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The 9 most frequent injuries in the athlete
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24 July 2018

The 9 most frequent injuries in the athlete

The 9 most frequent injuries in the athlete

Sports practice is healthy, it improves the quality of life and it makes us feel good in the day-to-day. However, injuries are part of the sport, accidents happen and with age the probability of leaving unscathed from a more intense activity decreases.


However, the human body fortunately has an excellent ability to self-regenerate, along with a good rest, makes recovery quicker and more effective.


Most frequent injuries:


Tendinitis - is the inflammation, injury, swelling or degeneration of a tendon A fibrous structure that attaches muscle to bones.


Stretching and muscular distention - is characterized by a partial or complete rupture of fibers or muscle bundles, resulting from an extreme effort performed by the muscle in question.


Muscle contusion - is considered an acute traumatic injury, due to direct trauma to the soft tissues, which causes pain and edema.


Caibrons - are involuntary contractions of a skeletal muscle. They are frequent during the night or in strenuous physical exercises, in people who do not have adequate physical conditioning.


Bursitis - is the inflammation of a synovial sac, a membranous sac lined by endothelial cells.


Sprains - can be defined as a traumatic injury to a joint, with stretching, tearing or rupture of one or more ligaments without displacement of the joint surfaces.


Ligament rupture - Ligament rupture occurs when ligaments that support a joint are suddenly stretched or torn.


Dislocation - is the sudden and lasting displacement, partial or complete displacement of one or more bones of a joint.


Low back pain - is characterized as a pain in the lumbar region, near the basin, ie in the lower region of the spine.



TENDINITIS


Tendonitis is inflammation of the tendon, a fibrous structure, such as a rope, that attaches the muscle to the bone.


In general, the symptoms of tendonitis are:


-Pain located in the affected tendon, which worsens with movement;
-Difficulty in performing movements with the affected limb;
-Decreased muscle strength in the affected limb;
-Mild edema or flushing and heat sensation;
-Decreased flexibility in the affected limb.


The causes of tendinitis are usually related to some risk factors, which are:


-Lack of muscle stretching;
-Inadequate posture;
-Repetitive movements;
-Age of patient;
-Sports activities in excess.


Tendonitis when treated in a timely manner can be cured. The treatment time varies according to the severity of the tendon injury. The quicker you initiate, the faster the cure will be.


For treatment to be effective it is necessary to avoid or, if possible, stop the activity that gave rise to the injury.


Treatment:


- The treatment is based on anti-inflammatories, ice application and physiotherapy;


- Application of ice (cryotherapy) in the affected area, usually produces good results;


- Corticosteroids and local anesthetics are sometimes injected into the tendon sheath (infiltrations);


- The treatment should be repeated periodically, until the inflammation disappears;


- In some cases therapeutic exercises (physical therapy) are recommended;


- For treatment to be effective it is necessary to avoid or, if possible, to stop activity that gave rise to injury. The rest is undoubtedly the most important.


- If the tendon does not recover at all, a chronic injury (tendinosis) can occur, with a greater compromise of the tension, and may even lead to its rupture;


- Persistent chronic tendonitis may require surgical intervention, with physiotherapy necessary.



STRETCHING AND MUSCLE STRAIN


The only difference between stretching and muscle strain is where the injury occurs. In the case of stretching, the lesion site is the muscle fibers (in the middle of the muscle), in the case of distension the site of the injury is the tendon.


Excessive stretching of the muscle, during running or in soccer game for example is the main cause for these two injuries. Treatment of the two lesions is very similar and requires the use of analgesics, anti-inflammatories and physiotherapy.


Stretching and Muscle Strain


There are muscles more susceptible and exposed to this type of injury, such as the hamstrings, quadriceps, twins and adductors.


Symptoms:


-Edema;
-Inflammation;
-Muscle aches;
-Bruise;
-Limitation of movement;
-Loss of strength;
-Muscle stiffness.


