Heal

Heal with exercise: How to prevent and manage sports injuries

WHAT IS THE RISK OF GETTING A SPORTS INJURY FOR A PERSON WHO EXERCISES FREQUENTLY?
Sports injuries can be divided into two types: Acute injury and chronic overuse. Acute injury occurs suddenly or as a result of trauma such as an ankle sprain or fracture.

Chronic overuse injury occurs over time, as a result of repetitive microtrauma of bones, muscles, tendons or joints. Tendinopathy or stress fracture is one example. Chronic overuse injury is more common than acute injury and more challenging to treat.

A study showed that among a younger age group, 51 per cent of exercisers suffer injury.

For the majority, the severity of injury ranges from mild to moderate. The risk of getting injured is more common in an older age group. Most of the injuries occur at lower extremities.

Among elite athletes, sprains (34.6 per cent) and strains (19.8 per cent) are the most common types of injury. Knee is the common site of injury. Most injuries occur during training (84 per cent) than during competition (16 per cent).

Running is one of the popular exercise activities among the general population. Although it is an effective and easy way to get health benefits, it is also associated with a high risk of injury.

Up to half of runners report an injury. Some of the running injuries are traumatic but the majority are due to chronic overuse.

Men have a higher risk of injury than women. Factors contributing to running injuries are old age, running on hard or concrete surface, too long a distance (such as marathon), a weekly distance of more than 40 kilometres, previous history of injury and using worn-out running shoes.

The most common running injuries include iliotibial band syndrome, patellofemoral pain syndrome, medial tibial stress syndrome (shin splints), plantar fasciitis, achilles tendinopathy and stress fractures of the metatarsals and tibial bone.

Pain is the main symptom and location of pain is important to determine the type of injury.

Usually, the severity is determined by the nature of pain. Pain can occur during running, at the start of running, at the end of running and stops when at rest. If the pain persists at rest, it suggests that the injury could be severe.

Other symptoms include swelling, bruises and tenderness around joints. Most acute injuries are presented with pain, associated with swelling, bruises and tenderness. Acute injury usually requires urgent medical attention. For chronic overuse injury, if the pain occurs for more than a few weeks, it is time to seek medical attention.

HOW DOES ONE PREVENT A SPORTS INJURY?
Some measures may prevent or delay the onset of a sports injury. For athletes, who spend most of their time training, proper techniques may reduce the risk of injury.

When running, a weekly distance of more than 65km offers a risk of injury. Adjusting the weekly distance, frequency and intensity will help reduce that risk.

Avoid sudden or abrupt changes in intensity, distance or duration of training. Some experts suggest a gradual increase using the rule of thumb of 10 per cent increase in weekly training.

Avoid training on hard or concrete surfaces and adjust hill training. Also avoid frequent long distance running. For example, running 20km is best done every 14 days. Get one or two days of rest in a week and alternate with cross training or strength training.

There is not enough evidence to support the theory that stretching and warm-ups can prevent injury. However, stretching may improve joint flexibility and reduce muscle pain and soreness after running. Warm-ups are important to prepare your body for running.

Choose running shoes that feel most comfortable, fit properly and are well suited to the shape of your foot.

However, some subpopulation with abnormal foot arch (high arch and pronated foot) may benefit from choosing the correct type of shoes. A higher foot drop of more than 6mm may prevent injury because it increases cushion and reduces ground reaction force.

For a person who likes to run barefoot or using minimalist shoes, proper transition is important. Performing strength exercise of specific muscles may also reduce risk of injury.

WHAT SHOULD ONE DO AFTER GETTING A SPORTS INJURY?
It is important to monitor symptoms of sports injury, especially pain. Listen to your body. Usually it starts with mild pain and is still bearable to exercise. Once you have this symptom, it suggests that you may have sports injury. These are steps you can take while observing the symptoms:

* Cut down on the duration, frequency and intensity of an activity and look at the response.

* Rest the affected area while adopting cross-training with other activities to maintain fitness level. Sometimes, pain occurs due to wrong exercise techniques. Consult a coach or trainer.

* Apply ice after an activity for minor aches and pain.

* Stretch the affected tendon or muscle regularly to reduce pain. If the pain is unbearable, consider taking anti-inflammatory medication after consulting a doctor.

* If symptoms persist for more than a few weeks or get more severe, a sports doctor will be able to evaluate and give a specific diagnosis of the condition. He will give a more detailed treatment plan for your specific condition. Physical therapy and athletic training services may also be part of the treatment plan.

HEAL WITH EXERCISE
An avid sportsman who believes in the healing powers of exercise, Assoc Prof Dr Ahmad Taufik Jamil is Universiti Teknologi Mara’s public health consultant and exercise physician. Reach him at atjamil@gmail.com.

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