Scott C. Faucett, MD, MS, discusses the top three injuries seen in non-professional athletes (shoulder, knee, hip). He shares important prevention tips, such as easing into a sport after any period of hiatus, daily stretching, and recognizing the difference between good and bad pain.
Dr. Faucett also explains when you should seek medical attention for pain, whether from a sports medicine doctor, physical therapist or orthopedic surgeon.
Selected Podcast
Prevention and Treatment of Common Injuries Suffered by the Nonprofessional Athlete
Featured Speaker:
Scott C. Faucett, MD, MS
Scott C. Faucett MD, MS is a board certified sports medicine orthopaedic surgeon, and a member of the Medical Staff at The George Washington University Hospital and is affiliated with The George Washington University Hospital and GW Medical Faculty Associates. Transcription:
Prevention and Treatment of Common Injuries Suffered by the Nonprofessional Athlete
Dr. Michael Smith (Host): Welcome to GW Healthcast. I’m Dr. Mike Smith. The topic today is prevention treatment of common injuries suffered by non-professional athlete. My guest is Dr. Scott C. Faucett, MD. Dr. Faucett is a board-certified sports medicine orthopedic surgeon and a member of the medical staff at The George Washington University Hospital and is affiliated with The George Washington University Hospital and GW Medical Faculty Associates. Dr. Faucett, welcome to the show.
Dr. Scott C. Faucett, MD, MS (Guest): Thank you for having me.
Dr. Smith: Let’s first define what we mean by non-professional athletes. So when you hear that phrase, what does that mean to you?
Dr. Faucett: So, to me, that’s an athlete of any age who may be practicing a sport – whether it’s a team sport or an individual sport – but not with the accoutrement of what a professional athlete may have. So, professional athletes often have a personal trainer. They often will have a coach that’s individualized to them. They can help guide their training and getting ready for competition, whether that be a race or just a soccer match. And so…
Dr. Smith: Right.
Dr. Faucett: …without those resources, often the non-professional athletes are left to their own resorts to kind of make their training schedule and be prepared for whatever they're trying to do.
Dr. Smith: Yeah. So, let’s run through then what you think are the top three, you know, most common injuries and then tell us how the non-professional athlete can prevent them?
Dr. Faucett: Sure. So, I think the top three -- one would be involving the shoulder and that’s usually what we call rotator cuff syndrome or also subacromial bursitis. The second most common is patellar tendonitis or patella femoral syndrome, and then the last would be trochanteric bursitis or gluteal syndrome.
And so the shoulder, this is often – we see this a lot in cross-fit athletes who kind of just way overdo their exercises and in terms of their overhead lifting and strength, and they over exert themselves such that that the tendon does not have an opportunity to repair itself between workouts causing this overuse injury. I’ll go onto the knee next unless you had more follow-up questions about the shoulder.
Dr. Smith: Well, yes. So, obviously that’s going to be something that’s common, maybe like in the non-professional baseball player, you know, where there's…
Dr. Faucett: Sure.
Dr. Smith: …there's a lot of throwing or football players… there's a lot of….
Dr. Faucett: …volleyball players…
Dr. Smith: …tag football, volleyball players. So, you know, when you see that type of injury like what's the first sign that an athlete should say ok, I have an issue, and I need to start taking care of this because I think what happens is sometimes it's too late. They really have the injury; they're not taking care of it. So, are there minor signs maybe before the injury gets too bad that should clue them in that there's something wrong?
Dr. Faucett: That’s a great question. We really try and focus on prevention. So, getting back into a sport that you may have been out of -- it’s important to ease oneself into that sport. So don’t go full bore, full weekend tournament in volleyball and expect your shoulder to be ok if you haven’t been playing volleyball in the past. The first step is prevention and kind of easing into whatever activity – whether it's in the weight room or on the court. But, certainly starting to feel pain and discomfort and more than just an overuse soreness that you might get after a good workout in the gym is this kind of pain with any sort of activity – any sort of motion, and it's more located towards the joint rather than in what we would call the muscle belly. So, if it's actually in the joint, that’s where the tendons is rather than the muscle belly, which resolves more by a soreness, overuse type of thing which is normal with activity. To build muscle we need a little bit of soreness because that’s the micro-injury the muscle does to get hypertrophied or larger.
Dr. Smith: Right. Well, I think you're right – that one of the – whether we're talking about shoulder, knee, ankle, you know, whatever that common injury is, -- I think that the non-professional athlete, and I kind of put myself into this category – I'm a big softball player –
Dr. Faucett: [laughs]
Dr. Smith: -- but,
Dr. Faucett: Sure.
