injury.

NSAIDs are commonly used for pain relief. However, if pain persists for >72 hours, a specialist should be consulted. Oral or injectable glucocorticoids are sometimes prescribed for persistent pain; these should only be prescribed by a doctor and only when necessary because glucocorticoids can delay soft tissue repair and sometimes weaken damaged tendons and muscles.

In general, injured athletes should avoid the specific physical activity that caused the injury until they have fully recovered. However, to reduce the chance of reinjury, they can engage in cross-training (i.e., doing different, similar exercises that are not likely to cause reinjury or pain). Returning to full activity should be gradual. Athletes should be put on a gradual program to restore flexibility, strength, and endurance. They should also feel mentally prepared to begin full-strength activity.

Prevention of sports injuries

Exercise itself helps prevent injury because the tissues become more elastic and resistant to the external influences they experience during various activities. At the beginning, exercises should be of low intensity to strengthen weakened muscles, tendons and ligaments. General warm-up increases the temperature, flexibility, strength and resistance of muscles to injury; it also increases performance by improving mental and physical fitness. Stretching lengthens muscles, so they can develop greater strength, although performing warm-up exercises with a light load has the same effect. Cooling down can prevent dizziness and fainting after aerobic exercise, helps remove metabolic products such as lactic acid from the muscles and bloodstream. Cooling down also helps to slowly and gradually lower the heart rate to the _resting heart rate, which is important for patients with heart problems. Cooling down does not prevent muscle pain caused by muscle fiber damage in the following days.

Injuries due to overpronation (inward rotation of the foot while bearing weight) can be prevented with strengthening shoes or special orthoses (elastic or semi-rigid).