Sports injuries

Playing sport and doing regular exercise is good for your health, but can sometimes result in injuries.

Introduction

Playing sport and doing regular exercise is good for your health, but can sometimes result in injuries.

Most people will only experience minor sport-related injuries such as cuts and grazes, [bruises] or blisters.

Pain, swelling and restricted limb movements are fairly common. Affected areas can include:

  • muscles
  • bones
  • ligaments (thick bands of tissue that connect one bone to another)
  • tendons (tough, rubbery cords that link muscles to bones)
  • joints – the hips, elbows, ankles and knees
  • cartilage (tough, flexible tissue that covers the surface of joints and allows bones to slide over one another)

Read more about typical sports injuries.

Why sports injuries happen

Sports injuries can be caused by:

  • an accident
  • not warming up properly before exercising
  • using inadequate equipment or poor technique
  • pushing yourself too hard (overtraining)

Your doctor may describe a sports injury as:

  • a sudden injury – which is the result of a sudden impact or an awkward movement
  • an overuse injury – which develops over time as a result of overusing certain parts of the body or poor technique

Overuse injuries are common in professional athletes because of the intense nature of their training.

Children can also develop overuse injuries. To reduce the risk they should be encouraged to play a variety of sports, and have any training monitored by a qualified coach.

What to do if you have an injury

Stop exercising if you feel pain, regardless of whether your sports injury happened suddenly or you’ve had the pain for a while. Continuing to exercise while you're injured may cause further damage and slow your recovery time.

If the injury is severe, such as a broken bone, dislocation or severe head injury, go to your nearest accident and emergency (A&E) department.

Treating sports injuries

You can treat most minor sports injuries yourself by resting the affected body part and using over-the-counter painkillers, such as paracetamol or ibuprofen, to relieve pain.

More serious sports injuries, such as a broken bone, torn ligament or damaged cartilage, will require specialist advice and treatment from doctors, surgeons or physiotherapists.

Read more about treating sports injuries.

Preventing sports injuries

Not all sports injuries can be prevented, but you can reduce your risk of getting injured by:

  • warming up properly before you exercise
  • not pushing your body beyond your current fitness level
  • using recommended safety equipment for specific sports, such as shin guards for football or a gum shield for rugby
  • receiving coaching to learn correct techniques

If you start a new sport or activity, get advice and training from a qualified healthcare professional or sports coach.

Are sports worth the risk?

After reading this article, you might get the impression that sports are risky activities, but this isn't the case. Any physical activity, even walking to the shops, involves some degree of risk.

It's important to remember the health benefits that sport and exercise can give you, such as:

  • reducing your risk of developing serious diseases later in life, such as heart disease and cancer
  • improving your mood, self-confidence and sense of wellbeing
  • helping you to maintain a healthy weight

Symptoms

Many sports injuries result in pain, swelling and restricted movement or stiffness in the affected area.

Sprains and strains are the most common type of sports injury. A sprain happens when one or more of the ligaments is stretched, twisted or torn. A muscle strain ('pulling a muscle') happens when muscle tissues or fibres are stretched or torn.

Most sprains and strains usually heal with rest and don’t require specialist treatment, although physiotherapy may speed up your recovery. Completely torn ligaments or muscle may need to be surgically repaired.

Other sports injuries include:

These are described in more detail below.

Back pain

Most sports carry a risk of causing back pain. Properly warming up before exercise can reduce this risk.

Back pain can be felt as soreness, tension or stiffness in the lower back, but it can also be felt in the neck, shoulders, buttocks or lower limbs.

Bone injuries

Repetitive activity or a heavy impact while playing sport can injure the bone, causing:

  • stress fractures – a tiny crack that develops in a bone as a result of repeated stresses (for example, overuse during high-impact activities like distance running). Resting the affected body part will heal most stress fractures
  • shin splints (painful shins) – caused by inflammation in the tissues surrounding the shin bone (tibia). This is common in any sport that involves running and is treated with rest, ice, elevation and appropriate strength and flexibility exercises
  • a broken ankle
  • a broken arm or wrist
  • a broken toe

A broken bone may cause swelling or tenderness around the injured area, and bleeding if the bone has broken the skin (open fracture). It's unlikely you will be able to use the affected limb.

The pain associated with a broken bone can also be severe and make you feel faint, dizzy and sick. Treatment will depend on which bone is broken and the type of fracture.

Read about [how to tell if you have broken a bone].