The classification of stretches is important in diagnosis, since it identifies and quantifies the injured area of ​​the muscle, the treatment criteria, the time of withdrawal from the sport and the prevention of sequelae.


We can classify the stretches according to the dimensions of the lesion in:


Grade I - is the stretching of a small amount of muscle fibers. The pain is located at a specific point, arising during muscle contraction against resistance and may be absent at rest. Edema may be present, but usually it is not noticed on physical examination.


Grade II - The number of injured fibers and the severity of the lesion are higher. The same findings of the first degree lesion are found, but with greater intensity and a slower recovery.


Grade III - This injury usually occurs triggering a complete rupture of the muscle or a large part of it, resulting in an important loss of function. The pain can range from moderate to very intense, caused by passive muscle contraction. Edema and hemorrhage are large, depending on the location of the injured muscle, edema, bruise and hematoma may be visible, usually located at a position distal to the injury due to the force of gravity.


If there is suspicion of stretching / muscle strain, an ice pack wrapped in a thin towel should be placed immediately for about 20 minutes and seek medical advice. Although signs and symptoms may confirm suspicion the only way to confirm muscle or tendon rupture is through and complementary examinations.


An athlete, exposed to any diagnostic negligence, will certainly increase his rehabilitation period and delay his return to physical exercise.


The factors of production of the lesion are diverse and it is important to know details of the clinical history and mechanism of the lesion:


-Physical fitness of the athlete (if injured at the beginning or end of the exercise);
-How was heating done;

-Climatic conditions and the state of emotional balance.


After initial treatment in the acute phase of the injury, with ice, rest, use of anti-inflammatories prescribed by a physician, sessions of physical therapy, the recovery of active movement begins, with load without causing pain. The inclusion of stretching exercises is fundamental in recovering the lesion. Throughout this sequence, functional recovery exercises are used that aim to return the athlete to the activity level before the injury, restoring the functional stability and the specific movement patterns for the sport, minimizing the risk of a new injury.


The course of treatment should be based on a daily assessment of pain, range of motion, muscle strength and subjective sensation of the patient. Failure to comply with treatment may result in new injuries in the same muscle and may result from sequelae and long periods of withdrawal from sport.


To prevent muscle stretching / distension, keep the muscle properly strengthened and stretched constantly, respecting body limitations and avoiding training alone, without professional guidance. However, even high-level athletes can experience stretches and muscle strains during their practice, but in any case, the goal of the training is to prevent this from happening.



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MUSCLE CONTUSION


Muscle contusion is usually caused by direct trauma. This type of injury is very common in athletes, especially in soccer players, but can happen in all who practice physical activity.


Muscle contusion can be classified as mild, moderate or severe depending on the severity of the stroke and the time required for its recovery.


Symptoms:


Severe pain in the affected area;
After a few hours or days, the hematoma stain will be visible;
Loss of strength or limitation of movement due to the stitches you feel during movements;
Rigidity.


Treatment:


The treatment of the muscular contusions can be divided in 3 phases:


1st acute phase: shortly after bruising, the intention of the treatment is to reduce pain and control any complications at the site (eg hemorrhage, fractures, etc.).


The simplest measures at this stage of treatment include resting with elevation, immobilization of the affected site and cold compresses for 1-2 days. During this time it is advisable to avoid applying heat to the site to avoid swelling.


If the pain of the injury is very intense, it is advisable to use Canadian or flares. In addition to avoiding muscle injury worsening, these supports also help prevent spinal overload and spondylitis attacks. Anti-inflammatories and painkillers prescribed by the doctor are also helpful in reducing discomfort.


2nd recovery phase: the goal at this stage is to restore mobility and muscle strength. Supervised exercises are recommended. The intensity of the exercises varies according to the tolerance of each person.


3rd phase of regeneration: in this last phase occurs the gradual recovery of the muscle. Treatment is done with resistance exercises.



CAIBRONS


The gums are involuntary and painful contractions of a muscle or a muscle group, mainly affect the posterior muscles of the leg. A cramp may begin during physical activity, at rest and even during sleep.


