Transcription:
Sports Injuries - Prevention and Treatment

Melanie Cole (Host): You know they tell us to stay active and how great it is to stay active and they tell us that it’s great for our children to be in sports. But then there’s sports injuries and they can take you out of the game pretty quick. Or if you’re an older weekend warrior, and you get an injury, boy it can keep you from exercising for a very long time. Here to tell us how to prevent sports injuries is Kyle Mrohs. He’s a physical therapist at Henry Mayo Newhall Hospital’s Golden Valley Physical Therapy Clinic. Kyle, first I just want to ask you about the field of sports medicine. Does it only help athletes or also like I was saying, the weekend warrior, those of us who like to go on the treadmill and do yoga?

Kyle Mrohs (Guest): No, it’s definitely going to apply to everyone whether they are like a top athlete or just someone who wants to get started with something. I would think of it like this. If you went to go see a doctor for your heart, right, you would go to a cardiologist or like a heart specific doctor. And if you wanted to see someone regarding like your kidneys, you would see a nephrologist. If you want to go and see a medical practitioner that is talking about physical fitness or just kind of moving and grooving; then that’s when a sports medicine doctor might be relevant.

Host: That’s a great explanation. Thank you for that and helps clear that up because some people think well you know I’m not going to really go see someone in sports medicine because I don’t really play sports. I just like to work out. But tell us about the conditions that you see every day, some of the common conditions and the factors that lead to the injuries that you see.

Kyle: Gosh, that’s a loaded question. Because everyone is different. And everyone is coming to see us for like many, many different things. But in our practice, or as an outpatient orthopedic field; we are going to see basically muscle joint issues. So, that could be everything from foot pain, ankle pain, knee pain, hip pain, back pain, all the way up to the top of your head. So, I can’t really say whether we see one thing more than the other, but we do treat a lot of spines, we treat a lot of knees, shoulders; things of that sort.

Host: What are the most common reasons for people to get that – when I mentioned weekend warriors, that’s people who don’t always have the adequate fitness level to go participate in whatever it is that they do and our athletes, our youth athletes with their chronic overuse and their sport specific training. What do you think are some of the reasons that we’re seeing so many more of these sports injuries?

Kyle: Well, to speak on the first ones, so say the weekend warrior group. So, you take someone, and they are relatively sedentary from 9-5, Monday through Friday, let’s say that’s one’s schedule. And then Saturday comes, it’s a great day and they are like I’m going to go run a certain distance. I’m going to do this today. But they haven’t prepared themselves for that all week long. And they go from literally zero to 60. You could imagine how that might be just more than the body can handle and then they’re going to have some type of ache or pain after that. So, that’s kind of the weekend warrior way that people can get injured. They go too fast, too soon without the adequate preparation.

And then for the overuse injuries, you can imagine I’m someone who has been doing the same sport for ten years and I went from a certain level to now a more advanced level. But all I do is this one particular task. All I do is this one particular sport. And so you can imagine our bodies get maybe overused in the sense of you’re always throwing the same way, you are always running the same way and you are never conditioning yourself to handle – to work the opposite side of your body.

So, we have a lot of things in our body that do a certain thing, right, we call them agonists. This muscle goes this way. It makes your bones go this way, but we also have antagonists. Things that do the opposite and when you want to condition your body, you need to make sure that both parts, the agonist and the antagonist are equally strong, if not, sometimes more strong in the antagonist part so that you are able to balance your body out.

Host: Wow, you’re a great educator, Kyle. So, let’s talk about our kids now, because as I said in the intro, we want them to be involved in team sports. It’s really good for sportsmanship and self-esteem and fitness level and all of those things. But then the injuries that we are seeing. Some kids are doing too much sport specific training. What recommendations do you give say my son, the gymnast about only training for one sport, all year round?

Kyle: Yeah, so, that is something that we’re seeing a lot more of and not just for gymnastics, but every sport, right? Soccer, baseball, football, any of this kind of stuff. Running. And so, maybe in the past, people would do a sport for a season and that season would be what three months, maybe six months? They would start it, they’d condition for it, they’d do the sport and then they take some time off and go be kids and go do other stuff, right? But now, we’re seeing people who are doing the sport, not just for three months or six months, but for 12 months and then 12 months stacked upon 12 months and then 12 months stacked upon another 12 months.

And you could just imagine how the sense of fatigue sets in and not just oh man I’m tired, but my joints are tired, my muscles are tired, my ligaments are tired and so if we don’t give the body adequate time to rest; then those things that get let’s say stressed, those things continue to get stressed and then stress can go from an acute flare up where oh I have a small pain to, I always have pain. My elbow always hurts. My back always hurts and then that just kind of keeps on going on and on.

