How to Prevent The Injuries Most Likely to Happen to You


How to Prevent The Injuries Most Likely to Happen to You

I grew up playing organized basketball, dedicating a total of 12 years to it.  In those 12 years, I’ve been fortunate enough to participate in many different forums (European Championships, college playoff games, etc.) in which I’ve met thousands of different athletes. Now that I’ve got a few silver hairs on my head, I engage in many different sports and activities (just for fun and good health), and I encounter perhaps even more people than I did in the good old days.

I’m telling you all of this because one of the things most people, whom I’ve met through sports, have in common is their negligence towards injuries. Most people think about injuries once they start to feel the pain and to experience the repercussions of getting hurt.

No, do not give me that “if you think negative, negative things will happen to you” hippy-dippy stuff.

What I am saying is, as someone who’s had plenty of experience with injuries – think about the injuries that you’re exposed to because of your activity of choice, and take action to prevent those injuries.

(The infographic is free to use, only with a contribution to https://battlethepain.org/)

As you can see from the infographic, there is a considerable amount of injuries that are common amongst most of the popular recreational sports and activities in the US (like ankle sprains, knee injuries, tennis elbow, etc.). These are the injuries we will talk about in this post.

The measures to prevent the injuries we will discuss are, for the most part, the same for all the activities displayed in the graphic. Of course, there are some specifics, which need to be altered based on the activity in which you most regularly engage. We won’t be able to mention all of those specifics from the point of view of each of the popular sports and activities. That would make this post longer than a small book.

Let’s get on with it.

Ankle Sprains

According to this PMC article, 23,000 ankle sprains happen in the U.S. every day. Ankle sprains are one of the most, if not the most, common injury amongst people who engage in any type of exercises involving running, jumping, swift changes of directions, or even walking (in the case of hiking).

Ankle sprains happen particularly often in team sports (like basketball, football, soccer, etc.), as you can easily sprain your ankle by stepping or landing on someone else’s foot. If you partake in such sports, it’s not a bad idea to take action to lower the risk of spraining your ankle.

Personally, I have suffered from dozens (without exaggeration) of ankle sprains. The nasty thing about ankle sprains is that each sprain makes your ankle weaker. This makes you more prone to subsequent sprains, as shown in this Foot Health Facts’ article.

So, how could this this cruel, snowball-effect of ankle spraining be prevented?

  • Tape Your Ankles or Wear an Ankle Brace

This JOSPT (Journal of Orthopedic & Sports Physical Therapy) article quotes a study, which examined the effectiveness of ankle tape or braces on sprain prevention in soccer players. The study examined 60 players who either had their ankles taped, or were given ankle braces throughout the duration of their season. In addition, the study examined 171 players who participated in the same league but wore no ankle protection. In the end of the season, it was reported that 17% of the players in the control group (the players who didn’t wear a brace) experienced an ankle sprain. In contrast, only 3% of the players who wore an ankle brace sprained at least one of their ankles.

By the way, a follow-up study was conducted on all the players who sprained their ankles throughout the first study, regardless if they had worn ankle protection or not. It was found that one in three of the players who didn’t wear ankle protection reported recurring sprains. One out of four of the he players who had sprained their ankles in the first study, in spite of wearing a brace or tape, reported a recurrence of ankle-sprains. Both of those numbers are very high, which supports the earlier point we made about the increased likelihood of subsequent sprains, once you’ve already sprained your ankle once.

  • Exercise to strengthen your ankle

We should clarify that spraining your ankle means that you’ve either stretched or torn the ligaments in your foot. As credible sources like HSS point out, even after your ligaments heal, they are weaker than they once were.

Therefore, you should do balancing and strengthening exercises, especially in first few months after your initial sprain, in order to get your ligaments back to their original state. The practice of strengthening one’s ankles has demonstrated to be effective in preventing sprains by the following study. This approach has been recommended by many highly credible sources like Williams College, the American Journal of Sports Medicine, and others.

The study from the paragraph above shares the following set of balancing exercises designed to help you prevent spraining your ankle.

As a basketball player, spraining my ankle became a “tradition” for me when I was 14. That tradition continued to manifest itself multiple times a year, all the way through my sophomore year of college. That’s when I retired from basketball. I wrote a post on Reddit, in which I further discuss my experience with ankle sprains in attempt to compel people not to repeat my mistakes.

It’s imperative you understand how much headache (or in this case ankle ache) you can save yourself if you spend time exercising your ankles. If you have sprained your ankle within the past year, this statement applies to you even more.

Knee Injuries

All sports involving rapid stop and go motions, as well as swift changes of direction, entail a high risk of knee injuries. Knee injuries are especially unpleasant, as their rehabilitation usually requires a great deal of treatment and time off. Here, we will briefly discuss some of the most common knee implications – the breaking or softening of your cartilage (also known as chondromalacia, or runner’s knee), tearing your knee ligaments (most commonly the ACL and the MCL), and the tear of the knee cartilage – the meniscus.

