Sports and Exercise Injuries
An Information Booklet
Introduction
Sport and exercise are good for you.
Regular aerobic exercise (exercise which gets you breathing heavily and your heart beating faster) helps to:
- reduce or maintain body weight
- control blood sugar (helpful for diabetics)
- maintain mobility and muscle strength, allowing daily activities to be undertaken more easily
- improve mood.
It is often said that you should consult your doctor before undertaking regular exercise. It is perhaps more important to consult your doctor if you are not taking regular exercise.
Although injuries sometimes occur during exercise or sporting activities, many of these injuries could be avoided. This booklet aims to explain how training, technique and the right equipment can help to prevent injury, and also gives advice on what to do when injuries do occur. The 'Useful addresses' section at the end of the booklet includes details of organizations which can provide further information, as well as details of how to contact the Arthritis Research Campaign (arc).
Age and exercise
Age is no barrier to physical activity, and there are many advantages to keeping fit at all ages.
It is very important to encourage children to exercise because there has been a trend in recent decades for them to be less active, with many harmful effects on their health. In addition, weight-bearing exercise in childhood and up to the mid-20s is important in building up the bones (maximizing bone density), which will reduce the risk of osteoporosis and fractures later in life.
As people get older they usually lose muscle bulk and strength. Exercise and training can help to prevent this. Weight-bearing exercise, such as walking, running and aerobics, can help to maintain bone density into later life.
As you grow older, you will be less able to make sudden explosive movements. You will tend to be less flexible and more prone to muscle and tendon tears. You may be more likely to suffer from pain in the joints, back and neck, and injuries may be slower to heal. Because of these changes it is important to ensure that exercise, training and competitive sport are tailored to your individual capacity, background and age.
Arthritis and exercise
Generally speaking, exercise is just as important for people with arthritis as it is for anyone else – because of the general health benefits that it brings. However the exercise may need to be modified to allow painful joints to move more easily. You should seek advice on this from a chartered physiotherapist (see arc leaflet 'Physiotherapy and Arthritis'), or from a specialist nurse, rheumatologist or other health professional with knowledge of your condition. See the arc leaflet 'Keep Moving' for general advice and specific exercises which will help people with arthritis to remain active.
How can I prevent injury?
As in all areas of 'health maintenance', prevention is better than cure, and many sports and exercise injuries can be prevented by preparing properly for your chosen activity.
Build up gradually
Proper training is particularly important for physically demanding sports, or if you have not been taking regular exercise.
Use the appropriate equipment
In most activities the most important equipment is footwear. Some sports need specialized equipment, and this should always be used where it is required (e.g. eye protection for squash, head protection for cycling and horse riding, a mouth guard in rugby and other contact sports). In racquet sports, it is important to have a racquet of the right weight and the right grip size for you.
Learn the correct technique
Technique is especially important when taking up a new activity. Seek advice from a coach who is qualified in your chosen sport.
Warm up
Warm-up prepares the body for exercise or your chosen sport. In particular, it starts to divert blood flow to the muscles which you will be using. Although there is controversy about the benefit of stretching in general terms, it is certainly believed to be helpful before explosive activities and power events.
Balance exercise with rest
Exercise for both strength and endurance should be balanced with rest. Tiredness may increase the risk of injury.
Aim to increase your muscle strength
Weight training increases muscle strength. Ideally this should be started in a gym under supervision since serious injuries to the spine and knees can come from incorrect lifting of heavy weights. Currently most gyms have fixed equipment, which avoids the risk of using free weights and allows more controlled strength training.
What are the different types of injury?
With any physical activity, injuries can sometimes happen, and it is important to know how to deal with them when they do. Generally speaking, sports and exercise injuries fall into two categories:
- 'acute' injuries, which happen suddenly, such as a sprained ankle or a torn muscle
- 'chronic' injuries, which are the result of either unaccustomed exercise or excessive exercise.
Acute injuries
Sadly, these will happen from time to time even after the most careful preparation. Many acute injuries to joints, muscles, tendons and ligaments cause bleeding, swelling and pain.
With all acute injuries, treatment should be immediate so that healing can start as soon as possible. Unless the injury is very minor, you should stop the activity and apply first aid treatment of ice and compression to the injured area. Ice and compression will help prevent bleeding and bruising of the injured tissue. The injured part of your body should be rested in a raised position, where practical.
For the first 24 hours after injury, ice (or alternatively a packet of frozen peas) should be applied for 10 minutes at a time. A piece of wet towelling must always be placed between the ice pack and the skin so that the skin is not damaged by ice burns. Cold running water can be used if ice or frozen peas are not immediately available. Avoid using ice for longer than 10 minutes at a time.
Chronic injuries
If you do more than your body can tolerate, then you may get a chronic or over-use injury. This can be caused either by doing an activity you are not used to or by doing an excessive amount of an activity. This is why it is so important to build up gradually. The amount of activity that can be tolerated before an over-use injury occurs will vary from person to person. Any body tissue may be injured by over-use.
