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Common Injuries in Nonprofessional Athletes

Non-professional athletes boast fitness and endurance in their fields. However, they are not immune to sports injuries.

Dr. R. Amadeus Mason, sports medicine physician, discusses common sports-related injuries, how to treat them at home, and when to seek medical attention.
Common Injuries in Nonprofessional Athletes
Featuring:
R. Amadeus G Mason, MD
R. Amadeus G Mason, MD is an assistant professor in the Orthopaedics and Family Medicine departments at Emory University. He is board certified in Sports Medicine and a registered MSK ultrasound specialist with a special interest in track and field, running injuries, soccer and biologic injections. He did his undergraduate at Princeton University, Medical school at Howard University and Sports Medicine Fellowship in Birmingham AL, with Dr. James Andrews. Dr. Mason is the Team Physician for Georgia Tech and Emory University Track & Field and Cross Country; and a Team Physician for USA Track & Field, and the National Scholastic Athletics Foundation. Dr. Mason also serves as a Sports Medicine consultant in his homeland of Jamaica and as the Chief Medical Officer for USA Track and Field at international competitions.

Learn more about R. Amadeus G Mason, MD
Transcription:

Bill Klaproth (Host): From ankle sprains to hamstrings strains, from shin splints to slipped disks, nonprofessional athletes face a variety of common injuries and here to talk about common injuries in nonprofessional athletes is Dr. Amadeus Mason, a sports medicine physician at Emory Sports Medicine Center. Dr. Mason thank you so much for your time. I appreciate it. So, when it comes to sports injuries, which injury do you treat most often?

R. Amadeus Mason, MD (Guest): I think the injuries that we treat most often are sprains or strains especially to the lower extremities. Talking about the knee or the ankle in particular.

Bill: So, those running, jumping that really takes its toll on your legs, that’s for sure. So, when it comes to those soft tissue type injuries; you just mentioned strains and sprains; what do we need to know?

Dr. Mason: What you need to know is that actually most of these sprains and strains are self-limiting. They are things that happen in the natural course of being active and out there and if you do the appropriate things; most of the time, they will resolve on their own.

Bill: So, resolving on their own and appropriate things, is that the RICE therapy, people can do this at home, the rest, ice, compression, elevation?

Dr. Mason: Yes, exactly. The RICE therapy is something that you can do on your own, that usually will give you a good improvement of these soft tissue injuries like sprains and strains and as long as you are following in that kind of a progression; it should resolve, but then sometimes, if it’s not responding, you then need to go on and do some other things.

Bill: So, if it’s not responding after a period of time, when should a person seek medical treatment?

Dr. Mason: I think if – you should seek medical treatment when you have attempted to do some kind of conservative intervention, that’s the RICE therapy, maybe some rest and then trying to get back to your activity you are either having pain during that activity or there is a limitation in your function that is not letting you get back to the previous level that you had before the injury. And I think that you need to know that just rest alone is not going to get something to heal. You have to do some activity like the RICE therapy to try and get the injury to heal itself.

Bill: So, let’s talk about more severe injuries. Let’s shift to that. When it comes to actual tears then, such as ACL or rotator cuff injuries; what should we know about that?

Dr. Mason: When you have torn something clearly you have kind of hit that threshold of you’ve tried to do the conservative treatment and it’s not getting better. The big thing there that you should know is that ignoring it does not make it better. You really need to get that looked at and investigated. When you have torn something; you usually have a higher level of impairment of function. If it’s your ACL; the knee feels unstable. If it’s your rotator cuff; you can’t lift your arm the way that it should. And if something like that is happening; you will very quickly see that the RICE therapy and rest is not getting that improved and that’s when you have to get into see somebody who is skilled in evaluating those injuries to get that addressed.

Bill: Ignoring it doesn’t make it better. I like that. So, and it sounds like if you have a severe injury like an ACL or a torn rotator cuff; like you said, there is going to be so much instability, you are pretty much going to know it and know that you have to go see the doctor. So, what about disk and spine injuries Dr. Mason. What should we know about that?