Chondromalacia

Let’s look at runner’s knee, first. This Harvard Health article points out that two of the factors responsible for the majority of chondromalacia cases are – the overuse of the knee, and the poorly aligned muscles and/or bones around the knee joint. In this post, we will focus on the latter.

According to the same Harvard article, exercising the muscles around your knee (especially your quadriceps), can help with muscle strength imbalance, which can be causing a misalignment in the area. If there’s an imbalance in your joints (something that can only be determined by a medical professional), the article recommends asking your doctor about shoe inserts. They can change your posture and fix the existing misalignments.

One of the most common causes of joint misalignment is being flatfooted. This is a common issue amongst people (up to 30% of people may be flat footed), so be sure to consult with your orthopedist about that. I suffered from runner’s knee, for which my orthopedist recommended knee braces, as well as shoe inserts. He claimed the braces might help stabilize a misalignment in my knees by pushing my kneecap upwards. The Harvard article that I referenced in the first paragraph about chondromalacia, supports this claim.

University of California, Berkeley, offers a great set of exercises for the muscles around your knee in the second page of this PDF.

ACL

As far as preventing a torn ACL, the Hospital of Special Surgery (HSS) focuses on the importance of a proper warm-up and stretch routines, before engaging in heavy impact activities. In addition, HSS offer a series of exercises within their post, which is designed to help you improve flexibility, strength (particularly of the core, hips, and legs), balance, agility, and your ability to jump and land safely. Implementing a set of exercises, like the one they suggest, is beneficial to preventing ACL tears, as well as many other injuries. Not to mention, such exercises will also help you improve your game noticeably.

MCL

The MCL (medial collateral ligament), much like the ACL, is a nasty injury, which takes you out of the game for a while. Professional and collegian football players bear the highest risk for tearing their MCLs due to the hard hits they are subjected to. For those kinds of injuries, the formula – avoid getting hit – is easier said than done.

For those of us who engage in flag football and pickup basketball for fun, however, the causes for MCL tears are almost always sudden movements or twists. Much like an ACL tear, to prevent an MCL injury you must strengthen your thigh, hip and core muscles through exercising. Balancing exercises are also beneficial for the prevention of knee injuries.

Meniscus

The meniscus is the cartilage in your knee, which serves as an impact absorber between the femur and tibia bones. As far as meniscus injuries go, there’s unfortunately not much we can do to prevent them from happening.

Shin Splints

As Medline points out, shin splints, or the inflammation of muscles, tendons, and bone tissue around your shin, are a common problem for physically active people.

They are normally caused by overtraining, exercising on hard surfaces (like concrete, asphalt, and even hard indoor floors), being flat-footed, running/walking uphill, or a combination of all the above.

Some measures we can take in order to avoid the pain of shin splints, according to Health Harvard and HSS, are:

  • Consult with an orthopedic to make sure you aren’t flat footed. If you are flat-footed, the orthopedic will recommend you shoe inserts.
  • Always warm up well before engaging in high, or medium intensity exercising.
  • Implement a stretching routine.

  • Don’t increase the intensity or duration of your exercise more than, roughly, 10%.
  • Avoid running on hard surfaces.

Shoulder Injuries

Rotator Cuff Tendinitis & Rotator Cuff Tears

As the University of Washington points out, the rotator cuff is a group of four tendons that connect the muscles from your shoulder blade to your upper arm bone (humerus). The rotator cuff essentially helps you raise and move your arm.

Rotator cuff tendonitis (also referred to as swimmer’s shoulder, pitcher’s shoulder, tennis shoulder, or quarterback shoulder) is the inflammation of a single tendon in the rotator cuff, which causes pain in certain movements. The condition is normally caused by activities that require you to raise your arm over your head. Therefore, it’s also common in activities like weightlifting and even wall painting.

The inflammation of a tendon in your rotator cuff can cause that tendon to tear. This is known as a rotator cuff tear.

The good people at Harvard Health recommend two things to prevent rotator cuff tendinitis and tear: avoid activities which involve lifting your arm over your shoulder (which probably is not an appealing option to anyone reading this article) or exercise and strengthen your rotator cuff.

While the Harvard Health article above doesn’t offer a particular set of exercises for rotator cuff strengthening, UC Berkeley picks up the slack:

Dislocated Shoulder

Shoulder dislocation is the condition in which your humerus (the bone of the upper arm) pops out of its socket (the cup-shaped outer part of your shoulder blade). This condition is normally caused when your arm is pulled or twisted outwards, upwards, or backwards with a big force. Therefore, there’s nothing you can do to prevent it.

SLAP Tear

SLAP tear (superior labral tear from anterior to posterior) is a tear of the soft tissue that surrounds your shoulder socket. Much like a rotator cuff injury, an overhead movement of the arm usually causes a SLAP tear. Unfortunately, not much can be done to prevent SLAP tears either.

Tennis Elbow

Image by Keith Allison on Flickr

Tennis elbow (lateral epicondylitis) is an inflammation of the tendons connecting your forearm muscles to your elbow. It’s almost always caused by overuse.

