The Injury Information Center

Anytime you engage in a fitness activity, injury is always a possibility. Many injuries are minor and temporary in nature, and will clear up quickly using basic sports injury home care. Other kinds of injuries are more serious, and can become both chronic and debilitating, forcing you to modify or stop your fitness program. While we can't diagnose and offer treatment plans for your aches and pains, we can present reliable information so that you can make more informed decisions about your injury care. Below you'll find information organized around common sites on the body for fitness-activity related problems, along with links to articles for further study. Remember, if you are at all unsure or concerned about the nature of your injury, or if it is not getting better, it is always best to consult your physician.

Basic Injury Care

Knee Injuries

Ankle and Foot Injuries

Shin Splints

Elbow and Wrist Injuries

Hamstring Injuries

Shoulder Injuries

Low Back and Abdominal Injuries

Preventing  Injuries

1. Basic sports injury care

Fitness related injuries tend to come in two varieties, acute and chronic. Acute injuries occur suddenly during an activity, and may be marked by sudden and severe pain, swelling, an inability to place weight on a lower limb, extreme tenderness in an upper limb, an inability to move a joint through its full range of motion, or the visible breakage or dislocation of a bone. Chronic injuries may include pain while performing certain activities, a dull ache when at rest, and swelling. 

Whether an injury is acute or chronic, the most important thing you can do initially is to stop engaging in activities that cause pain as you're likely to cause further harm to the injured area and slow healing. As to when it's time to visit your doctor, that's a decision only you can make. However, you should certainly see a doctor if you are experiencing severe pain, swelling or numbness; you can't put weight on the injured area; or the pain or ache of an old injury is accompanied by increased swelling, joint abnormality or instability; or the injury just isn't getting any better after several days. 

Caring for minor injuries yourself really centers on two things: reducing inflammation of the injury site and protecting the site from further injury. We do this primarily through the RICE method. RICE stands for REST, ICE, COMPRESSION and ELEVATION. Applying ice to an injury is extremely important and should be done as quickly as possible. Ice the affected area for 10 to 20 minutes every hour for the first three days after the injury (or at least three times during the day). This, along with wrapping and elevating the injured limb will help to reduce inflammation (when you wrap an injury, make sure that it is firm, bit not so tight as to restrict blood supply). Note: you may also want to add ibuprofen to that regimen, as it is also excellent for reducing inflammation.

After 72 hours of applying ice or cold to the injured area, apply moist heat (make sure that there area is no longer swollen).

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2. Knee injuries

Knee injuries can be both painful and vexing, as healthy knees are important to most daily activities. Most knee injuries are ligament sprains and strains, tendinitis, bursitis, or injuries to the meniscus.

Ligaments: Ligaments are connective tissue that connect bone to bone, and there are four ligaments in the knee joint: the medial (inside) and lateral (outside) ligaments on either side of your knee, and the other two ligaments (the ACL and the PCL) are inside the knee, and cross each other as they stretch diagonally from the bottom of the thighbone to the top of the shin bone.

An injury to the lateral or medial ligaments is usually the result of a fall or contact injury or from quick stops and turns, and is likely to cause immediate pain to the injured area that is worse when you try and walk or bend your knee. Likewise you'll also probably know it right away if you tear the ACL, as you'll likely hear a popping noise followed by intense pain and immediate swelling. ACL tears usually happen when the knee is twisted or overextended. PCL injuries as a result of athletic activity is somewhat less common. 

Tendonitis: Tendons are connective tissue that connect muscle to bone. One of the most common tendon injuries to runners and other athletes is a tendinitis that can cause pain and swelling at the front of the knee or just below the kneecap. The discomfort usually isn't constant, but tends to occur when you jump, run, squat or climb stairs. Tendonitis as a result of running and other athletic activities is common.

Meniscus: The meniscus is a C-shaped piece of cartilage that curves within your knee joint. Tears in the meniscus will often result in mild to moderate pain and inflammation that develops over 24-48 hours. It can tear from sudden pivoting or turns, but in older adults can tear the meniscus through repetitive movements due to degeneration over time of the meniscus.

Bursitis: Bursae are small sacs of fluid on the outside of the knee joint that that allow tendons and ligaments to glide smoothly over the joint. Inflammation of the bursae is called bursitis, and can lead to warmth, swelling and redness over the inflamed area, aching and stiffness when you walk, and significant pain when you kneel. When the bursae on the lower inner side of the knee is affected, you're likely to have pain when going up and down stairs. Bursitis tends to occur as a result of kneeling for long periods of time.

Dealing with knee injuries means employing RICE (Rest, Ice, Compression, and Elevation) and taking an over-the-counter anti-inflammatory if necessary. If the symptoms are acute or persist, check with your doctor.

To reduce your susceptibility to knee injuries, note the following:

* Allow yourself adequate recovery time between workouts. Failure to do so leaves you open to overuse injuries. Pay attention to those aches and pains.

* Keep your leg muscles both strong and flexible. Weak and inflexible muscles are a leading cause of knee injuries because they provide less support for the stress exerted on your knee joints.

* Get good running shoes and/or orthotics to help you correct biomechanical problems in your gait.

* Be careful of sudden stopping, turning, twisting and pivoting moves.

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3. Ankle and foot injuries

There are four common sports injuries to the foot and ankle: ankle sprains, Achilles tendon injury, general overuse injuries, and shin splints. We discuss shin splints in the next item, so we'll concentrate on the describing the other three common types of foot and ankle injuries:

Ankle Sprains: Sprained ankles are one of the most common sports injuries. Because the inner ankle is more stable than the outer ankle, a misstep or fall can cause the ankle to turn inward, tearing the ligaments and causing a sprain. 