Dr. Smith: …but here’s the thing, though. I won’t play for maybe a couple of months and then I’ll go to a big tournament…
Dr. Faucett: Yes.
Dr. Smith: -- and so that’s the problem – and I go hard out, right? So, that’s the problem. So, I think you gave some great advice. Prepare for that tournament, right? Ease into it, play a couple of games before. Maybe a couple of innings – that’s a great approach, right?
Dr. Faucett: Yes, and as we age, our ability to be prepared for an event like that is lessened. So, it’s really important that before you go all out and at least you spend a few minutes stretching -- getting all of your muscles stretched out. It’s more important as we age than when you were 20; we could just go out and play a game.
Dr. Smith: I want to come back to that idea of warming up. Let's go through the injuries, though. So, we talked about the shoulder. Let's move to the knee. Tell us --
Dr. Faucett: Yeah.
Dr. Smith: -- the common injury there and how can we prevent that?
Dr. Faucett: The common injury there is runner’s knee, and it’s otherwise patella femoral syndrome, and this is just an overuse from the kneecap. It tends to do with fatigued strength in the upper thigh and buttock area such that the mechanics of running start to fall apart, and our body’s resilience to keep moving forward, overcome the poor mechanics in their knee and then the knee gets sore. We don’t know a lot about it, but we do know that they tend to have gluteal medius, or the butt muscle, and then the thigh muscle quad deficit in terms of endurance, and so the key thing there is finding an adjusted running, training program, specifically tailored to each person. So, not looking at, oh I read an article and now it said I need to hit these milestones to reach my half marathon. You’ve got to look at what is your running experience; what is your running technique; what’s your shoe wear, all these kinds of things and have a more individual kind of goal. So, it may take you twice as long to get ready for a half marathon, but that’s important.
Dr. Smith: Yeah. So, for the non-professional athlete who may not have the resources, as you mentioned, you know, the professional athlete does – especially for runners, right? The mechanics of how we run is very important, right? There's a right way to run, and there’s a wrong way to run and so what’s your advice there? Should someone who’s prepared for a marathon maybe spend a little money for a couple of sessions on the mechanics of running? Would you suggest that?
Dr. Faucett: I absolutely think that’s very helpful. Having – there are running shops in many metropolitan areas that will do a running analysis and kind of guide you in terms of your running technique. Running clubs that you can join for a little bit and still get some of those resources as well.
Dr. Smith: So, let's talk about the next or the third most common injury that we see and how can we prevent it that? Go ahead.
Dr. Faucett: That’s the hip, and that’s trochanteric bursitis, and that’s also due to a gluteal deficiency injury. That’s very commonly seen as pain on the side of the thigh, and that’s an overuse often with kind of stair climbing, and in today’s world, we sit in the office all day long. We spend a lot of time -- we’re not activating our gluts, and we develop glut deficiency, and so this is really the weekend warrior who develops this problem where they all day long they're sitting in their office and then over the weekend they want to go do some sort of activity--
Dr. Smith: [chuckle] Right.
Dr. Faucett: -- and the glut is just not – it does not have the endurance that it used to have.
Dr. Smith: Yeah, that sounds a lot like me and a lot of my friends, I think actually, Dr. Faucett.
Dr. Faucett: Sure.
Dr. Smith: Yeah, so, it sounds – so when it comes to preventing these injuries, you started to hit on something about warming up. This is -- it's interesting because we do know that there's benefit to warm up, stretch the muscles, but as we get older, there's the idea of having to warm up, just doesn’t sound fun anymore. So, how important is it that we stretch, we ease into the activity, and more importantly, what about, you know, even during the week when you're not as active – doing some stretching exercises? What do you think about all of that?
Dr. Faucett: I think it is very critical to be doing that. I recommend, you know, a morning kind of stretch session that you can do. Working on the Achilles tendon, working on the kind of the gluts, the IT band, the back, and then the shoulder stretching. So you can get these stretches online, but these will just help kind of relieve any sort of the aches and pains you may have during the week, and in particular before an event, spend least 10 minutes stretching the major muscle groups getting you ready for the event.
Dr. Smith: Yeah. Keeping our muscles nice and long and flexible--
Dr. Faucett: …and limber…
Dr. Smith: --is important, yeah as we get older, I think we all recognize it. It's just no fun doing stretches. That’s the problem, Dr. Faucett.
Dr. Faucett: (laugh)
Dr. Smith: If we (laugh) – and I guess yoga might be something people can also look into. That’s a great way…
Dr. Faucett: Yep.