The lack of physical conditioning and fatigue can be resposnable by gauges and other muscle injuries.


Excessive use of a muscle, dehydration, muscle tension or simply holding the same position for an extended period of time can result in a muscle cramp. In many cases, however, the exact cause of the symptom is unknown.


Factors that may increase the risk of muscle cramps include:


-Advanced age;
-Dehydration;
-Pregnancy;
-Excessive alcohol intake;
-Presence of metabolic diseases.


Muscle cramps usually go away on their own and rarely require medical attention. However, seek professional help if the gibberet presents:


-Severe discomfort;
-Edema in the leg, redness or skin changes;
-Muscle weakness;
-When it happens frequently;
-When it is not associated with an obvious cause, such as fatiguing exercise.


Treatment:


To relieve the pain of muscle cramps, you can apply a hot or cold compress on the aching muscles at the first sign of a spasm. If the pain does not subside consult your doctor because you may need help with anti-inflammatories.


Care to prevent:


-Stretch and warm up muscles before beginning physical activity;
-Drinking fluids properly;
-Have a balanced diet;



BURSITE


Bursitis is inflammation of the synovial sac, a fluid-filled structure that is located between a tendon and the skin or between a tendon and the bone, with a function of damping and aiding in the slippage of tissues and nutrition.


The occurrence of Bursitis is more common in the shoulders, elbows and hip. It can also occur in the knees, heels and big toe, in addition to other joints.


In general, bursitis occurs near the joints that perform repetitive movements. This disease can be acute or chronic.


The most common cause of bursitis is the repetition of movements in certain joints or positions that can cause damage to the bursa. This can happen in the following situations:


-Throwing balls or lifting something over head repeatedly;
-Lean on elbows for long periods of time;
-Kneeling for long periods of time;
-Spend a lot of time sitting, especially in places with hard and uncomfortable surfaces.


Bursitis beyond the excessive and conical use of the joints may also be caused by:


-Orthopedic trauma;
-Rheumatological processes;
-Gout or by some type of infection.


Risk factors:


-Age (becomes more common with aging);
-Occupations or hobbies: If a person has a profession or has a hobby that requires repetitive motion or puts pressure on a specific joint, they are more likely to develop bursitis.
-Rheumatoid arthritis, gout, diabetes increase the risk of developing bursitis.


Symptoms:


-Pain in the joints and sensitivity when pressing the region around the joint;
-Stiffness and pain when moving the affected joint;
-Edema, warmth, or redness in the joint, especially when on infection.


Treatment:


-Rest;
-Application of ice (cryotherapy) at the site of injury and use of analgesic for pain with the assistance of the physician.


If these measures are not enough, they use the doctor who can help you in other ways such as:


-Medication;
-Physiotherapy;
-Infiltrations;
-Surgery.


Untreated bursitis can progress to some more serious health problems, such as chronic bursitis. In addition, several repetitive injections of steroids, within a short time, can cause tendon damage.



SPRAIN


Sprain is an injury to the ligaments of a joint without displacement of the joint surfaces. In case of sprain, the normal radius of action of a joint is exceeded with the effect of the impact and causes distortion damage in the capsule-ligament apparatus.


The ligaments are tissues of elastic structure that connect the bones and are found in the joints.


The cause itself is when the joint is subjected to a sudden movement there is risk of a sprain of degree 1,2 and 3. This is what happens with athletes (soccer players, tennis players, etc.) who make movements abrupt and violent. The walk or a false move may also cause a sprain.


The risk factors are mainly sports and fatigue in general (which weakens and can lead to sprain).


Symptoms:


- Ache;
- Edema in the injured joint along with some sensitivity in the local joint;
- In more severe sprains there may be deformity (change in the normal contour of the joint) and a marked change in joint function. This change in function may include a feeling that the joint becomes unstable or unreliable, a feeling that the joint is too loose, or that the bones are not aligned in their positions.