Achilles tendon injury: The Achilles tendon connects the muscles of the lower leg to the heel bone. Sports such as running that tighten the calf muscles can overstress this tendon and cause tendonitis or a rupture. Achilles tendinitis is characterized by pain and tenderness at the back of the heel and possibly extending up to the lower calf.

Overuse injuries: Running long distances without adequate rest, increasing running distances and intensity too rapidly, and even running on unfamiliar surfaces can cause stress fractures and muscle and tendon strains. Stress fractures are tiny breaks in a bone caused by repeated forces against the bone.

Most foot and ankle injuries are treated by RICE (Rest, Ice, Compression and Elevation) and ibuprofen, along with taping or immobilization of the foot to protect it from further injury. If symptoms are severe, or if it does not improve after several days, it would be prudent to see your doctor.

To help protect yourself from foot and ankle injuries, note the following:

* Keep the calf and leg muscles strong and flexible to help cushion the foot and ankle

* Make sure you sufficiently rest and recover between exercise periods

* Use good running shoes and orthotics that properly fit your feet

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4. Shin splints

Shin splints are a common injury for runners, and are often characterized by redness, swelling and pain along the shin bone of the leg. For runners, the cause is often inflammation of the periostium of the tibia bone (the sheath surrounding that particular bone).

Shin splints are often caused by sudden increases in intensity or distance in the running schedule, and can be aggravated by excessive pronation of the foot (excessive pronation is defined as the foot rolling inward toward the arch during running). Tight Achilles tendons and weak ankles can also contribute to the development of shin splints.

The key to dealing with shin splints is to reduce inflammation, and that can be done through application of ice and taking an over the counter anti-inflammatory. It is also important to rest and take a break from the training schedule until the pain is gone. You can also tape the ankle to take the pressure off of the muscle attachments. Stretching the calves and massaging the muscle in the affected area can also speed healing.

To help keep shin splints from returning (or to keep from getting them in the first place), you'll want to correct the problems that led to the injury:

* Regularly stretch the calves and Achilles tendon to keep them flexible

* Exercise the calves to keep them strong

* Correct the biomechanical problems in the running stride through better shoes and orthotics, and make sure the shoes have proper shock absorbing properties.

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5. Elbow and wrist injuries

Tendonitis is the most common sports injury to the elbow (i.e. "tennis elbow" and "golfer's elbow"). The tendons in the elbow are as susceptible as any joint to injury from repeated  stress or from sudden increases in the intensity of the fitness regimen.

RICE (Rest, Ice, Compression and Elevation), along with an over-the-counter anti-inflammatory such as ibuprofen are the proper way to deal with tendonitis of the elbow. If the tendonitis is severe, worsens, or doesn't begin to get better within a few days, it's best to see your doctor.

All of the above also applies in the case of wrist tendonitis. To protect yourself from tendonitis in these joints, remember the following:

* Keep the muscles of the forearm and upper arm flexible and strong.

* Pay attention at the first sign of pain in these joints and rest for a few days

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6. Hamstring injuries

The hamstrings can refer to both the large muscles in the back of the lower leg, and the tendons that connect those muscles to the bone. Hamstring pulls are generally injury to the tendons, and are treated (depending upon the severity of the injury), by applying RICE (Rest, Ice, Compression, and Elevation) along with an over-the-counter anti-inflammatory.

As with most injuries, the best way to prevent hamstring pulls are to keep the muscles strong and flexible, and to pay attention when the body needs rest and recovery.

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7. Shoulder injuries

Shoulder injuries can be caused by falls, racquet sport injuries, and even just every day activities. The most common non-contact injuries are tendonitis, sprains, bursitis, and specifically- rotator cuff injuries.

Any injury to the shoulder that causes pain, inflammation, and limited range of motion should be dealt with by applying RICE (Rest, Ice, Compression, and Elevation) and taking an over-the-counter anti-inflammatory. A doctor's advice should be sought if it is not getting better within a few days.

We'll deal with rotator cuff injuries separately due to their being so common:

The rotator cuff is a group of small muscles that work to provide the shoulder with stability as it moves. Injuries to the rotator cuff are common is sports and fitness, and like most other injuries can be either acute or chronic. An acute injury is one that you that happens as a result of a quick, powerful movement such as a fall or fit. Chronic injuries can be identified by:

* Pain, normally on the dominant side

* Pain often worse at night, sometimes interrupting sleep

* Eventual inability to lift the arm out to the side or to do activities with the arm over the head

Chronic problems are common in the 40+ age group, but can happen to anyone. Rotator cuff injuries can be both debilitating and painful, so never try to "work through" a suspected rotator cuff injury. If pain, inflammation and injury persist- see your doctor.  

As always, you can help protect your shoulder by keeping the muscles strong and flexible, and by getting enough rest and recovery between workouts.

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8. Low back and abdominal injuries

Lower back trauma is exceedingly common, and many factors can play a part: damage to discs; as well as strains and tears of muscles, tendons, and ligaments. Most injuries will heal with sufficient rest, cold therapy (RICE) and anti-inflammatory medications, but any injury or symptoms that are severe or that persist should lead you to see your doctor.

Abdominal strains and pains are often caused by overuse or sudden increases in the intensity of training (particularly to weak abdominals), or quick movements that can tear muscles. As always, the key to dealing with relatively minor injuries is rest and ice. 

Protecting the abdominals and lower back involved keeping both of these muscle groups strong, keeping the lower back flexible, and wearing shoes with proper cushioning.

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9. Preventing injuries

The key to the prevention of most sports injuries are:

* Keeping your muscles and connective tissues strong and flexible through regular exercise and stretching

* Wearing athletic/running shoes that are properly cushioned and that fit your feet properly

* Proper nutrition and cardiovascular exercise to reduce body fat

* Careful attention to good exercise form

* Getting proper rest and recovery between exercise periods

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