Dr. Smith: …to get some exercise and stay limber.
Dr. Faucett: Yeah.
Dr. Smith: But, ok, so we know warming up’s important. We’ve got to stretch. That’s a great way to prevent things, but inevitably, some of us are going to get injured. When do we seek medical help, and when do we go to that – someone like you, not just the primary care physician? Give us some things – some guidelines there.
Dr. Faucett: So, often places if this becomes more problematic or there's at least, you know, a week, 10 days, I usually recommend trying if it's safe to take an anti-inflammatory – a brief anti-inflammatory to help with managing the pain and discomfort. Wrapping, ice and avoidance of the activity while still doing some of the stretching, I think, is important. If it's still not getting better after a week or so of that, then I do think seeking the care of a sports medicine doctor to get a referral for a physical therapist would be very helpful in terms of retraining that muscle and speeding up the recovery because what I see happens – is people will rest for a month and then they just go back –
Dr. Smith: Yeah.
Dr. Faucett: -- just as hard and unless we really focus on building the deficient muscle, you can get in a cycle, and it keeps getting worse.
Dr. Smith: Yeah. How important, you know, when – as a non-professional athlete, how important is it that I need to pay attention to the pain, right? I know that – I think this is important because there’s good pain, right? Like that soreness that’s important, but then there's bad pain. So, can you help us --
Dr. Faucett: Sure.
Dr. Smith: -- distinguish between the two?
Dr. Faucett: Yes. So, if you actually have pain over the muscle, that’s a good pain. That is pain that the muscle is using to get bigger and stronger. If you're having pain over the tendon or where it attaches to a bone, that is bad. That is tendon pain, and that takes – that’s more of a chronic overuse injury, and that is going to take more time to get better, and so if you feel like a tearing, searing pain over the tendon, where it attaches to the bone, that’s the problem.
Dr. Smith: Well that’s great advice. That’s good to know. So, Dr. Faucett, let's end this way. You know, as an orthopedic surgeon, what's the take-home message you’d like the audience to hear about preventing common injuries?
Dr. Faucett: So, it's important for us all to be active, and we need to continue to do that, but we need to do it in a safe manner and the slower you get into an activity, the better, and maintain, like I said, the importance -- maintaining stretch and flexible muscles is key and then when you do start to have pain and injury, seek medical care to help you recover quicker and get back to what you want to do and stay active.
Dr. Smith: Yeah, that was perfect. Thank you, Dr. Faucett for the coming on the show today. You're listening to the GW Healthcast. Please visit GWDocs.com to get connected with Dr. Faucett or another provider, or call 1-888-4GW-DOCS to schedule an in-person or virtual appointment.
This is Dr. Mike Smith; thanks for listening.
Prevention and Treatment of Common Injuries Suffered by the Nonprofessional Athlete
Dr. Michael Smith (Host): Welcome to GW Healthcast. I’m Dr. Mike Smith. The topic today is prevention treatment of common injuries suffered by non-professional athlete. My guest is Dr. Scott C. Faucett, MD. Dr. Faucett is a board-certified sports medicine orthopedic surgeon and a member of the medical staff at The George Washington University Hospital and is affiliated with The George Washington University Hospital and GW Medical Faculty Associates. Dr. Faucett, welcome to the show.
Dr. Scott C. Faucett, MD, MS (Guest): Thank you for having me.
Dr. Smith: Let’s first define what we mean by non-professional athletes. So when you hear that phrase, what does that mean to you?
Dr. Faucett: So, to me, that’s an athlete of any age who may be practicing a sport – whether it’s a team sport or an individual sport – but not with the accoutrement of what a professional athlete may have. So, professional athletes often have a personal trainer. They often will have a coach that’s individualized to them. They can help guide their training and getting ready for competition, whether that be a race or just a soccer match. And so…
Dr. Smith: Right.
Dr. Faucett: …without those resources, often the non-professional athletes are left to their own resorts to kind of make their training schedule and be prepared for whatever they're trying to do.
Dr. Smith: Yeah. So, let’s run through then what you think are the top three, you know, most common injuries and then tell us how the non-professional athlete can prevent them?
Dr. Faucett: Sure. So, I think the top three -- one would be involving the shoulder and that’s usually what we call rotator cuff syndrome or also subacromial bursitis. The second most common is patellar tendonitis or patella femoral syndrome, and then the last would be trochanteric bursitis or gluteal syndrome.
And so the shoulder, this is often – we see this a lot in cross-fit athletes who kind of just way overdo their exercises and in terms of their overhead lifting and strength, and they over exert themselves such that that the tendon does not have an opportunity to repair itself between workouts causing this overuse injury. I’ll go onto the knee next unless you had more follow-up questions about the shoulder.
