Looking Up | Causes, Treatment and Prevention of Common Sports Injuries

Love Sports but Want to Prevent Injury? What You Need to Know

The Clearing Team
The Clearing Team

Whether you are a professional athlete, a recreational athlete, or a weekend warrior, overuse injuries that result from participation in physical activity can affect anyone. Aside from strained muscles, these injuries often impact the parts of the body that experience a high amount of stress during activity: the bones, joints and tendons. The risk of these injuries increases with age.

In this article, we will take a look at common pain conditions typically incurred from sports overuse injuries, including what causes them, how to treat them and how to prevent them. 

Specifically, we will look at the following sports injuries and topics:

  • Runner’s foot, including: stress fractures, plantar fasciitis and Achilles tendonitis
  • Tennis elbow 
  • Shin splints
  • Swimmer's shoulder
  • Recovering from sports injuries
  • Preventing sports injuries

Runner’s foot 

Runner’s foot is an umbrella term that refers to a number of overuse injuries of the foot that are common in runners. It is also common in people who engage in sports with a lot of running, like soccer or basketball. 

During running activities, the feet bear a lot of the body’s weight and the pounding of the pavement, field, or court mile after mile. So it’s no wonder that they are prone to a number of injuries. In long distance and marathon runners, foot and ankle injuries are the most reported injuries. These injuries include stress fractures, heel pain, and plantar fasciitis. 

Below are some of the most common injuries that affect runner’s feet:

Stress fractures 

Stress fractures are very small cracks in bones that are typically caused by repetitive activity and overuse. The weight-bearing bones of the foot and lower leg are most susceptible due to the amount of force they absorb during activities like running and jumping. The most common cause of a stress fracture is a sudden increase in physical activity without giving the body enough time to rest. 

This injury is common in athletes, particularly long-distance runners and track-and-field athletes, accounting for up to 20% of sports clinic injuries. Stress fractures are also common in military recruits who start basic training. This is because the recruits are suddenly doing lots of intense physical activity. Stress fractures impact women at slightly higher rates than men.

Stress fractures occur most often in the shin bones, or tibia, and in the feet. In the feet, they most often occur in the bones of the ankles and in the metatarsals, the long bones that run along the feet below the toes. 

For context, bones are in a continual state of turnover, known as bone remodeling. This is a process in which old bone tissue is replaced with new bone tissue. Large cells called osteoclasts break down old bone into parts and minerals, which get recirculated into the body and release calcium into the bloodstream. At the same time, cells called osteoblasts form new bones. 

As a child is growing, new bones are formed faster than old bones are resorbed. When the skeleton matures in young adulthood, destruction and formation of bone are about the same. This balance maintains the skeletal structure. 

However, if someone works their body too much, older bone starts breaking down faster than new bone is created. This leads to bones becoming weaker and prone to stress fractures. If a person has osteoporosis, an age related disease where bones become thin and brittle, or some other condition that has weakened their bones, they are even more susceptible to stress fractures.

Symptoms of a stress fracture include pain, aching, or swelling at the site of the fracture. Someone with a stress fracture may also feel tenderness or “pinpoint” pain when touched at the site or increased pain during activity. 

Plantar fasciitis 

Plantar fasciitis is one of the most common causes of heel and sole foot pain. The plantar fascia is a thick bank of connective tissue that runs along the bottom of the foot, connecting the heel to the toes. It plays an important role in providing support for the arch of the foot, as well as shock absorption. 

The tissue of the fascia can become inflamed from too much stress or strain, typically from overuse injuries like running. Plantar fasciitis can also result from trauma injuries. The condition may start with microtears in the connective tissue of the fascia from repetitive stress due to standing, running, and weight bearing, and then progress over time to include calcifications and thickening of the tissue.

This condition is quite common, with millions of Americans suffering from it every year. It is estimated that 1 percent of the population is experiencing pain from plantar fasciitis in any given month, and the treatment cost is estimated to range from $192 to $376 million annually. 

