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Head, shoulders, knees, and toes. If you’ve been anywhere near a young child, you’ve certainly seen a version of the body-parts dance. It may as well be a performative guide for those who enter the world of sports medicine. Be it basketball season, the heat of a baseball summer, or — deep breaths — football in the fall, sports bring injuries. Yes, to heads, shoulders, knees, and toes.
We asked Dr. Wesley Owen, a sports-medicine physician with Campbell Clinic, about the most common injuries he sees, and what athletes — from park-walkers to marathon-runners — can do to avoid them.
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Ankles
Whether you roll it while scoring a game-winning touchdown or simply misjudging a curb on a dog walk, the ankle is a joint that almost begs for mistreatment. Small bones connected to small muscles by small tendons. And an ankle can rotate only so far.
“Ankle injuries affect everyone from weekend warriors to professional athletes,” emphasizes Owen. “Treatment will vary based on the severity of an ankle sprain, from a wrap to help with compression and swelling, to a period of time immobilized in a boot, maybe with crutches.”
Consider the weight our ankles must support (virtually our entire body). And the range of motion we demand, especially when running, jumping, pivoting, even stopping. “People can have ankle weaknesses that predispose them to injury,” explains Owen. “People don’t put a lot of emphasis on conditioning the ankle with specific exercises to decrease the chances of an injury. Now, after an injury, they’re very mindful about it.”
☛ One easy-to-practice ankle exercise: Pretend you’re writing the alphabet with your front toe. Balance is also critical to ankle strength. Standing atop an exercise ball, or even a pillow, will force your ankles to flex in healthy places. “Small movements will help strengthen ligaments that are stretched,” says Owen. “Unfortunately there’s a rubber-band factor. Once you sprain your ankle — and stretch those ligaments — you may be predisposed for more sprains.”
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Lower Back
The lumbar spine is made up of five vertebrae. If you’re active and of a certain age, you’ve likely heard from all five. It could be a sprain, a slipped disk, or a spasm that locks your body into a position not conducive to an active lifestyle. “We don’t think of degenerative disk disease with younger patients,” says Owen. “They typically have more of an acute injury, whether it be a lifting motion, or a jerky, twisting motion. And this could lead to a strain or bulging disk. If it’s large enough, it could cause issues with nerve or cord compression.”
While a weight room sees its share of back trauma, the lower back can be victimized by overuse, and nowhere near a barbell. “Athletes that do a lot of repetitive motions — gymnasts doing back handsprings or pitchers leaning back to throw a baseball — can develop issues of stress fractures that cause lower back pain. It’s a buildup.”
☛ How to avoid lower-back trauma? It’s not all that different from conditioning ankles: stretches and range-of-motion exercises. And no, hundreds of sit-ups to strengthen your core aren’t the answer. Owen suggests static holds like planks and bridges (there are numerous positions for these). “Rotational movements with a medicine ball or resistance band are proper core exercises,” he adds.
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Elbows
Have you heard of lateral epicondylitis? You’ve more than likely felt it. As Owen describes the stress: “Inflammation of the common extensor muscles of the forearm where they attach to the lateral epicondyle of the elbow.” We call this tennis elbow in polite company. And you don’t even need to own a tennis racket for the discomfort to change the way you pick up a coffee mug or turn the steering wheel of your car.
“This isn’t necessarily an injury,” notes Owen. “It’s in the realm of repetitive overuse for any type of swinging or lifting. The pain tends to generate on the thumb side of the bone. But there’s also a lot of dysfunction with gripping of the wrist and lifting of the wrist in certain movements.”
☛ Strengthening the forearm, often with resistance exercises, goes a long way toward preventing recurrences of tennis elbow. “A lot of it comes down to proper mechanics with swinging or lifting,” says Owen. Campbell Clinic has technology — as does the University of Memphis — that can evaluate, measure, and quantify an athlete’s mechanics in a performance lab.
Next time you hear a baseball analyst talk about a pitcher’s “mechanics” being awry, know that there’s more at stake than a ball or strike. “Mechanics are often thrown out the window,” adds Owen. “People simply want to lift as much as they can or throw as hard as they can, and that usually leads to issues.” (YouTube offers a plethora of videos on mechanics in several sports. Keep in mind, though, that techniques will vary based on your body type.) Warming up before activity and cooling down afterwards are additional ways to keep the “tennis” out of the elbow.
image courtesy dreamstime
Brain
There’s a fourth area of the body where Owen emphasizes special care and attention for athletes of any age: the brain. A concussion — fundamentally a bruise on your brain — is not strictly a football injury. Owen sees these in athletes from any sport with any degree of impact. (They’re a big problem in women’s soccer.) He and a team of colleagues manage and treat concussions, and Owen notes that every brain injury is like a snowflake: unique unto itself. Treatment varies. Recovery time varies. But let it be said from the mountaintop: There’s more at stake with a brain injury than those to an ankle or elbow.
“The biggest thing is getting a quick evaluation,” says Owen. “Whether that be on the sideline with a licensed medical trainer or getting in to see a doctor as soon as possible. We can work on cultivating the right treatment for the individual athlete. We want to decrease the likelihood that they’ll try and self-return to the sport too soon, risking re-injury or a more catastrophic outcome.”
There’s an added layer Owen sees to the challenge of addressing concussions, particularly in young patients. “We’re often dealing with student-athletes,” he notes. “We talk about rest, both cognitively with school and also the rest from sport. Some activity level will be tolerated. But there are some activities they simply won’t be allowed to do. We treat symptoms and we track progress. There could be worsening anxiety or worsening depression. We aim to manage all those symptoms, with medications if indicated, but also from a psychological standpoint.”
Ankle, back, elbow, and brain. They don’t lend themselves to a performative dance in quite the way other body parts have. But they’re worth the extra care and attention. Be ready for your next game.