Dr. Smith: Well, yes. So, obviously that’s going to be something that’s common, maybe like in the non-professional baseball player, you know, where there's…
Dr. Faucett: Sure.
Dr. Smith: …there's a lot of throwing or football players… there's a lot of….
Dr. Faucett: …volleyball players…
Dr. Smith: …tag football, volleyball players. So, you know, when you see that type of injury like what's the first sign that an athlete should say ok, I have an issue, and I need to start taking care of this because I think what happens is sometimes it's too late. They really have the injury; they're not taking care of it. So, are there minor signs maybe before the injury gets too bad that should clue them in that there's something wrong?
Dr. Faucett: That’s a great question. We really try and focus on prevention. So, getting back into a sport that you may have been out of -- it’s important to ease oneself into that sport. So don’t go full bore, full weekend tournament in volleyball and expect your shoulder to be ok if you haven’t been playing volleyball in the past. The first step is prevention and kind of easing into whatever activity – whether it's in the weight room or on the court. But, certainly starting to feel pain and discomfort and more than just an overuse soreness that you might get after a good workout in the gym is this kind of pain with any sort of activity – any sort of motion, and it's more located towards the joint rather than in what we would call the muscle belly. So, if it's actually in the joint, that’s where the tendons is rather than the muscle belly, which resolves more by a soreness, overuse type of thing which is normal with activity. To build muscle we need a little bit of soreness because that’s the micro-injury the muscle does to get hypertrophied or larger.
Dr. Smith: Right. Well, I think you're right – that one of the – whether we're talking about shoulder, knee, ankle, you know, whatever that common injury is, -- I think that the non-professional athlete, and I kind of put myself into this category – I'm a big softball player –
Dr. Faucett: [laughs]
Dr. Smith: -- but,
Dr. Faucett: Sure.
Dr. Smith: …but here’s the thing, though. I won’t play for maybe a couple of months and then I’ll go to a big tournament…
Dr. Faucett: Yes.
Dr. Smith: -- and so that’s the problem – and I go hard out, right? So, that’s the problem. So, I think you gave some great advice. Prepare for that tournament, right? Ease into it, play a couple of games before. Maybe a couple of innings – that’s a great approach, right?
Dr. Faucett: Yes, and as we age, our ability to be prepared for an event like that is lessened. So, it’s really important that before you go all out and at least you spend a few minutes stretching -- getting all of your muscles stretched out. It’s more important as we age than when you were 20; we could just go out and play a game.
Dr. Smith: I want to come back to that idea of warming up. Let's go through the injuries, though. So, we talked about the shoulder. Let's move to the knee. Tell us --
Dr. Faucett: Yeah.
Dr. Smith: -- the common injury there and how can we prevent that?
Dr. Faucett: The common injury there is runner’s knee, and it’s otherwise patella femoral syndrome, and this is just an overuse from the kneecap. It tends to do with fatigued strength in the upper thigh and buttock area such that the mechanics of running start to fall apart, and our body’s resilience to keep moving forward, overcome the poor mechanics in their knee and then the knee gets sore. We don’t know a lot about it, but we do know that they tend to have gluteal medius, or the butt muscle, and then the thigh muscle quad deficit in terms of endurance, and so the key thing there is finding an adjusted running, training program, specifically tailored to each person. So, not looking at, oh I read an article and now it said I need to hit these milestones to reach my half marathon. You’ve got to look at what is your running experience; what is your running technique; what’s your shoe wear, all these kinds of things and have a more individual kind of goal. So, it may take you twice as long to get ready for a half marathon, but that’s important.
Dr. Smith: Yeah. So, for the non-professional athlete who may not have the resources, as you mentioned, you know, the professional athlete does – especially for runners, right? The mechanics of how we run is very important, right? There's a right way to run, and there’s a wrong way to run and so what’s your advice there? Should someone who’s prepared for a marathon maybe spend a little money for a couple of sessions on the mechanics of running? Would you suggest that?
Dr. Faucett: I absolutely think that’s very helpful. Having – there are running shops in many metropolitan areas that will do a running analysis and kind of guide you in terms of your running technique. Running clubs that you can join for a little bit and still get some of those resources as well.
Dr. Smith: So, let's talk about the next or the third most common injury that we see and how can we prevent it that? Go ahead.