Those with particularly high or flat arches are more prone to developing plantar fasciitis, as well as those with tight muscles of the lower rear leg, especially the lower calves (the soleus). This is because these conditions place more stress on the plantar fascia.

The pain is usually described as a sharp pain that can radiate out from the heel. It is also usually most severe first thing in the morning.

Achilles tendonitis 

Achilles tendonitis occurs when the tendon that attaches the calf muscle to the heel bone becomes inflamed. The Achilles tendon is the largest and strongest tendon in the body. Its strength and flexibility allow you to do activities that use the ankle and heel, like walking and running, as well as more explosive movements like sprinting and jumping. 

However, because the tendon handles great force, it is susceptible to injury. Achilles tendonitis usually results from microtears that occur in the tendon during strenuous, high impact activities, like running and jumping. When these activities are performed too often, the body is not able to repair the tissue before additional strain is placed on it. 

Achilles tendonitis is a progressive condition that worsens over time if not addressed. If someone injures their tendon and continues to engage in the activity that led to the injury, tendonitis can result in breakdown of the tissue and even a ruptured tendon. This is an extremely painful condition that can only be fixed through surgery. 

Ruptured tendons are especially common in those who engage in sports like running, track and field and basketball. In fact, 24 percent of athletes and 9 percent of recreational athletes develop Achilles tendonitis in their lifetimes.

The connective tissue of the Achilles tendon weakens with age. This means that older people are more susceptible to injury, especially if they engage in intense sports only sporadically, such as on the weekends — the so-called “weekend warriors.” 

The pain resulting from Achilles tendonitis typically begins as a mild ache in the lower calf or above the heel after running or engaging in other sports. More severe pain may occur after prolonged running, stair climbing, jumping or sprinting. Tenderness or stiffness is usually most severe in the morning and during or after intense activity, but often improves with mild activity.

People who take fluoroquinolone antibiotics, like Cipro, are at greater risk of developing tendon injury, including tendonitis and tendon rupture, especially of the Achilles tendon. The exact mechanism by which these drugs increase the risk of tendon injury is not known, but theories include fluoroquinolones preventing collagen synthesis or blood supply to the tendon.

Tennis elbow

Tennis elbow, or lateral epicondylitis, refers to tendonitis in the elbow. The tendon that connects the muscles of the outside of the forearm to the elbow can become injured from repetitive injuries that can arise from actions such as swinging. 

Tennis elbow involves the muscles and tendons of the forearm that are responsible for the extension of the wrist and fingers. It can result from damage to a specific forearm muscle, the extensor carpi radialis brevis (ECRB), which helps stabilize the wrist when the elbow is straight. 

The ECRB is engaged during certain movements such as a tennis groundstroke. When it is weakened from overuse, microscopic tears form in the forearm tendons, which attach to the bones in the elbow. This leads to inflammation, tenderness and pain on the outside of the elbow.

Athletes are not the only ones who are susceptible to tennis elbow. Many people whose occupations or recreational activities require repetitive and vigorous use of the forearm muscles, or repetitive extension of the wrists and hands, are also often afflicted. This includes construction workers such as carpenters, plumbers and painters, as well as auto workers and cooks.

Similar to other types of tendonitis, like Achilles tendonitis, tennis elbow typically develops gradually and worsens with activity that engages the forearm muscles, like gripping, swinging and using tools.

Shin splints

Shin splints, also known as medial tibial stress syndrome (MRSS), is a pain that occurs along the inside of the shin bone (tibia). It usually starts because of a sudden increase in certain types of physical activity. It is one of the most common causes of exercise-induced lower leg pain, and is frequently seen in runners, dancers, gymnasts and military personnel engaged in intense physical activity like basic training. 

Running, or other activities of high load and impact on the lower limbs, put stress on the tibia. This can cause inflammation of the surrounding tissue. One meta-review of several studies of shin splints found that the frequency in runners ranged from 13 to 20 percent, and from 7 to 35 percent in military personnel. 

Women develop the condition more often than men. This may be tied to the fact that women have higher incidences of low bone density and conditions like osteoporosis.

