HERSHEY, Pa. — Injuries are a reality in any sport, from recreational leagues all the way to the pros. Whether they’re obvious, like a multicolored bruise or a broken bone, or more subtle, such as a concussion, injuries happen.
Penn State Health Sports Medicine physicians Dr. Douglas Leder, Dr. Stephanie Carey and Dr. Caitlyn Haines and certified athletic trainer Kourtnie White discuss six common injuries facing athletes, the modes of prevention and treatment available, and when to safely get back to playing.
AC sprain: Haines
Symptoms: The acromioclavicular (AC) joint can be sprained or “separated” when there is traumatic injury to the shoulder. Usually this happens with a fall or high impact to the outer shoulder area. The athlete experiences pain over the front and top of the affected shoulder.
Prevention/treatment: The best way to prevent an AC joint separation is avoiding high-force impacts. Treatment depends on the degree of injury and can range from conservative measures like anti-inflammatories and rest to surgery if the joint is significantly separated.
Return to play: Athletes may need some time off before returning, but others may miss little to no time if the sprain is mild and the shoulder exhibits full range of motion. Most important, players must be able to protect themselves from further injury, particularly during contact sports. Recovery time can range from one to six weeks unless surgery is needed.
Ankle sprain: Leder
Symptoms: An ankle sprain or injury to the various ligaments which stabilize the ankle usually occurs when an athlete stretches, falls upon or exerts their ankle in an abnormal way, resulting in stretching or tearing of the ligaments. It may result in a painful popping sensation followed by immediate pain and potential swelling of the affected area.
Prevention/treatment: To decrease the risk of ankle sprains, athletes should strive to
be well-conditioned before a season, and warm up with gentle stretching before a practice or game. Athletes also should wear proper footwear for their sport. Wearing protective braces or having the joint taped before playing can be beneficial for those with a history of ankle sprains. It’s important to rest to prevent further injury after one occurs. Icing, compression and elevation may help if swelling develops, and anti-inflammatory medications can reduce pain. An X-ray or MRI may be needed to determine the injury’s severity.
Return to play: Low-grade ankle sprains may require several days to weeks of rest, but it’s important to begin rehabilitation exercises as soon as pain is tolerable. Athletes should wear an ankle brace or have the ankle taped when starting rehabilitation to improve stability and prevent reinjury. High-grade ankle sprains can be treated with conservative measures, but high-level athletes who suffer severe ligament tears may benefit from surgery to return to sport sooner.
Concussion: Carey
Symptoms: Concussions are traumatic brain injuries typically caused by significant force to the upper body. Symptoms include headaches, confusion, dizziness, blurry vision, fatigue, irritability, mood changes and difficulty with concentration and memory.
Prevention/treatment: Wearing mouthguards and overall body strengthening exercises can help decrease concussions. When a concussion is present, mental rest is needed. Avoiding screens, such as phones and TVs, for 48 hours after injury is advised. Also avoid loud sounds, bright lights or activities that increase symptoms. If having difficulty sleeping, avoid napping. Physical activity should be slowly added as guided by an athletic trainer since it can help with healing.
Return to play: Resolution of symptoms can take a few days, weeks or months based on various factors. It can be dangerous if a second concussion occurs before the initial symptoms subside. When symptoms resolve, the player must complete progressive stages of physical activity to ensure it is safe to return.
Contusion: White
Symptoms: Contusions, or bruises, occur from blunt force trauma, often due to a collision with another athlete, playing surface, et cetera. Contusions are often painful, discolored, raised areas where impact occurred, potentially causing injury to underlying tissues.
Prevention/treatment: Immediately following impact, medical staff should evaluate a contusion to rule out a more serious injury, such as fracture or laceration. An ice bag and compression can be applied for immediate pain relief. Athletic trainers also may provide custom padding to protect the injury while it heals. It’s important to wear all protective equipment properly to prevent these injuries.
Return to play: Athletes who suffer from contusions often return to the field of play within minutes of incurring the injury. Temporary weakness of underlying muscles, however, may require longer rest and rehab prior to return. The affected area may require additional, temporary protection to encourage proper healing and pain relief.
Meniscus tear: Leder
Symptoms: The meniscus, a layer of fibrous cartilage between the bones of the knee, helps with shock absorption, weight distribution, stability and movement of the knee. While meniscus tears can be degenerative and occur over time, sudden twisting, pivoting or cutting movements can cause acute meniscus tears. Athletes may experience a painful popping sensation, followed by worsening pain, swelling and difficulty walking. Instability and “locking” of the knee may suggest a more severe meniscus tear.
Prevention/treatment: Athletes can work to prevent meniscus injuries by strengthening thigh and leg muscles before a season. Athletes should warm up and gently stretch before activities, progressively increasing the intensity and duration of activity. Patients experiencing a painful popping sensation after twisting or cutting should rest and apply ice to the knee. Elevation, compression and anti-inflammatory medications can help with pain and swelling. Using hinged knee braces may allow athletes to move with greater stability and less pain. If it is painful to stand or walk, X-rays may be needed to rule out fractures. With knee locking or other severe symptoms, an MRI can determine severity of a tear and rule out other soft-tissue injuries.
Return to play: In general, it’s best to rest for several days after a meniscus injury. When symptoms are tolerable and pain lessens, athletes may begin rehabilitation under the supervision of health care professionals. To return to play, patients should demonstrate the ability to perform sports-specific skills without pain, a painless range of motion and full strength. High-level athletes and those with severe tears may benefit from surgery.
Mental health: Haines
Symptoms: Athletes suffer from mental health disorders at rates similar to the general population. Sport-specific stressors can put them at risk for developing an anxiety or depressive disorder, including coaching or parental expectations, pressures surrounding body image and fear of injury. Symptoms vary widely among athletes, which is why it is important to include mental health screening questions as part of a pre-participation physical exam.
Prevention/treatment: Prevention is crucial in identifying athletes who may be suffering from a mental health disorder. Management of the athlete with a mental health disorder requires a multidisciplinary care team with help from coaching staff, athletic training staff, sports medicine physicians, therapists or counselors and, possibly, psychiatrists.
Return to play: Assessment of athletes’ mental health is needed to determine whether they’ll require time away from sports. If supported by their care team, they could return in a relatively short amount of time, but they should maintain frequent check-ins with athletic trainers and primary care physicians once playing again.
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The Medical Minute is a weekly health news feature produced by Penn State Health. Articles feature the expertise of faculty, physicians and staff, and are designed to offer timely, relevant health information of interest to a broad audience.
