September 30, 2024
by Ernie Mundell
A tumble, a tackle: Anything can bring on a sidelining sports injury.
Now, four experts in such injuries at Penn State Health give advice on recovery and when it’s okay to return to play.
AC shoulder sprains
This happens when your acromioclavicular (AC) joint pops out and separates or is sprained, typically after a fall that lands on the shoulder area. You’re going to feel pain all over the front and top of the shoulder, said Penn sports medicine physician Dr. Caitlyn Haines.
Treating AC sprains “depends on the degree of injury and can range from conservative measures like anti-inflammatories and rest to surgery if the joint is significantly separated,” Haines explained.
Returning to play again depends on the extent of injury, she said.
“Athletes may need some time off before returning, but others may miss little to no time if the sprain is mild and the shoulder exhibits full range of motion,” Haines noted. Recovery times can range from one to six weeks. Keeping the shoulder from a repeat injury is paramount, she added.
Ankle sprains
Ankle sprains typically involve damage to connective ligaments, not bone, said Penn sports physician Dr. Douglas Leder.
You’ll know when you’ve sprained your ankle.
It “usually occurs when an athlete stretches, falls upon or exerts their ankle in an abnormal way, resulting in stretching or tearing of the ligaments,” Leder said. “It may result in a painful popping sensation followed by immediate pain and potential swelling of the affected area.”
Help reduce your odds of an ankle sprain by conditioning before a sports season begins, and warming up with stretches before a practice or game, say the physicians.
“Athletes also should wear proper footwear for their sport,” Leder added. “Wearing protective braces or having the joint taped before playing can be beneficial for those with a history of ankle sprains.”
After a sprain, resting the ankle is key, with ice, compression and elevation of the ankle if swelling develops, and anti-inflammatory medications to ease pain. A doctor might order an X-ray or MRI to assess the severity of the sprain.
In terms of recovery, low-grade ankle sprains may require several days to weeks of rest, but it’s important to begin rehabilitation exercises as soon as pain is tolerable, Leder advised.
Wearing an ankle brace or ankle tape can help stabilize and protect the joint through recovery, and using these devices during play might help protect your ankle if you’ve had a history of such sprains.
Surgery is rare, but “but high-level athletes who suffer severe ligament tears may benefit from surgery to return to sport sooner,” Leder said.
Concussions
Folks engaged in contact sports like football, hockey and boxing know that head impacts can happen and lead to concussion.
Wearing mouthguards and strengthening up the body can help decrease concussions, but when one happens it’s usually characterized by “headaches, confusion, dizziness, blurry vision, fatigue, irritability, mood changes and difficulty with concentration and memory,” said Penn sports physician Dr. Stephanie Carey.
After a concussion, avoid mental strain, including the use of screens, such as phones and TVs, for 48 hours following the injury.
“Also avoid loud sounds, bright lights or activities that increase symptoms. If having difficulty sleeping, avoid napping,” Carey said. “Physical activity should be slowly added as guided by an athletic trainer since it can help with healing.”
She said there’s no firm timeline on when a concussion patient should return to play, since each case is different.
“Resolution of symptoms can take a few days, weeks or months based on various factors,” Carey said. “It can be dangerous if a second concussion occurs before the initial symptoms subside. When symptoms resolve, the player must complete progressive stages of physical activity to ensure it is safe to return.”
Contusions (bruises)
These can be severe bruises occurring after contact with other players or a playing surface. As explained by Penn certified athletic trainer Kourtnie White, “contusions are often painful, discolored, raised areas where impact occurred, potentially causing injury to underlying tissues.”
After this kind of injury, medical staff should examine the injury to make sure it’s more serious, such as a fracture or laceration. Ice and compression can help ease pain.
“Athletic trainers also may provide custom padding to protect the injury while it heals,” White said. “It’s important to wear all protective equipment properly to prevent these injuries.”
Returning to play is often quick; many athletes get back on the field or court within minutes of injury.
“Temporary weakness of underlying muscles, however, may require longer rest and rehab prior to return,” White said. “The affected area may require additional, temporary protection to encourage proper healing and pain relief.”
Meniscus (knee) tear
When you tear your meniscus, the cartilage that lies between the bones of the knee, you may feel “a painful popping sensation, followed by worsening pain, swelling and difficulty walking,” Penn expert Leder said.
“Instability and ‘locking’ of the knee may suggest a more severe meniscus tear,” he added.
Proper pre-season conditioning can lower the odds of a meniscus tear, as will gentle stretching before each game or practice.
If a tear does occur, ice applied to the knee should help ease pain and swelling, as will elevation, compression and anti-inflammatory medications.
“Using hinged knee braces may allow athletes to move with greater stability and less pain,” Leder added. “If it is painful to stand or walk, X-rays may be needed to rule out fractures. With knee locking or other severe symptoms, an MRI can determine severity of a tear and rule out other soft-tissue injuries.”
As to returning to play, wait at least several days before doing, Leder said. Professionally guided rehab is key.
“To return to play, patients should demonstrate the ability to perform sports-specific skills without pain, a painless range of motion and full strength,” Leder said. “High-level athletes and those with severe tears may benefit from surgery.”
Mental health
Penn specialist Haines said that while athletes tend to experience mental health ills at rates similar to the general public, sports can bring unique stressors that put them at special risk for anxiety disorders or depression.
“Coaching or parental expectations, pressures surrounding body image and fear of injury,” can all trigger such issues, Haines said. She urges that mental health screening become part of any physical exam prior to participating in organized sports.
“Prevention is crucial in identifying athletes who may be suffering from a mental health disorder,” Haines stressed. “Management of the athlete with a mental health disorder requires a multidisciplinary care team with help from coaching staff, athletic training staff, sports medicine physicians, therapists or counselors and, possibly, psychiatrists.”
Returning to play is a concern for mental as well as physical health, Haines said.
“If supported by their care team, they could return in a relatively short amount of time, but they should maintain frequent check-ins with athletic trainers and primary care physicians once playing again,” she said.
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