Other symptoms depend on the involved joint and the ligament that has been injured. For example, an ACL (anterior cruciate ligament) sprain may lead an athlete away immediately because of severe pain, swelling, and a feeling that the knee is moving outward. However, sprain of LCP (posterior cruciate ligament) may cause only a slight swelling that does not motivate the athlete to stop playing.


Treatment:


Grade 1: where only micro-lesions affect the ligaments.


- Rest, do not walk on the affected limb;
- If it is on the ankle, knee, use Canadian if necessary;
- Raise the limb;
- Apply ice for 20 minutes over the affected area, with a blanket wrapped to avoid burns on the skin.


Grade 2: where micro-lesions occur or partial rupture of the ligaments.


- Immobilization may be required to allow more time for recovery.


Grade 3: There may be total rupture of one or more ligaments.


- Being serious the orthopaedist may consider putting plaster for two to three weeks or an immobilizing boot with subsequent recommendation of physiotherapy;


Surgery may be needed to repair the damage, and is done especially in competitive athletes to ensure safety on return to practice. People, for example, who do sprains quite frequently (unstable ankle) may also need surgery to repair the ligaments.



LIGAMENT RUPTURE


Ligament rupture occurs when the ligaments that support a joint are suddenly stretched or torn. The ligaments are fibrous tissues that hold the bones together.


Usually, ruptures occur in the joints of the lower limbs, such as ankles, knees, or toes. Where it is most common the rupture of ligaments is in the ankle joint.


It occurs frequently also on the wrists and fingers, especially on the thumb.


A rupture can be caused by a fall that leads to a sudden twist of the joint. You are also more likely to experience a ruptured joint if you are overweight.


Symptoms:


Spontaneous pain and palpation;
Edema;
Difficulty in moving the injured joint;
In more severe situations, walking or support may be impossible;
Ecchymosis may appear later (hours / days) dark (purple) tone on the skin due to bleeding.


Care you should have:


Not to return to the race, or to any other heavy exercises, until being free of pain and the doctor to authorize;
Begin to exercise slowly, when doctors approve;
Always stretch yourself with some professional help before going to the gym or doing sports activities, this releases the muscles and tendons, which lessens the strain on the ligaments;


A simple rupture takes between 8 and 12 days to recover, are those that there is a slight edema and little pain to the palpation of the injured site.


A severe rupture may take longer and often require surgical correction. This is the case of the cruciate ligaments or sprains with great instability of the ankle.


Treatment:


Apply ice (10-15 minutes several times a day for the first 72 hours) to always take care to put a towel around the ice to avoid getting burned;


Protect the joint by avoiding painful movements;


Raise the injured limb to help reduce edema and pain;


Rest to decrease edema and allow recovery of the lesion.


When the pain subsides begin to perform normal and slow movements.


Elastic ligation to make compression at the lesion site, thus reducing internal bleeding. Caregivers may tell you to keep the bandage for 5 to 8 days and may have to continue to use for physical activity for another 3 to 4 weeks.


Perform movements several times a day in the joint near the injury, such as the fingers or toes, other than the ligature. In doing so, you will avoid stiffening of the joint;


Medication prescribed by your doctor (analgesics, anti-inflammatories).



DISLOCATION


Dislocation is the displacement of one or more bones from a joint and occurs when a force acts directly or indirectly on our body. Sometimes the dislocation may be related to a fracture of a bone, which confuses it with sprain or contusion. When the displacement between bones is partial, it is called subluxation.


Although any joint is susceptible to a dislocation there are some more common ones of suffering a dislocation: Shoulder, hip, knee, femur, elbow, ankle, fingers.


Dislocation can occur in anyone and it is important to be aware, as in any situation, it also has some risk factors:


-Athletes;
-Seniors;
-People with rheumatoid arthritis;
-Babies and children;


Dislocation can occur in two types:


Complete luxation: the one in which the bones that constitute a joint are completely divided.