Shin splints are progressive, usually beginning as a dull pain along the inside part of the shins, and increasing to an intense pain if activity is not halted. Risk factors include a high BMI, unusually flat arches of the foot, pronation (putting more pressure on the inside of the foot when walking or running), tight calf muscles and engaging in high-impact activities on hard surfaces such as concrete.

Swimmer’s shoulder

Swimmer’s shoulder, clinically known as “internal impingement,” is a very common form of shoulder pain in swimmers. This is due to repetitive use of the shoulder — competitive swimmers can perform thousands of strokes in a single workout. 

Swimmer’s shoulder also affects people who play professional and recreational baseball, football and tennis. But, it can also result from more low-key activities like throwing your dog a ball every day for many years. 

The rotating movement places great demand on the shoulder joint, muscles and tendons, including the rotator cuff. The rotator cuff tendons surrounding the shoulder joint can become pinched or otherwise irritated, leading to inflammation and pain. 

As in tennis elbow, swimmer’s shoulder may involve fatigue of certain muscles of the shoulder involved in swimming. Typically, the pain experienced is located on the front or outside of the shoulder and upper arm. 

SUMMARY

Both tennis elbow and swimmer's shoulder can arise from repetitive use of the arms or shoulders. Tennis elbow involves the muscles and tendons of the forearm, while swimmer's shoulder involves muscles and tendons around the shoulder, including the rotator cuff.

Recovering from sports injuries

The first step in healing any sports injury is to stop the activity that has led to the injury, and give the affected muscle, joint, tendon, or ligament a rest. Getting a diagnosis from a doctor or physical therapist will help you understand the injury and come up with a plan to expedite healing and regain full range of motion.

The best way to heal “runner’s foot” injuries, for example, is to stay off the affected foot, halting any activities which may be contributing to the injury. Minimizing the body weight and stress placed on the various bones, joints and tendons of the feet will allow the healing process to begin. 

A visit to your doctor is recommended in order to receive a diagnosis that will allow you to pinpoint the source of the pain and take appropriate measures to heal most quickly. Your doctor will examine you and may order imaging studies to better understand the injury. 

Stress fractures usually heal with rest and time, although your doctor may recommend a wrap or splint to help keep the bones aligned so that they heal properly. Healing from tendon and ligament injuries such as plantar fasciitis, Achilles tendonitis, tennis elbow and swimmer’s shoulder usually involve additional steps. These may include regular icing and physical therapy, such as stretches to loosen the muscles and tendons, and massage to increase blood flow to the affected area.

Non-steroidal anti-inflammatory drugs may be recommended, including over-the-counter anti-inflammatories like ibuprofen, to bring down the swelling. In more severe cases, steroid injections and surgery are sometimes necessary. 

Preventing sports injuries

Keeping the joints and connective tissue, like tendons and ligaments, strong, healthy and flexible may play an important role in preventing injuries to these tissues as well as facilitating healing. Exercises and stretches to keep this tissue strong and limber are very important. 

You may also want to consider taking supplements that support bone and joint health, such as Vitamin D, glucosamine, chondroitin, natural eggshell membrane and other natural ingredients. 

One of the best ways to prevent the various sports injuries mentioned in this article is to ramp up your physical activity slowly and gradually. Many of the conditions mentioned result when the frequency, intensity, or duration is suddenly increased, and the body does not have time to adjust and build up strength, flexibility and tolerance. 

Always warm up before participating in intense physical activity to increase blood flow to the muscles and joints, which may help prevent injury.

Clearing can help you stay active 

Whether you’re a weekend warrior, pro athlete or couch potato, Clearing recognizes that each person’s pain is unique. That’s why we’ve created a comprehensive healthcare platform to help you get the chronic pain relief you need. Start a free trial today with a treatment plan that may include a prescription compound cream and Personalized Home Exercise Program. Simply click the button below to get started.  

This article is for informational purposes only and does not constitute professional medical advice. Always seek the advice of your healthcare professional with any questions or concerns you may have regarding your individual needs and medical conditions.