Dr. Faucett: That’s the hip, and that’s trochanteric bursitis, and that’s also due to a gluteal deficiency injury. That’s very commonly seen as pain on the side of the thigh, and that’s an overuse often with kind of stair climbing, and in today’s world, we sit in the office all day long. We spend a lot of time -- we’re not activating our gluts, and we develop glut deficiency, and so this is really the weekend warrior who develops this problem where they all day long they're sitting in their office and then over the weekend they want to go do some sort of activity--
Dr. Smith: [chuckle] Right.
Dr. Faucett: -- and the glut is just not – it does not have the endurance that it used to have.
Dr. Smith: Yeah, that sounds a lot like me and a lot of my friends, I think actually, Dr. Faucett.
Dr. Faucett: Sure.
Dr. Smith: Yeah, so, it sounds – so when it comes to preventing these injuries, you started to hit on something about warming up. This is -- it's interesting because we do know that there's benefit to warm up, stretch the muscles, but as we get older, there's the idea of having to warm up, just doesn’t sound fun anymore. So, how important is it that we stretch, we ease into the activity, and more importantly, what about, you know, even during the week when you're not as active – doing some stretching exercises? What do you think about all of that?
Dr. Faucett: I think it is very critical to be doing that. I recommend, you know, a morning kind of stretch session that you can do. Working on the Achilles tendon, working on the kind of the gluts, the IT band, the back, and then the shoulder stretching. So you can get these stretches online, but these will just help kind of relieve any sort of the aches and pains you may have during the week, and in particular before an event, spend least 10 minutes stretching the major muscle groups getting you ready for the event.
Dr. Smith: Yeah. Keeping our muscles nice and long and flexible--
Dr. Faucett: …and limber…
Dr. Smith: --is important, yeah as we get older, I think we all recognize it. It's just no fun doing stretches. That’s the problem, Dr. Faucett.
Dr. Faucett: (laugh)
Dr. Smith: If we (laugh) – and I guess yoga might be something people can also look into. That’s a great way…
Dr. Faucett: Yep.
Dr. Smith: …to get some exercise and stay limber.
Dr. Faucett: Yeah.
Dr. Smith: But, ok, so we know warming up’s important. We’ve got to stretch. That’s a great way to prevent things, but inevitably, some of us are going to get injured. When do we seek medical help, and when do we go to that – someone like you, not just the primary care physician? Give us some things – some guidelines there.
Dr. Faucett: So, often places if this becomes more problematic or there's at least, you know, a week, 10 days, I usually recommend trying if it's safe to take an anti-inflammatory – a brief anti-inflammatory to help with managing the pain and discomfort. Wrapping, ice and avoidance of the activity while still doing some of the stretching, I think, is important. If it's still not getting better after a week or so of that, then I do think seeking the care of a sports medicine doctor to get a referral for a physical therapist would be very helpful in terms of retraining that muscle and speeding up the recovery because what I see happens – is people will rest for a month and then they just go back –
Dr. Smith: Yeah.
Dr. Faucett: -- just as hard and unless we really focus on building the deficient muscle, you can get in a cycle, and it keeps getting worse.
Dr. Smith: Yeah. How important, you know, when – as a non-professional athlete, how important is it that I need to pay attention to the pain, right? I know that – I think this is important because there’s good pain, right? Like that soreness that’s important, but then there's bad pain. So, can you help us --
Dr. Faucett: Sure.
Dr. Smith: -- distinguish between the two?
Dr. Faucett: Yes. So, if you actually have pain over the muscle, that’s a good pain. That is pain that the muscle is using to get bigger and stronger. If you're having pain over the tendon or where it attaches to a bone, that is bad. That is tendon pain, and that takes – that’s more of a chronic overuse injury, and that is going to take more time to get better, and so if you feel like a tearing, searing pain over the tendon, where it attaches to the bone, that’s the problem.
Dr. Smith: Well that’s great advice. That’s good to know. So, Dr. Faucett, let's end this way. You know, as an orthopedic surgeon, what's the take-home message you’d like the audience to hear about preventing common injuries?
Dr. Faucett: So, it's important for us all to be active, and we need to continue to do that, but we need to do it in a safe manner and the slower you get into an activity, the better, and maintain, like I said, the importance -- maintaining stretch and flexible muscles is key and then when you do start to have pain and injury, seek medical care to help you recover quicker and get back to what you want to do and stay active.
Dr. Smith: Yeah, that was perfect. Thank you, Dr. Faucett for the coming on the show today. You're listening to the GW Healthcast. Please visit GWDocs.com to get connected with Dr. Faucett or another provider, or call 1-888-4GW-DOCS to schedule an in-person or virtual appointment.
This is Dr. Mike Smith; thanks for listening.