Incomplete luxation: Also called subluxation, it is the displacement of the bones that occurs in a reduced form, where the bones do not separate completely.


Causes:


-Direct or indirect trauma;
-Falls;
-Fracture;
-Congenital lesions;
-Ligament, capsular or muscular loosening formed by chronic diseases.
-The dislocation can cause some consequences in other parts of the body, such as tendon rupture that should be treated later with physical therapy.


Symptoms:


-Immediate pain during movement;
-Loss of movement;
-Numbness around the traumatized area;
-Tingling sensation.

-With the clinical examination performed by the physician, the diagnosis of the dislocation is decisive, but the location of the injured site can not be accurately determined. This requires an X-ray to be confirmed and the procedure can also identify whether or not there was a fracture at the time of trauma.


Treatment:


The treatment for dislocation needs to be precisely with a physician because the process is painful and is based on repositioning the bone at the place of origin. Most of the time the patient is under analgesic or local anesthetic during the procedure.


Depending on the case of the dislocation, it may require surgical intervention.


After all this, it is necessary that the patient has immobilized joint to have a better healing and avoid other possible dislocations.


The recovery time varies according to the degree of dislocation, during which time some medications will be prescribed by the doctor so that the patient can withstand the pain.


When the joint is recovered, it is recommended that the patient perform some physiotherapy sessions to increase the joint amplitudes.



LOMBALGIAS


Low back pain is characterized as a pain in the lumbar region, near the basin, that is, in the lower region of the spine. This pain may be mild or intense and may have a variable duration. Almost all people suffer from back pain at some point in their lives.


In general, low back pain significantly interferes with daily activities. In the athlete, regardless of the sport level, it is also one of the main reasons for physical incapacity with direct damage in training and competition.


The most frequent sports to feel pain in the lower back are: gymnastics, soccer, rowing, swimming, athletics, among others.


Low back pain can not be defined as a disease, but a set of symptoms in the lower back.


In clinical terms, there are two types of low back pain, which vary according to their duration:


Acute low back pain: it is the most common, it can last from 4 to 6 weeks. It usually affects younger people and has no defined factor, most of which occurs after exercise because of over-exertion.


Chronic low back pain: usually lasts about 12 weeks, mostly people over 35 years. Its origin is due to the inflammation of some nerve of the spine.


Low back pain may occur after a specific movement, such as weight lifting, trunk flexion, or may result from age-related wear and tear.


Degenerative spinal changes begin at age 30 and increase the risk of low back pain, especially when some activities are over-exercised.


However, age should not be an impediment to an active life and it is possible to practice sport even in the presence of these degenerative changes.


The main causes of low back pain are posture problems (poor posture): be it sitting; lifting or carrying excess weight.


Risk factors:


-Obesity;
-Sedentary lifestyle;
-Smoking;
-Bad posture;
-Kind of work;
-Depression.


How to Prevent?


-Practice of supervised regular physical activities (stretching, weight training, pilates, water aerobics, etc.);
-Pre and post-workout exercises (workout);
-Maintain normal weight;
-Maintain good posture (head up, shoulders straight, chest forward, weight distributed on both feet).


Symptoms:


-Severe back pain;
-Pain in the hips, groin, thighs and lower back;
-Pain and difficulty in sitting or walking;
-Increased tension in the muscles of the back;
-Back pain that gets worse when you lean your body back;
-Burning sensation or tingling in some part of the body.


Treatment:


-Hot water bottles (put in the area and letting stand for about 20 minutes), take care and wrap with a towel to not cause burn);
-Massages (to relieve muscle pain);

-Stretching (doing with the help of a professional to reduce pain);
-Rest (avoid doing exercises or activities of great effort or repetitive effort, to avoid worsening pain symptoms);

-Medication with prescription.

-The goal is to help decrease the inflamed region, lengthening the muscles, fighting back pain and returning the integrity of the spine.


By Ana Silva, Physiotherapist