As you might imagine, we see a lot of athletes in the practice. They play baseball, football, basketball, tennis, cross-country, and other team sports. We have many who are engaged in personal fitness, such as jogging, weight training, and CrossFit. There is always a chance for injury, and my task is to assess each situation individually for the cause of the problem and treated appropriately. Often my charge is to also treat quickly because a team has an upcoming need for a particular athlete. No pressure, right?
"Finding your game" is what happens when you achieve optimum function at any level of fitness. I take particular pleasure in helping senior athletes maintain optimum function so that they can enjoy life as they should in the golden years, whether that means playing golf or tossing grandchildren into the air to hear them laugh.
When athletes and weekend warriors are injured, they may try to play through pain, hoping a painful elbow or low back will get better by itself. As a rule of thumb, the earlier a musculoskeletal injury is assessed and treated, the sooner healing can begin. An untreated injury can easily slide from "acute" into "sub-acute," and even into "chronic." Each phase has its own characteristics and challenges.
The acute phase lasts from 48 to 72 hours after injury. This phase is characterized by pain, inflammation, loss of range of motion, increased temperature around the injury and swelling. It is very helpful if I can get to a patient at this point of an injury. Early intervention may translate into shorter duration of loss of function. By the way, we typically use ice to reduce swelling at this phase of the injury, not heat, which could increase swelling.
An injury can become sub-acute at any point after that period. In this phase, the swelling decreases or disappears altogether and range of motion improves. The sub-acute phase can stretch out for weeks and even months, depending on the severity of the injury and the rehabilitation required. During this phase, we want to work on flexibility, postural retraining, non-weight-bearing strength/coordination training and pain management. I think many professional athletes spend the majority of their careers in the sub-acute phase of injury because their teams cannot do without them for long enough to complete healing.
Our culture screams at us on television and in print ads that pills are the answer. We pop aspirin, ibuprofen, naproxen and other NSAIDs (non-steroidal anti-inflammatory drugs) to mask pain—and get back in action. The demand is for immediate full recovery, promised by the manufacturer of the pills. Unfortunately, by numbing the pain of an injury, we lose touch with the body's signals. Without a "guardian" in place to keep us from overstressing a body part, we can easily worsen the original injury—and we won't even feel it until the NSAID wears off. I get particularly disgusted when I see someone on television purporting to have severe arthritis who says they just pop two Alleves and keep on going. This whole notion is crazy, and it is irresponsible to mislead people this way.
Besides silencing a self-protective dialog with our own bodies, NSAIDs have many documented negative side effects—particularly in the gastrointestinal
tract. Ibuprofen alone kills nearly 20,000 people annually from gastric bleeding. Perhaps the most important point to keep in mind is that NSAIDs treat only symptoms. They do not heal an injury.
The more effective way to deal with injury is to treat the cause. A thorough exam, imaging when needed, realignment of the skeleton, and assisting the soft tissue to heal naturally will yield superior long term results. When the cause of a musculoskeletal injury is properly treated, healing can begin.
If I am not familiar with a sport, I ask many questions about what is demanded of athletes who participate. This tells me a lot about the kinds of injuries that would be expected with certain activities, and it helps me to zero in on specific muscles, tendons, ligaments, and joints. This is an important part of the history of the injury.
The care and feeding of athletes is an important part of what I do everyday. Optimizing the function of all the levers and pulleys in the human body increases athletic efficiency, speed, and ability. I take great pleasure in hearing from athletes after we have treated them as they tell us about better speeds on cross-country events, better ability to jump or tumble in cheerleading, etc.
If you have an athletic injury, remember that diagnosis and treatment are better done early than late. Don't procrastinate. Find your game, and stay on it.