Hamstring injury

Hamstring injuries are tears to the tendons or large muscles at the back of the thighs. They are common among athletes.

Sudden lunging, running or jumping can cause the hamstring tendons or muscles to tear, which can be felt or heard as a pop and will be immediately painful. The muscle will spasm (seize up) and feel tight and tender. In severe cases, there will also be swelling and bruising.

Hamstring injuries usually heal on their own if you rest until it feels better. This may take days, weeks or months depending on the severity of the tear. Speak to a sports physiotherapist if you're unsure.

Head injuries

A minor head injury, such as a bump or bruise, is common and doesn’t need treatment. If you have any concerns, see your doctor or local walk-in centre.

You should go to your nearest accident and emergency department if any symptoms of a severe head injury develop, such as:

  • unconsciousness, either very briefly or for a longer period of time
  • difficulty staying awake or still being sleepy several hours after the injury
  • a seizure or fit, when your body suddenly moves uncontrollably
  • difficulty speaking, such as slurred speech
  • vision problems or double vision
  • difficulty understanding what people say
  • vomiting

If you think someone has a severe head injury, immediately take them to the accident and emergency (A&E) department of your nearest hospital, or call for an ambulance.

Heel pain

Heel pain (plantar fasciitis) can happen when the thick band of tissue that runs under the sole of the foot becomes damaged. It's common in runners and joggers.

It can cause a sharp and often severe pain when you place weight on your heel. In most cases, only one heel is affected, although it is thought that up to a third of people have pain in both heels.

Inflamed joints

Joint inflammation can be caused by conditions that affect the joints and tendons, such as:

  • bursitis – inflammation of a bursa, which is a small fluid-filled sac underneath the skin, usually found over the joints and between tendons and bones
  • tendonitis – inflammation of a tendon around the shoulder, elbow, wrist, finger, thigh, knee or back of the heel (Achilles tendonitis)

Tennis elbow is a type of tendonitis that affects the outside of the elbow, caused by repetitive movement of the muscles in the lower arm. Golfer’s elbow is similar but the swelling occurs on the inside of the elbow.

Knee pain

Sudden knee pain is common in contact sports, especially those that involve twisting. If the cartilage or ligaments are damaged, this can cause knee swelling.

Other knee conditions include:

  • Runner’s knee – caused by overuse of the knee. Symptoms include soreness and discomfort beneath or to one side of your kneecap. It can also cause a grating sensation in your knee.
  • Cartilage damage – in severe cases, a piece of cartilage can break off and become loose, affecting the movement of your joint. This can cause a feeling of the joint locking or catching. Sometimes, the joint may also give way. Keyhole surgery may be necessary for investigation and treatment.
  • A torn anterior cruciate ligament (ACL) – see below.

Knee ligament damage

The anterior cruciate ligament (ACL) is one of four ligaments in your knee. It can tear if you suddenly stop or change direction, or if you land badly from a jump. If you tear your ACL, you may hear a pop or crack at the time of your injury.

An ACL tear is a fairly common sports injury and around 20% of all sports-related knee injuries involve the ACL. The symptoms of a torn ACL include:

  • severe pain in your knee
  • instability in your knee, which means you cannot put much weight on it
  • swelling in your knee
  • not having the full range of movement in your knee and, in particular, not being able to straighten your leg

Depending on the severity of your ACL tear, you may need to have reconstructive surgery to repair it.

Shoulder pain

Shoulder pain is common in sports that include repetitive movement such as overarm bowling or throwing. Tendons around the shoulder (the rotor cuff) can become inflamed (tendonitis) or torn, causing pain.

A dislocated shoulder may be caused by a heavy fall or a sudden impact. The upper arm painfully 'pops' out of the shoulder joint and you will not be able to move the arm.

If you have a dislocated shoulder, you should go to the accident and emergency department of your nearest hospital. It may help to support the arm with a sling. In hospital, the shoulder will be put back into the joint with the help of strong painkillers or sedation.

Treatment

Treatment for a sports injury will depend on how severe the injury is and the part of your body affected.

If your injury does not require medical treatment – for example, a mild sprain or strain – you can treat it at home using PRICE therapy.

PRICE stands for protection, rest, ice, compression, and elevation.

