The Mystery is in the History
Careful history taking and examination helps the sports medicine physician diagnose the condition. It is helpful to know what maneuver produces the pain; or when the pain occurs. Many times with an overuse the injury the symptoms will first occur after the activity; then earlier and earlier into the activity until you become symptomatic at rest. It is important to seek medical attention long before that occurs. It is not normal to have pain with the activity. It is important to consult a physician regarding your symptoms, and to find the cause of the injury so that re-injury does not occur once the present injury is treated.
What are the treatment principles for Overuse Injuries?
Management of the condition depends on the severity. Relative rest, which is stopping the aggravating activity while maintaining cardiovascular activity with another activity is one aspect of the treatment program. For example, use of a stationary bicycle or elliptical, or swimming, which are nonimpact activities, might be an alternate activity for a runner while the injury is healing. One needs to individualize the modified activity for the patient and their injury. Other aspects of the treatment plan are pain management with nonsteroidal anti-inflammatory medication as indicated if no contraindication; physical therapy to include instruction in stretching and strengthening exercises; use of an appropriate brace or support for the injured body part; correction of predisposing factors; and modification of biomechanics.
Are there some injury prevention guidelines?
We would all like to prevent an injury from occurring and to maximize our athletic endeavors. Some key points to remember to help get you there are: appropriate training and conditioning for the sport; check your biomechanics for the sport; allow for adequate recovery and do not engage in your sport when you are tired or in pain. Engage in a variety of sports and activities so that you are not always using the same muscles in the same way. Many elite level athletes complement their specialized sport training with another sport. For example, a cyclist might skate or play hockey in the off season to maintain muscle balance of the quadriceps and hamstring muscles of the thigh. It is best to be proactive and prevent the injury from happening.
Dr.Cohen will be discussing Stress Fractures and Biomechanical assessment in future blogs.