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Improving Physical Ability

Understanding Common Injuries, Causes and Treatment

Physiotherapist at the Regeneration Physiotherapy Group Sam Harbottle highlights some of the most common injuries that occur in physical activity and sport

Understanding the common injuries that occur to participants is an important part of supporting them at your sessions. if you know what to expect, then you can gain knowledge on how they can best be treated.

Sports Injuries 101

Tendons are thick bands of high tensile collagen fibres that connect muscle to the bone. They are flexible and durable and enable the body to generate force from the muscle contraction.

Ligaments are thick bands of cartilage that attach bone to bone and ensure stability around a joint.

Muscles are soft tissue made up of bundles of fibres that, when contracted, generate force and allow movements.

Bones provide the support structure to the body and are made up of a type of protein called collagen and calcium that enables them to be strong and flexible.

Strains are an overstretching/contraction injury that affects the muscles and/or tendons, usually with a tear or ‘pull’ occurring.

Sprains affect ligaments and are an overstretching or tearing of the ligament. This occurs because of trauma.

An easy way to remember is strains has a 'T' in it, and so does tendon.

Youth participants

While injuries can occur to anyone, at any time, there are several common injuries that are more prevalent in younger participants because they are still growing and developing.

Ankle sprains are the most common injury in all sports, often referred to as "rolling the ankle" or "turning the ankle”. An ankle sprain injury involves damaging the ligaments on the outside of the ankle after losing your footing, moving on an uneven surface, or looking to move and react quickly.

Often, the injury isn’t too severe, and usually, with the help of PEACE & LOVE (for more on this, read our guide, Understanding First Aid and Injury Management), followed by a rehabilitation plan, recovery is usually quick.

Importantly, it’s key to rehabilitate and strengthen the injured ankle properly because the chance of re-sprain is significantly higher after the first.

The biggest predictor of injuries is sustaining a previous injury!"

‘Patellofemoral syndrome’ or as we know it, ‘knee pain’ is another injury common in young people and is especially common in girls.

It is usually considered an overuse injury and the pain is often observed in the front of the knee near the kneecap (patella).

There are various reasons for this issue to occur, the most common being a muscular imbalance in the thigh.

Overuse is also another reason.

Physiotherapy is the best remedy for identifying the cause and nature of the pain and an appropriate treatment plan and remedial programme can be implemented to develop the muscles.

Osgood Schlatters is a very specific type of injury that occurs during maturation. It is defined as a traction injury on a special type of growth plate called an apophysis, which is located at the top of the shin bone.

It is often seen in youth participants because it mainly arises from tight and often strong thigh muscles, which can occur during the growth spurt when bones develop and grow quickly, usually much faster than the muscles, which are trying to catch up. Pain and swelling can be observed (often severe) as well as a lump at the top of the shin bone.

Treatment includes:

  • rest
  • reduction in physical activity (managing load, volume, and frequency)
  • stretching
  • the use of a non-steroidal anti-inflammatory drug (ibuprofen to manage the inflammation and pain).

An assessment is recommended to find the cause of the swelling and pain. 

Anterior Crucial Ligament (ACL) tears are sadly becoming an all-too-common injury in sport and are quite severe in nature.

Many require surgical interventions and a long rehabilitation programme to return to play (from seven to ten months).

The ACL is one of the ligaments responsible for stabilising the knee.

It can be ruptured during twisting/traumatic movements of the knee.

Returning to competition too quickly, without achieving milestones and medical support, correlates highly with a reoccurrence of the same injury.

Rehabilitation and a return to play programme are essential for successful recovery. 

Tennis Elbow (could easily be golfers, squash, baseball or cricket elbow) is very prevalent in younger athletes participating in high repetition racket/bat sports. The injury occurs from overuse (high repetition of the same action) and results in inflammation and pain towards the inside of the elbow. Sometimes participants can also feel pain towards the outside of the elbow.

One modern treatment now available for these injuries is the use of shockwave therapy, which helps to speed up recovery. Unfortunately, the injury can take several months to settle down and full resolve, but early intervention and treatment have helped reduce healing times. An initial assessment from a physiotherapist is the best initial stage to identify the injury and create a rehabilitation and maintenance plan. 

And the rest! There are numerous other overuse injuries which we see in young people who participate in sports including:

  • Severs Disease, a painful heel condition that occurs when the Achilles tendon pulls on the growth plate at the heel becoming inflamed and painful
  • Iliotibial Band (ITB) Syndrome. The ITB is a thick band that runs from the hip to the knee on the outside of the thigh. The tissue becomes tight and rubs against the thigh bone, becoming inflamed and causing knee pain, hip pain, and swelling
  • Spondylosis is a stress fracture in the lower back caused by bending, hyperextension, and rotation/twisting activities when the body is still growing and developing. It is often seen in gymnasts, and sports that require throwing/striking and rotation (cricket, tennis)
  • Rotator cuff tendonitis is the inflammation of the tendons in the shoulder that connect the muscle group. This creates irritation, pain, and inflammation in the shoulder area when it is moved. This is often caused by overhead actions and movements such as throwing and hitting.

Understanding how much exercise children and young people do and adjusting this amount can often help a lot with avoiding injury.

As an example, many young people:

  • frequently take part in Physical Education
  • play with friends in their free time
  • compete at the weekend in sports teams
  • attend multiple training sessions and practices
  • participate in lunchtime and after school clubs
  • represent their school in physical activities and sports
  • play more than two sports regularly.

This amounts to a lot of exercise (volume, frequency, load on their body).

Having a physiotherapist working within your interdisciplinary team or supporting you as a coach to advise on best practice can help you decide how much you should (or shouldn’t) be doing in your practice sessions.

They can also advise on prehabilitation activities and programmes and advise on high risk movements.

Reflect

How much activity and sport do your participants do?

How often do they practice and compete?

How long for?

What are their other sporting commitments?

Have you considered their PE and school activities?

 

Consider

Do you consider the load that your participants have in sessions?

The frequency that they perform actions in your sessions?

The amount of time they are activity practicing?

Does your sport have recommendations on the number of repetitions? Guidelines on overuse activities?

 

Gender and injuries

The differences in anatomy between boys and girls means there are several specific injuries that each are more vulnerable towards. The ‘Gender Gap,’ as it’s known, indicates that women, as a general population, are more vulnerable to injury than men.

There are several reasons for this gap and a lot of the risks remain uncertain. One well-researched example is the occurrence of ACL ligament injuries. In women, the ACL is placed under x6 more stress than in men, simply because of the shape of their hips (to allow for childbirth), known as the Q angle.

Biomechanics (movement patterns and analysis), flexibility, strength, hormones (including during menstruation), body composition and anatomical differences are all reasons cited for the ‘Gender Gap’. 

While some of these factors are fixed and outside of the control of the participant, coach and interdisciplinary team, many can be assisted and supported, and the associated risks reduced through a specific and regular physical preparation programme. 

More from the Regeneration Physiotherapy Group

This guide is part of a suite of resources developed in partnership with the Regeneration Physiotherapy Group

Get the other resources

Related Resources

  • Understanding First Aid and Injury Management

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  • Getting the Best Value From Working With a Physiotherapist

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  • Coaching Female Athletes to Benefit Female Athletes: Injury Occurrence

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