Preventing tennis elbows involves (referencing to WebMD and University of Rochester):

  • Warming up before engaging in activities which put pressure on your elbow (playing tennis, weight lifting, baseball, golf, throwing a football, etc.).
  • Stretching your arms.

  • Using correct techniques and movements when practicing activities that put pressure on your elbow (applies to all kinds of sports and movements, not just tennis). Examples of bad tennis techniques that may increase the chances of tennis elbow, according to the University of Rochester article, are:
    • Improper backhanded stroke.
    • Hitting the ball off-center of the racket.
    • Hitting heavy/wet balls, or using a heavy racket.
    • Using a too tightly strung, or too short, racket.
  • Strengthening the muscle in your shoulder, wrist, back, and arm to take some load off your elbows. In addition, HSS suggests strengthening your core and leg muscles, because those muscles should be the driving force behind a backhanded stroke.
  • Wearing a counterforce elbow brace. This is a strap, which is made for you to wear on your forearm, right beneath your elbow. The good people at WebMD state that a counterforce brace isn’t generally used for tennis elbow prevention (rather it’s recommended for treatment), but doctors recommend it to people at high risk for tennis elbow. The purpose of the brace is to distribute pressure evenly throughout your arm muscles and to ease the pressure of your elbow tendons.

Hamstring Strains

Image by Steven Pisano on Flickr

A mild hamstring strain (a.k.a pulling a hamstring) may need only a few days to recover, but a severe strain can take you out of the game for months. “Moreover, nearly one third of those injuries (hamstring strains of all degrees) recur within the first year following a return to sport, with subsequent injuries often being more severe than the original” (source).

The clinical review we quoted in the previous paragraph states that hamstring strains are one of the most common acute (long lasting) muscle injuries for sports that demand lots of sprinting. Pulling your hamstring is also common in activities like dancing, which is believed to be in part due to the extreme stretches your hamstrings incur.

Possible risk factors of pulling your hamstring, according to the publication we’ve been referencing in the past two paragraphs, are:

  • Deficit in hamstring flexibility.
  • Deficit, or a decrease, in quadriceps flexibility.
  • Deficit in hamstring strength. In addition, imbalance in muscle strength between the hamstring and quadriceps resulted in 4-fold increase in risk for pulling a hamstring.

The article states that incorporating hamstring exercises has been observed to substantially decrease the risk of hamstring strains.

Andrea Papson, PT, wrote a post in HSS that featured some of the hamstring strengthening exercises she conducts with her patients for hamstring strain prevention.

The clinical review states that neuromuscular control exercises, which target your lower-body and core, have been suggested to help hamstring injury prevention. Some examples of such exercises, according to the publication, are high knee marching, quick-support running drills, forward-falling running drills, explosive starts, and others.

In addition, the clinical review states that improving your running form (e.g. upright posture, forward flexed, etc.) has been observed to decrease hamstring injury occurrence by 70% on average.

Heat Exhaustion

As each year seem to bring us hotter days than the year before (climate.gov), heat exhaustion still appears to be a problem in the U.S. If not taken care of, heat exhaustion may lead to heatstroke, which is a sometimes-deadly condition. Thankfully, heat exhaustion is relatively easy to prevent.

In an article dedicated to heat exhaustion, UCONN states that the following factors put an individual at risk for the undesirable condition.

  • Exercising in hot (above 91℉) and/or humid weather conditions.
  • The lack of sufficient water intake before and during exercising.
  • Inappropriate activity-to-rest ratio (too much activity and not enough rest, obviously).
  • Body Mass Index over 60lbs.

All of these factors can be avoided (some more easily than others). If, for whatever reason, you can’t exercise or play outside in less than 91-degree weather, the same UCONN article recommends gradually acclimating to exercising in such conditions. In other words, avoid playing a game of football outdoors until you’ve spent a few days prior exercising in the appropriate conditions, by gradually increasing the intensity.

Conclusion

The best way to deal with an injury is to avoid it in the first place.

Clearly, you can’t take action to prevent every possible injury under the sun. When I was a teenager, a teammate of mine tore his meniscus while he was jumping over a small puddle. There’s no way to see an injury like that coming, and when we are that unfortunate, we just have to accept our faith.

However, the injuries that we are exposed to because of our every day activities (for some people it could also be their work) should be acknowledged and addressed.

Take ankle sprains, for example. As we already mentioned, they are amongst the most common injuries for almost all physically active people. An ankle sprain may result in you not being able to work, exercise, or even play with your children. In addition, it guaranties you pain and having to limp everywhere. On top of all of that, now a subsequent sprains is much more likely to occur, brining you more of this vicious cycle.

So, why not wear an ankle brace when you play, and/or exercise your ankle once in awhile to prevent a sprain? That applies to all injuries, which pose risk to you. After all, none of the preventative measures we talked about are so hard to implement that they aren’t worth our time or money.

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