Tag Archives: injury

Muscle Contusion

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Muscle contusions, in which the skin and underlying muscle is bruised, can occur in any contact sport, such as football, hockey or rugby, or during any activity that increases the chances of falling on a hard surface, such as figure skating. Usually this injury is minor and doesn’t even require taking a break from training. Sometimes, however, a particularly serious contusion can cause long-lasting pain or other complications, including acute compartment syndrome and myositis ossificans.

In addition to the discoloration that is the signature of a bruise, a contusion can cause swelling at the injury site. A very severe contusion also should alert you to the possibility of damage to the underlying muscle or bone, and a contusion in the abdominal area could potentially cause damage to internal organs.

For these reasons, you should consult a sports medicine specialist if you have symptoms of a contusion. He or she will perform a physical examination to identify exactly where the bruise is located, and may also use a computed tomography (CT) scan, ultrasound, or magnetic resonant imaging (MRI) to make a diagnosis and rule out any other injuries.

To speed recovery, rest, icing, compression and elevation may be enough for relatively minor contusions, and your specialist may recommend you take an NSAID or other painkiller, such as Advil. Don’t massage the injured area.

Within a few days, swelling should go down, but you shouldn’t resume training until your specialist says you’re ready. Stretching, strengthening and range-of-motion exercises can all help you heal and regain your strength and flexibility.

Taking these precautions and treating your contusion correctly may knock you out of the game for a few weeks, but it can help you avoid more serious and potentially dangerous conditions.

Myositis Ossificans

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A muscle contusion, when the skin and underlying tissue become bruised, can be a painful condition. But infrequently, this injury can give way to myositis ossificans: the growth of bony protrusions within the bruised muscle. After six or seven weeks, this bone growth stops and is slowly reabsorbed; still, the bone itself remains and can be felt through the muscle and skin. Even after this resorption, however, some bone may remain in the muscle.

The reason why some contusions cause myositis ossificans and others don’t isn’t known. However, injuries that are very severe, aren’t properly managed and treated, or occur repeatedly can increase the chance of this bone growth. Because contusions are often caused by blunt trauma to the body, athletes most at risk are those in sports in which a ball or another player can hit them, such as football, hockey, cricket or rugby.

Myositis ossificans is not detectable immediately; initially, symptoms are those of a contusion, such as pain, tenderness and swelling in the affected area. After a few weeks, however, bone growth may begin, and it may be detected as a hardness or lump within the muscle; accompanying this may be increased pain upon waking in the morning, and increased discomfort with activity. Eventually, the bone stops growing and begins to be reabsorbed by the body; it’s possible this new bone will never be completely absorbed, however.

If you suspect you have developed myositis ossificans, consult a sports medicine specialist. He or she will examine the area, try to identify the source of the injury, and X-ray the affected limb to detect bone growth. A magnetic resonance image, or MRI, or an ultrasound might also be necessary to rule out other causes of pain.

There is little that can be done to speed up the rate at which the extra bone is reabsorbed. However, your sports medicine specialist might recommend exercises to increase range of motion, and instruction to avoid activities that aggravate the pain. In some cases, surgery is performed to remove the bone growth, but this remains a controversial method as in some cases it can accelerate the regrowth of the bone.

In the future, prevent myositis ossificans by promptly and properly treating injuries with rest, ice, a compression bandage and elevation of the injured limb. These treatments can not only put you on the road to recovery more quickly than continuing to use the injured muscle–it can also prevent further conditions such as myositis ossificans.

Snapping Hip Syndrome

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If you experience a snapping or clicking sensation when you flex or extend your hip (by bringing your knee towards your waist or by straightening the hip joint), you may have snapping hip syndrome, also known as clicking hip. This condition is harmless unless it is accompanied by pain, which can persist for months or even years if untreated.

Snapping hip syndrome is most common among athletes whose sports require repetitive movements, such as runners, soccer players and equestrians. The more common type of snapping hip syndrome, known as extra-articular snapping hip, occurs when the connective tissue that runs down the outer side of the leg, from the hip to the knee, becomes thickened. This enables the band to rub against and catch on nearby bones or on the fluid-filled sac on the outside of the hip bone, known as a bursa. This rubbing can cause the pain that sometimes accompanies snapping hip syndrome.

The other, less-common type of snapping hip syndrome is known as intra-articular snapping hip syndrome. This occurs when the tendon stretching from the inner thigh to the pelvis becomes inflamed. In this case, the clicking sensation is caused by the tendon snapping over the head of the hip bone.

If your snapping hip is not painful, there’s no need to consult a sports medicine specialist. If, however, your hip is bothering you, simple at-home measures may heal your hip. These include cutting back on your training, applying ice to the hip, and modifying the way you exercise to minimize repetitive hip movements. Anti-inflammatory medications, such as ibuprofen, can also reduce discomfort.