Treating an over-use injury is a question of easing off or stopping the activity that produced the injury, and using an alternative one that does not over-use the affected part of the body. In some situations, it may help to change your equipment, such as using a lighter racquet with a larger grip. Adjustments to your training or technique might also be necessary for a chronic injury to recover.
Exercises are recommended for chronic injuries, but it is better to 'load' the muscle as it extends rather than as it contracts. You should seek advice on this from a physiotherapist.
Recovery
The body has a marvellous capacity to heal itself provided it is allowed to do so. This means that it is important not to return to full competition or activity until your injury is completely healed. In the very early stages, when there is a great deal of swelling and pain, you would be well advised to rest the affected area. Nevertheless, you must begin gentle movement and exercise of the injured part as soon as possible. This is usually after the first few days and once the swelling is under control.
It may be necessary to obtain advice from a physiotherapist or other health professional about specific exercises to help the injury. Many will take self-referrals but a GP can also refer you. The exercises and movement should be gradually increased but should never cause significant pain. The aim of exercise after injury is to restore the full range of movement, to help the injured part regain full strength and to recover the endurance of the muscles, which may have been affected by the injury. Balance exercises are also important to restore control of the limb. These can be done using a balance board, which is particularly useful for ankle and knee injuries. Sometimes, exercises performed standing on one leg can help with balance.
For some injuries you may be advised to wear a brace or strapping to help your injury to recover and prevent it happening again. These devices are available in sports shops, or you may need an allied health professional (physiotherapist, podiatrist, osteopath, chiropractor) to advise you and supply these items.
Who can help with sports injuries?
A doctor will check whether your injury requires any further medical or surgical treatment. The doctor can also arrange an x-ray or further specialized advice where necessary. The doctor may advise painkillers or, if there is a lot of swelling in an acute injury, a short period on an anti-inflammatory tablet.
Other health professionals (physiotherapist, podiatrist, osteopath, chiropractor) have important roles in dealing with injuries created by sports and exercise – their specific roles will depend upon the type and location of the injury. They will also be able to advise about prevention and return to sport. The professional organizations listed in the 'Useful addresses' section can help you to find a local practitioner. Health professionals with a particular interest in this area of work sometimes work from Sports Injuries Clinics.
Remember...
- Make sure you are physically fit and correctly equipped before you take part in sport. Warm up properly beforehand.
- Plan your training programme so that your activity is stepped up gradually to avoid injury. Take advice from a qualified coach or join a sports club.
- Do not continue your sport with a painful injured limb. Make sure you get proper and prompt treatment. Initially this may include rest, at least for the injured part of the body.
- Make sure your injury has healed completely before fully returning to sport. Otherwise it may happen again and you could develop a long-term injury.
- In planning your recovery from an injury seek the advice of an experienced physiotherapist to plan your exercise programme.
- In the early stages of an injury, use ice for 10 minutes maximum. Make sure you place a wet towel between the ice and your skin.
- Do not massage or use heat on an acutely injured area within the first 48 hours, as this increases blood flow and may aggravate bleeding and swelling.
- Make sure any supportive strapping is applied initially by an experienced person.
- When in doubt about the treatment of an injury, seek the advice of an experienced doctor or other health professional.
Useful addresses
The Arthritis Research Campaign (arc)
PO Box 177
Chesterfield
Derbyshire S41 7TQ
Phone: 0870 850 5000
www.arc.org.uk
As well as funding research, we produce a range of free information booklets and leaflets. Please contact the address above for a list of titles or, on this website, see Publications for People with Arthritis.
Arthritis Care
18 Stephenson Way
London NW1 2HD
Phone: 020 7380 6500
Helpline (freephone): 0808 800 4050
www.arthritiscare.org.uk
Offers self-help support, a helpline service, and a range of leaflets on arthritis.
British Chiropractic Association (BCA)
59 Castle Street
Reading
Berkshire RG1 7SN
Phone: 0118 950 5950
www.chiropractic-uk.co.uk
Can supply details of chiropractors in your area.
Chartered Society of Physiotherapy
14 Bedford Row
London WC1R 4ED
Phone: 020 7306 6666
www.csp.org.uk
General Chiropractic Council (GCC)
44 Wicklow Street
London WC1X 9HL
Phone: 020 7713 5155
www.gcc-uk.org
The regulatory body for chiropractors in the UK; can also supply details of chiropractors in your area.
General Osteopathic Council
176 Tower Bridge Road
London SE1 3LU
Phone: 020 7357 6655
www.osteopathy.org.uk
Can supply details of osteopaths in your area.
The Society of Chiropodists & Podiatrists (SCP)
1 Fellmonger's Path
Tower Bridge Road
London SE1 3LY
Phone: 020 7234 8620
www.feetforlife.org
Represents state-registered chiropodists and podiatrists.
