These proactive measures and cutting-edge treatments go a long way toward preventing injuries in active adults and young athletes.
Maintaining an athlete’s joy of sport is the goal for many sports medicine specialists.
“It comes down to this: Sports are what we do in our free time, what we do for fun,” says Dr. Justin Gent, an orthopedic sports medicine surgeon at Illinois Bone and Joint Institute. “Doing it as safely as possible – that is always the most important thing for me.”
Plenty of student-athletes come to see Gent and his colleagues. After all, the Next College Student Athlete recruiting organization reports that nearly 8 million high schoolers participate in sports in the U.S.
But adults aren’t strangers to the orthopedic office, either. In fact, a CivicScience report estimated 20% of Americans played in a recreational sports league last summer.
“We see the entire spectrum, from young athletes to older athletes,” says Dr. Harpreet Basran, a sports medicine orthopedic surgeon at Illinois Bone and Joint Institute. “I see great athletes trying to get a Division I scholarship and a patient who likes playing basketball once a week and says, ‘I’d like to maintain that for my health.’ That’s a critical component of what kind of treatment they’re going to get. We find out what it is that they need and fit that into a treatment plan.”
There are two main types of sports injuries: acute and overuse injuries.
Acute injuries include things like fractures, rotator cuff tears and dislocated joints – injuries that happen in a split second, like when you slide into home plate and collide with the catcher.
Some of these acute injuries require surgery, though today many can be handled with minimally invasive, arthroscopic procedures.
Overuse injuries are aptly named: they come from repetitive work, like constant throwing or natural wear, because tendons lose elasticity as they age, Basran says.
Rest, physical therapy and/or injections often help with these injuries, though surgery can be needed if the injury is serious enough.
The most common injuries presenting themselves to orthopedic surgeons often depend on the season, says Gent. In spring, throwers for baseball and softball fill the office with elbow and shoulder issues. In summer, it’s more common to see lower-extremity injuries from cross country runners and adults training for marathons. In fall, high school football players show up with knees and ankles that need work, while volleyball players have their share of ankle injuries. Winter in the Midwest brings skiing injuries as well.
“It goes in waves, those different injuries,” Gent says.
However, no matter the season, the most common injuries are simple sprains or strains, says Dr. James Sostak, an orthopedic surgeon who specializes in sports medicine at Fox Valley Orthopedics, with physician clinics in Geneva, Algonquin, Barrington, Elgin and Yorkville.
“Ankles and shoulders would be most common,” Sostak says. “That just means they basically injured some of the ligaments around the joint. Most of them are relatively minor and don’t require more than X-rays to make sure there are no fractures. We’ll offer rest, anti-inflammatories, maybe put on a brace, and hopefully within two to four weeks we’re back to playing normally.”
How to Prevent Injury
If Sostak had a soapbox, he would ask younger athletes to strengthen their core.
As the team doctor for several high schools, Strikers Fox Valley Soccer Club and the Kane County Cougars, Sostak shares that message whenever possible.
“I have a whole handout on bodyweight exercises,” he says. “Building up hip strength and abdomen strength, whether it’s runners or throwing athletes, these are the years they can get stronger. If you’re going to play a year-round sport, we need to figure out a way to prevent those overuse injuries, and this is how we do it: we get your legs strong and we get your core strong.”
Physical therapists apply this same technique both as a preventative measure and to help athletes heal from an injury, says Basran.
“When we see throwers who have Tommy John surgery – which repairs the elbow ligament – they’re always amazed because therapists will be focused on their hips and their core even though they have an arm injury,” Basran says. “It’s critical to preventing these injuries.”
Athletes used to develop core strength almost intuitively by participating in multiple sports that moved the body in a variety of different ways.
But many younger athletes today become specialized in one sport, and that often leads to overuse injuries.
“It’s so much better for their performance. It’s the simple idea of cross training that’s been around forever: if you move your muscles in a different pattern, it improves athletic performance,” says Gent. “It makes you better in your primary sport by training in other sports. How you move without the ball on a basketball court is different but similar to how you move on the soccer field. And in younger children, it helps them develop eye-hand coordination.”
For athletes determined to play one sport, it becomes even more important to follow the No. 1 rule of participating in any strenuous activity: warm up properly.
“Most kids are in a travel sport – they’re in year-round with barely any break – so they need to treat themselves like adults and warm up,” says Sostak. “Usually, that’s the biggest reason we see injuries. It’s from not warming up properly. The age we need to focus more on some of those things, like stretching, is becoming younger and younger.”
“The No. 1 injury prevention strategy is to make sure you have the right equipment and your body is prepared for the sport,” says Gent. “Warm it up, make sure your flexibility is there. Especially for older patients, if you feel something is tired or sore or achy before you even start, you need to think about it or even skip paddleball. Listen to your body. Understand what you need to perform your sport well. That’s the best way to avoid getting hurt.”