If the pain persists, consult a professional. He or she can diagnose the condition and put you on the road to recovery. Your sports medicine specialist will ask you to move your leg to recreate the snapping sensation, and he or she might even be able to feel the tendon snap as you move. He or she might also order X-rays to rule out other causes of the clicking such as bone problems.

Once you have recovered from snapping hip syndrome, make sure you keep the muscles of your hip strong and flexible. Also increase your mileage gradually so you don’t overtax your hip before it’s in training condition.

Winged Scapula

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When the shoulder blade, or scapula, sticks out, sometimes causing pain or pressure, the condition is known as winged scapula. The scapula sticks out most when you lift your arms or when you push against something with your arms, and you might have stiffness or trouble elevating your arms all the way. It may also be difficult to lift objects that ordinarily are not too heavy for you.

Winged scapula results from nerve damage along the shoulder from trauma to the joint or a contusion, such as being hit by a ball or another player in contact sports such as football. When this nerve is damaged or bruised, it can paralyze a muscle in the shoulder known as the serratus anterior muscle, allowing the scapula to poke out abnormally. From the time of trauma to when the scapula begins to stick out, weeks may elapse, since the the muscle known as the trapezius must stretch before the shoulder blade can protrude.

If you think you have a winged scapula, consult a sports medicine specialist. He or she can conduct tests to evaluate the extent of the nerve damage. Then, he or she might prescribe rehabilitation exercises to re-train the shoulder muscle, if the damage is mild. If damage is more extensive, however, surgery might be necessary. A surgeon will make a small incision to decompress the nerve that has been damaged. As you recover, sleeping in certain positions and maintaining proper posture can help the nerve heal.

Clavicle Fracture

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If you fall onto your outstretched arm or you shoulder, or are directly hit on your collarbone, this can cause a fracture of the collarbone, or clavicle. Symptoms commonly include pain and swelling around the collarbone, and you may also be able to feel the fracture through the skin. You may feel sharp pain whenever you make a movement that disturbs the clavicle.

Sports that increase the risk of a clavicle fracture include those that put you at risk of falling, such as figure skating and hockey, and those that often involve collisions with other players, such as football.

If you think you have fractured your clavicle, consult a sports medicine specialist. Also, try to avoid moving the affected arm, and apply ice to decrease swelling and ease pain.

A sports medicine specialist likely will examine your clavicle, and will take X-rays to determine whether the collarbone has been fractured. Depending on the severity of the fracture, you may need to keep your arm in a sling to give the collarbone a chance to heal. In most cases, the bone heals by itself, and no surgery is necessary.

If, however, the fracture is so severe that immobilizing the arm doesn’t heal it, or if parts of the bone are sticking out of the skin, surgical methods likely will be necessary to help the bone heal. Surgery to repair the bone generally involves inserting a metal plate and screws to hold the bone in place. Once the bone has healed, this metal plate can be removed, but often is simply left in place.

After the clavicle has healed, whether from surgery or from immobilization in a sling, it’s important to regain range of movement and strength through rehabilitation exercises, which your sports medicine specialist will prescribe to you.

Frozen Shoulder

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When the joint between the shoulder blade, or scapula, and humerus, or upper bone of the arm, becomes stiffened or less supple, it causes a condition known as frozen shoulder. When this occurs in athletes, it’s often due to trauma to the shoulder joint and is also called post-traumatic stiff shoulder. Sports that increase the risk of frozen shoulder include those that may cause you to fall, such as ice skating. The condition can also develop after a period of not using the shoulder joint at all. It’s most common among older athletes.

Symptoms commonly include aching, pain and loss of mobility in the affected shoulder. The shoulder often will heal itself without surgical intervention. However, if you think you may have frozen shoulder, consult a sports medicine specialist. He or she will examine your shoulder to establish the cause of your stiffness, and determine the extent of the damage to the joint.

You may be directed to perform rehabilitation and strengthening muscles for your shoulder, avoiding overstretching the joint. If these exercises prove ineffective, oral or injected steroids might be considered to help the shoulder heal. And if that doesn’t heal the shoulder, surgery may be necessary to release the stiffened shoulder capsule.

The prognosis for frozen shoulder is generally positive; most people’s shoulders return to normal without surgery, although it may take one to three years to heal.

Rib Stress Fracture

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The serratus anterior is a muscle in your back that helps you perform pull-ups and push-ups. But when this muscle contracts repeatedly, it can batter the rib bones. One possible result is an overuse injury: stress fracture of the rib.

Sports that involve a lot of overhead motion, such as tennis or baseball, increase the risk of a stress fracture of the first rib when a muscle in the neck pulls on a small recession in the ribs known as the subclavian sulcus. Rowing also involves a lot of contraction of certain back muscles, and most commonly causes a stress fracture of the fourth or fifth rib. 

Symptoms of a rib stress fracture include soreness at the front of your neck, along with pain and tenderness around the shoulder blade.

