How to Care for Sports-Related Injuries
Location of Injury: Knee
Overdoing it―as in too much jogging―can aggravate the knees. Sitting for long periods or frequently walking down stairs can make matters worse. Women are especially prone to knee problems. "Their wider pelvises may put more force on the knees," says osteopath Robert Gotlin.
What to avoid: Activities that put direct stress on the knees, like running, skiing, lunges, and certain yoga poses. Also avoid stretches that bend the knees too much, like the classic runner's stretch, in which you grab a foot from behind and pull it back toward the body.
What you can do: Biking is fine, but raise the seat so your knees don't bend too much. Swimming is a good choice, too―just avoid the breaststroke, because of its bent-knee kick. An elliptical machine is also a smart option, since it puts little stress on the joints.
What would make it better: Try exercises that strengthen and stretch the hip and leg muscles, such as leg presses, moves on a balance board, and hip, buttock, hamstring, and calf stretches (for specific exercises with drawings, go to familydoctor.org).
Location of Injury: Lower Back
Likely cause: "Lower-back pain can result from lifting heavy objects or simply twisting at an odd angle, but often the cause is unknown," says Stanley A. Herring, M.D., medical director of spine care at the University of Washington in Seattle.
What to avoid: Heavy lifting, high-impact activities like running, and yoga and Pilates moves that involve bending forward and twisting. All may increase pressure on the shock-absorbing disks of the spine. You might also want to steer clear of tennis and golf.
What you can do: Walk. Biking (don't slouch) and swimming are also good.
What would make it better: Strengthening muscles in your abdomen, hips, and pelvis will help support the lower back. Try crunches and back-extension exercises. Even though rest might seem like the best course, keep moving. "Inactivity won't help you get better faster," Herring says, "and you may lose strength and flexibility."
Location of Injury: Shoulder
Likely cause: Repetitive overhead activities, like serving tennis balls or swimming the crawl, can inflame or even cause mini tears in the tendons of the rotator cuff, the part of the shoulder that connects the upper-arm bone with the shoulder blade and allows circular motion. Not warming up may be a factor, too.
What to avoid: Overhead motions that irritate already painful muscles. Also avoid exercises that strain the shoulders, such as military presses, water-skiing, sit-ups with the hands behind the head, and yoga positions like downward dog and plow.
What you can do: Run, use an elliptical machine, bike (but stick to recumbent or stationary bicycles), or swim the breaststroke.
What would make it better: Shoulder-stabilizing exercises―such as internal and external rotation moves using stretchy bands (see familydoctor.org)―strengthen the muscles that keep the ball of the arm bone in the shoulder socket.
Location of Injury: Elbow or Wrist
Likely cause: "Elbow pain often results from poor technique or from using the wrong piece of equipment―a tennis grip that's too large for your hand, say, or a golf club that's too heavy," explains William Levine, M.D., director of sports medicine at Columbia University Medical Center, in New York City. "Wrist sprains can come from overuse or falls."
What to avoid: Anything that puts strain on the arms, such as tennis, golf, swimming, weight lifting, push-ups, overhead activities (like rock climbing), and any exercise that keeps the elbows locked straight or strains the wrists. People with elbow pain should avoid road biking, which puts pressure on the lower arms.
What you can do: Concentrate on activities that don't rely on the arms, like running, using an elliptical machine, and recumbent or stationary biking.
What would make it better: Perform wrist-extension exercises that stretch the muscles on the side of the elbow, such as raising the wrist toward the ceiling while holding a light dumbbell and then slowly lowering the weight. To strengthen lower-arm muscles, squeeze a rubber ball for a few minutes three times a day.
Location of Injury: Foot
Likely cause: Stabbing pain in the heel or the arch can signal plantar fasciitis, an inflammation of the band of ligaments on the bottom of the foot. The condition is caused by too much running or walking, or wearing high heels, or shoes that are too narrow.
What to avoid: Exercises that put pressure on the heels, such as running, walking, and hiking.
What you can do: Swimming and biking are good choices because they're not weight-bearing activities. You may want to wear stiff-soled sneakers while biking to support your heels.
What would make it better: For plantar fasciitis, to decrease tension on the ligaments, do gentle calf stretches (see familydoctor.org). To strengthen the foot, grab a towel with your toes and drag it toward you.
When to See a Doctor
Consult a doctor if:
You're in acute pain, your injury doesn't feel better within two to three weeks, or you develop new symptoms. Your doctor might refer you to a physiatrist, a sports-medicine doctor, or an orthopedic surgeon specializing in your type of injury.
Bring records that pertain to your injury to the first visit. The doctor will conduct a thorough exam, but be sure to describe the history of your injury, including when it hurts and when it doesn't.
Ultimately you want to leave with a diagnosis, and an idea of what the next steps will be: Do you need further tests? Should you do certain types of exercise and avoid others? Would physical therapy help?
"Go over your options for different types of treatments," says Margot Putukian, M.D., director of athletic medicine at Princeton University. "By the end of the visit, you want to have a plan of action"―and a sense of when you'll begin to feel better.