Dr. Mason: Disk and spine injuries are – they are a lot more difficult because they can be a lot more subtle in that some pretty significant disk injuries don’t give you back pain. I think that’s the biggest takeaway that disk and spine injuries don’t always give you back pain initially. A lot of times, it will give you calf pain, leg pain, foot pain, shoulder pain and that is a harbinger of a deeper more remote injury to your back or to your spine.

Bill: So, watch out for that referring pain, is that right?

Dr. Mason: Yes.

Bill: Okay, very good. And how do you generally diagnose sports injuries? Is it by feel, examination or generally do you have to take it up a notch to potentially an MRI or an x-ray?

Dr. Mason: Well, the way that you diagnose – when I talked a little bit earlier about going to somebody who is skilled in treating these injuries; somebody like a sports medicine physician who knows the history, the questions to ask and the physical exam to do, you can get a good understanding of what the issues are from just asking questions and doing a physical exam. In my hands, usually, I will order an MRI or additional imaging to confirm my suspected diagnosis or to do surgical planning.

Bill: And Dr. Mason when RICE therapy on their own doesn’t work, and they come to see you; what are the next steps then? Is it physical therapy and medications?

Dr. Mason: Well what physical therapy and medications should be doing, should be augmenting and easing the progression back to your activities. So, what happens when you injure a part of the musculoskeletal system is you lose a pain-free function. You now have pain when you try to do things. What therapy does is it puts you through those ranges of motion and function in a controlled environment and gives you the support to be able to get and reeducate those muscles, ligaments and tendons on how to fire safely to do the function. And assuming that that goes well, you return back to your activities. Where the anti-inflammatory or medications come in is they help to alleviate pain. A lot of patients always say oh I don’t want to take the medicine because it’s masking the pain. It’s not masking the pain, but it is decreasing the pain to allow you to then do the motions that are normal and that you want to reinforce and get back to doing.

Bill: Well that makes sense. And does physical therapy work most of the time for most nonprofessional athlete injuries?

Dr. Mason: Some form of physical therapy because we go back to our RICE therapy that or rest, ice, compression and elevation, those are all principles that the physical therapist will be using and in some avenue, either going further down the line with different types of compression, different types of heating modalities and so for most things I’d say 70-80% of things with physical therapy you should be able to get back to normal function or near-normal function.

Bill: And then can you touch on surgery a little bit too?

Dr. Mason: Okay, so that 20-30% of injuries that are not getting better conservatively; that’s when you have to go in and do a surgical procedure. Those usually involve some kind of tear to a structure or significant damage to tissue in the area. And what surgery normally does is return or try to restore normal architecture of the tissue, put the ligament back together, put the – close the gap in the tissue, try to approximate the ligament the way that it should be or the tendon the way that it should be. Now once the surgery has done that; you still have to come back and do physical therapy because that’s kind of the final common pathway to get you back to your normal function.

Bill: And with advancements in surgery, a lot of these operations have become more commonplace, so the prognosis is usually very good for someone who has an ACL or rotator cuff or an ankle injury etc. Is that right?

Dr. Mason: Yes the prognosis of the surgical procedures has gotten much better in that we are now able to – we have a better understanding of what the physiology and the pathophysiology is so we can restore things back to normal and have a better understanding of what normal function is beforehand so we know what we are trying to get back to.

Bill: Very good and lastly Dr. Mason, if you could just quickly wrap this up for us. How can a nonprofessional athlete prevent some of these common injuries?

Dr. Mason: The big thing with preventing these injuries is trying to prepare yourself for whatever activity you are going to do. Have a plan as to how you are going to get to that activity. A lot of times, people will say alright I want to go run a 10K or I want to go back to playing basketball like I did in high school. If you haven’t been doing that consistently; you need to prepare your body for those different kinds of stressors. You wouldn’t go on a long trip across the country in a car without preparing your car for that trip. Same principle for doing a difficult or a focused physical activity that your body is not used to doing. You should prepare yourself for that and that should help you to reduce your injuries.

Bill: So, preparation is the key. That is great advice Dr. Mason and thank you for your time today. For more information please visit www.emoryhealthcare.org/orthopedics, that’s www.emoryhealthcare.org/orthopedics. You’re listening to Advancing Your Health with Emory Healthcare. I’m Bill Klaproth. Thanks for listening.