If you think you have a stress fracture of the rib, stop training to avoid further damage. Then consult a sports medicine specialist. He or she will rule out other possible causes of your pain, and may use X-rays, computed tomography (CT) scan, a bone scan, and/or magnetic resonance imaging (MRI) to evaluate the extent of any possible damage to your rib.

If you do have a stress fracture of the rib, your sports medicine specialist likely will recommend you avoid using the arm, immobilizing it in a sling. It generally takes about eight weeks for a stress fracture of the rib to heal.

Use caution when you are given the go-ahead to get back to training. You may need to perform rehabilitation strengthening or stretching exercises to make sure that your muscles and bones are up to the task; certain strengthening exercises, which your sports medicine specialist or coach can recommend, can also decrease the risk of re-injury. In addition, increase your training gradually, and in sports such as rowing, don’t overload the resistance when training on an ergo-meter.

Hip Labral Tear

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The cartilage that lines the rim of your hip joint’s socket is known as the labrum, and it helps hold your hip joint together by acting like a suction cup. When this cushioning tissue tears, the condition is known as a labral tear.

Sports that increase the risk of labral tear include golfing, soccer, football, ballet and hockey. A hip labral tear can cause a “catching” sensation or a clicking sound in the hip joint, along with hip pain and stiffness. But sometimes a hip labral tear can exist without causing any signs or symptoms.

The tear can occur in contact sports, such as football, if the hip is involved in a collision. The repetitive motions common in sports such as softball also can make one prone to a labral tear, as can structural abnormalities in the hip, which increase the amount of wear and tear the hip undergoes during exercise.

Consult a sports medicine specialist if you think you may have a hip labral tear. It’s important to get this condition treated, as it can predispose you to osteoarthritis and further hip injury later in life. The doctor may order an X-ray or magnetic resonance imaging (MRI) to get a close look at the problem and rule out other possible causes of your pain.

For some people, rest, pain relievers and compression are enough to heal the tear. Physical therapy can also help you recover, and can also assist you in avoiding re injuring the hip. Finally, surgery is necessary in rare cases to remove or repair the damaged tissue.

To prevent a recurrence of a hip labral tear, make sure you allow plenty of time to recover from exercise, and that you increase your mileage and training gradually.

Two other common athlete hip injuries are a hip flexor strain and a hip pointer.

Elbow bursitis

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The tip of your elbow may seem bony, but there’s actually a sac called a bursa that sits between the bones that make up the elbow. Elbow bursitis, also known as students elbow, occurs when this sac becomes inflamed or irritated, resulting in pain during activity and while at rest, swelling, difficulty in moving the elbow, and sometimes a feeling of warmth around the elbow.

Elbow bursitis can be caused by trauma, such as a fall, or long-term pressure on the elbow from leaning on it. Infection from a cut or scrape can also cause the bursa to swell, and this infection is what leads to the feeling of warmth some people with elbow bursitis experience. Because falls can cause elbow bursitis, athletes who play sports that put them at risk of falling, such as ice skating, hockey or gymnastics, or at risk of getting hit on the elbow, such as cricket, are at increased risk of this condition. But anyone who falls and experiences elbow trauma can get elbow bursitis.

If you think you have elbow bursitis, see your doctor or sports medicine professional. He or she likely will recommend that you immobilize the affected elbow; draining the fluid in the bursa may also be necessary, as may antibiotics if the bursa is infected. An X-ray of the elbow might be necessary to see if you have bone spurs; these sometimes are found in patients who get elbow bursitis often. Finally, surgery to remove the affected bursa might be necessary if lesser measures prove ineffective.

To prevent elbow bursitis, wear elbow pads to protect your elbow from getting hit with a ball and to cushion it if you fall.

Calf Strain

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Running is great exercise and is a necessary part of training for a multitude of sports, but increasing mileage too quickly, or warming up or cooling down insufficiently, can lead to a strain of the three muscles of the calf in the back of your lower legs. Although you might try to continue running if your calf pain is mild, you’ll likely change your stride slightly without realizing it, and this can make the strain worse.

Athletes most prone to a calf strain are those who do a lot of running or who increase their mileage very quickly, such as distance runners, basketball players and soccer players. Running while you’re dehydrated also can put you at increased risk of a calf strain, so it’s important to drink plenty of water before, during and after exercise. Finally, having low foot arches can make boost your chances of straining your calf muscles, so make sure you have appropriate footwear for running or training.

Rest and the use of ice packs and anti-inflammatory medication may be enough to help your calf heal; massaging it may also quicken recovery. But if the strain is more serious and pain doesn’t fade, you may have a more serious injury, and you should consult your doctor or sports medicine specialist so he or she can evaluate your symptoms and help put you on the road to recovery.

To prevent a calf strain, stay hydrated during exercise. Wear appropriate footwear, and warm up and cool down fully whenever you run or train. Additionally, strengthening and stretching certain muscles can protect against muscle strains, because the stretchier a muscle is, the less likely you are to pull it.