When to See a Specialist
Athletes, particularly runners, are notorious for pushing through the pain.
And sometimes that’s OK, so long as you’re closely monitoring your body’s signals, Sostak says.
“I had a cross country runner who was getting ready for sectionals and was having knee pain,” Sostak says. “We took an MRI to make sure it was OK for them to work through the pain, because sometimes it is OK, and sometimes it’s not. We can tell you.”
Most acute injuries are serious enough that athletes of any age know to see a specialist right away.
But for other injuries, how do you know when it’s serious enough? The nice thing about orthopedics is that these specialists will see a patient immediately after an injury occurs, regardless of its severity, Sostak says.
“We’re happy to see anybody any time – that’s why our orthopedic urgent care is here,” Sostak says, referring to FVO’s OrthoFirst emergency clinics. “We take walk-ins. If you have any concerns or questions, I don’t care if it’s one day of pain or two weeks of pain. Sometimes a football player will sprain an ankle and they’ll come in that night. If parents assess it, and they want to try to ice it, take ibuprofen, see in a couple days, that’s fine, too. We’re here to provide peace of mind.”
Most sprains and strains will recover in a couple of weeks, says Basran.
“Worrisome signs for me are when it’s affecting your gait or you can’t straighten your knee all the way. Limitations in ambulation or gait or full motion get our attention,” he says.
Many athletes will feel or hear a pop when an injury occurs – like an ACL tear – and swelling around a joint is the body’s normal reaction, Basran says. But swelling also can be a sign of structural damage, he says, so athletes need to pay close attention to the injured area.
Shoulder injuries, in particular, should be handled carefully. “It’s a different recovery afterwards,” Basran says. “But if we can catch them early, many can be treated with physical therapy or injections. I recommend getting in sooner than later.”
The threshold for self-treatment doesn’t change with age. The best advice is to listen to your body, Gent says.
“Some kids, they just keep going and they don’t pay attention to when they’re breaking themselves down,” he says. “That’s especially true with my runners or the kids who do cross country – anything where it’s more of an endurance sport. Sometimes the thing not to do is to push through the point from soreness to pain. Instead, listen to your body more.”
Why Do Physical Therapy?
Sometimes, athletes refrain from seeing an orthopedic surgeon because they don’t want to go through physical therapy – what they often see as the obstacle blocking them from playing.
In reality, physical therapy is a way to expedite the recovery process, Sostak says.
“We live in a world where a lot of us want the quick fix and quick answer,” says Basran. “Certainly, I do, too. But the truth is, the human body really is amazing with the healing properties we have, and a good physical therapist can promote that healing. The true art of physical therapy is not only to strengthen but to get proper muscle balance.”
When an injury first occurs, therapists work gently to reduce the swelling. Then, they focus on getting an athlete’s motion back, no matter what joint is injured, Sostak says.
“You’ve got to be able to move the joints without pain, without swelling, to get back to full participation, Sostak says. “They’re not going to take someone’s swollen ankle and move it all over the place. They’re gradually building you back to full motion and strength. Usually, two times a week is standard, sometimes three.”
But a therapist can’t do the work alone. Recovery speed often depends on the athlete’s determination and willingness to listen to the therapist, trainer and coach.
“It’s more work outside of therapy than it is in therapy,” says Sostak. “You go twice a week and they show you things, but they give you things to do at home, and that’s the key to rehab – it’s patient centered. We can tell them where to go, but they’re going to have to take the reins to some extent.”
Physical therapy after surgery can be very different than physical therapy as treatment in place of surgery, Gent says. But the goal is the same: “getting athletes back to what they love doing,” he says. “It is not necessarily torture.”
“Therapists are right there with you,” Gent adds. “They’re good people who are helping you through this process, and if they see you are getting pushed a little too hard, they’ll back off. They have options to help you regain the function you need; they’re experts at having multiple modalities to getting a patient back to where they want.”
Doctors are always looking for new treatment options, and there’s a huge push for stem cell treatment in orthopedics, says Dr. Harpreet Basran, a sports medicine orthopedic surgeon at Illinois Bone and Joint Institute.
“Stem cell injections are basically your own stem cells that utilize the regenerative properties of your blood by putting them in places that need help healing,” he says.
Basran has been using stem cells for 15 years for certain injuries, but research continues to seek out additional scenarios for this kind of treatment, he says.
“Tennis elbow – or tendinitis around the elbow – is a chronic nuisance and takes a while to shake,” Basran says. “Bracing, therapy and cortisone can help, but initial indications in research show that because that part of the body is slow to heal, stem cell treatment works great there.”
Patellar tendinitis, Achilles tendinitis and possibly hamstring injuries also could be good qualifiers, Basran says.
“It’s a very exciting part of orthopedics: How can we augment our own healing potential with certain treatments?” he says. “We focus so much on surgery, but there will be so much technology going forward.”