  • Protection – protect the affected area from further injury – for example, by using a support.
  • Rest – avoid exercise and reduce your daily physical activity. Using crutches or a walking stick may help if you cannot put weight on your ankle or knee.
  • Ice – apply an ice pack to the affected area for 10–30 minutes. A bag of frozen peas, or similar, will work well. Wrap the ice pack in a towel to avoid it directly touching your skin and causing ice burn.
  • Compression – use elastic compression bandages to limit swelling.
  • Elevation – keep the injured leg, knee, arm, elbow or wrist raised above the level of the heart. This may also help to reduce swelling.

After 48 hours of PRICE therapy, stop compression and try moving the injured area. If, after this time, your symptoms are worse, speak to your doctor.

PRICE therapy can be useful for any sports injury, but some injuries may require additional treatment.

Pain relief

Painkillers, such as paracetamol can be used to help ease the pain. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can also be used to help ease the pain caused by sprains and fractures and help reduce any swelling.

Aspirin should not be given to children under 16 years of age.

Immobilisation

Immobilisation helps prevent further damage by reducing movement. It also reduces pain, muscle swelling and muscle spasm.

A sling can be used to immobilise an arm or shoulder until medical advice is given. A splint or cast made of plastic or fibreglass may be used to protect injured bones and soft tissue.

After a knee injury or knee surgery, a leg immobiliser made from foam rubber, may be used to keep the knee in a fixed position and prevent it from bending.

Corticosteroid injection

If you have severe or persistent inflammation, a corticosteroid injection may be recommended. The steroid cortisone is injected through a fine needle into the affected area. It is usually combined with an anaesthetic so it is not painful.

Corticosteroid injections can usually be given once every three to six months. More frequent injections are not usually recommended because they can damage tissue.

People who have a corticosteroid injection find that their pain improves significantly or disappears completely over the next few weeks to months. However, for some, the pain relief is minimal or only lasts for a short period. A few people will see no improvement, or symptoms may get worse.

There is a small risk of infection and other side effects after a corticosteroid injection. You may feel discomfort at the site of the injection for up to 48 hours.

Physiotherapy

Physiotherapy involves using massage, manipulation and special exercises to improve the range of motion and return the normal function of injured area.

For example, someone recovering from a long-term injury may benefit from a programme of walking and swimming to help strengthen the muscles in the affected body part.

Massage

Some sports therapists and coaches believe that massage may speed up the recovery process. Supporters of massage argue that it helps to:

  • encourage the flow of blood into the affected body part and the nutrients in blood can help repair any damaged tissue
  • increase flexibility in the affected body part

Massage is not recommended if you have a serious soft-tissue injury, such as a torn ligament, as it could make the injury worse.

Despite being a very popular treatment, there is little hard evidence that massage aids recovery. However, it can reduce stress levels and make you feel more relaxed, which may be important benefits themselves.

Heat treatment and ultrasound therapy

Some sport therapists argue that using heat therapy (heat pads or lamps) and ultrasound therapy (high-energy sound waves) may work in a similar way to massage by stimulating blood flow to the affected body part. However, as with massage, the evidence for both these treatments is not conclusive.

Ultrasound seems to speed up the healing process of fractured bones. However, there is little evidence that it speeds up the healing process in other types of sports injury.

Heat treatment seems to help relieve pain, but again, there is little evidence that it can speed up the healing process.

Surgery

Most sports injuries do not require surgery but very severe injuries, such as badly broken bones, may require corrective surgery. In some cases it may be possible to use a non-surgical technique, known as closed reduction, to realign broken bones.

During surgery for a broken bone it may be necessary to fix the bones with wires, plates, screws or rods, known as open reduction and internal fixation (ORIF).

A torn knee ligament can also require reconstructive surgery.

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Rehabilitation

Rehabilitation is an important part of treating sports injuries. A rehabilitation programme aims to return the injured body part to normal function by gradually introducing it to movement and exercise.

With most sports injuries, after the initial recovery, it helps to move the injured part as soon as possible to help speed up the healing process. Gentle exercises should help improve the area’s range of motion. As movement becomes easier and the pain decreases, stretching and strengthening exercises can be introduced.

During the rehabilitation process, you should not attempt to do too much too quickly. Start by doing frequent repetitions of a few simple exercises before gradually increasing the amount that you do. Avoid painful activities and do not return to your sport until you have no pain, and full strength and flexibility have returned to the injured area.

A healthcare professional, such as a physiotherapist or sports injury specialist, can help you design a suitable rehabilitation programme and advise you about which exercises you should do and the number of repetitions.

Content supplied by NHS Choices