So, it’s important to let the body rest and it’s important to let things be seasonal if you will. In addition, it’s also important to think of well, let’s say – let’s taking throwing for instance. I throw with my right arm and I throw, and I throw, and I throw and then I play during a game and I throw really hard and then I go to practice and I throw maybe a little bit less hard, but then I throw hard again, so on and so forth. What am I doing for my left side of my body? What am I doing for the other parts of my body that are involved in that throwing? Or am I only thinking about my right arm?

We use a term myopic right? You’re looking at just one thing. You’re not looking at the whole thing and so with throwing, for instance, you got to talk about the spine, you have to talk about the hips, you have to talk about the core and not just oh, is my arm strong. If we only think about that one part of your body, that part is going to get worn out and so we can let people do their sports longer if we help condition so that they can work on all the other parts of the body and not just exhaust that one part that they are thinking of.

Host: So true. What great advice Kyle. Now, we’ve got these injuries and as I said my son’s a gymnast, so I’m forever doing various modalities to help him. What do you like? If somebody does feel those chronic injuries or they have an acute injury but it’s really not bad enough to take them off to the ER. What do you like? Do you like ice? Are you a heat guy? Do you like bracing, wrapping? What do like us to do for some at home treatments?

Kyle: So, I like to start with the least invasive and then go from there, right? So ice and heat are great like frontline or first line of defense that we can use. Some easy recipes to remember is basically if something is red and swollen and bruised and hot; then you want to cool it down and so you want to use ice. So, if you roll your ankle or you get a bruise or this or that, you are going to want to use ice and not heat. Heat is going to come in later when things aren’t inflamed, and they are not swollen. And if you use it too soon, then it’s only going to make things worse. So, let people know that for sure.

As far as any medications, in physical therapy, we don’t prescribe medications and so that’s out of my purview. But you can always talk to your physician about that. Because people might have other health considerations. But basically, there’s like a recipe where they talk about PRICE. They say P-R-I-C-E. So, Protect, Rest, Ice, Compression and Elevation. You can’t do that to every part of your body. So, for instance you can’t elevate your chest, but you can lay flat for instance. But if you roll an ankle as an example, you could wrap it up tight, put some ice on it, lift it up above your heart so that the swelling can get out of there and then you can also just let it rest and not put anymore stress on it for some time being. And that will help kind of calm down that initial stage of the injury.

Host: That’s great information and so helpful because people are never quite sure whether they should use heat or ice. I’ve been asked the question a million times. So, you really cleared that up very well. When is it you want people to see a doctor for an injury and then to get a referral to physical therapy?

Kyle: So, it depends on the injury and the sport that you were playing. But let’s just go over the big scary stuff. So, if you lose consciousness, if you are having trouble seeing, if you are bleeding profusely, if your leg is so swollen that it looks like it’s going to pop or if you’re walking really painfully or cannot walk, these are all the times when you definitely want to go see a doctor and sooner than later.

Host: That’s important information for listeners to hear and how do you determine as a physical therapist, return to play after an injury? What are you looking for before you are going to sort of set someone back out on their own or because athletes, they want to get back, but you may not give them the okay. What are you looking for?

Kyle: So, from the very beginning when a person comes in, we’re always looking for how they are doing and progressing towards getting back to whatever they want to get back to, whether it’s throwing or running or jumping or playing just in general. So, the things that we will be looking for is to make sure that they have all the range of motion that they need to whatever part of their body it is, making sure there is no swelling, making sure that they are strong enough and that they are fast enough, and they are comfortable enough with whatever demands they might need to put their body through. Whether it’s jumping off something or running really fast and then stopping and then changing direction.

And so, we have a bunch of different tests that we can put someone through, kind of like running them through the paces to make sure that they are able to do what they need to do out on the field, but in a safe controlled environment where if something should come up, we can always fix it there and then before they go and meet a competitor. And so, the physical therapists will be working with the person to get them ready for that level and then before they are done with us; we should put them through those tests to give them a sense of confidence that heh, I got this, I can do those things.

Host: Wow, great information and I can really hear the passion in your voice Kyle. So, as you wrap it up for us, best advice for prevention of sports injuries, for staying active and what you want people to know about the things that they can do to help avoid some of these injuries we have been discussing.

Kyle: What I’d like people to do is I’d like them to listen to their bodies and I’d like them to know that pain, if they feel pain, is something coming from your brain letting you know heh, something doesn’t feel right, something got stretched too much, something got loaded too much and I don’t feel good right now. And to not just press through it and ignore it and think oh, pain is weakness leaving the body or no pain, no gain. Because when we go into those types of really tough guy mentalities then that’s when things get hurt and ignored and then it turns into a chronic situation. And that’s no fun for anyone.

And so, I want them to know heh, pain is an issue and it’s something where if you feel it, then you should talk to someone about it whether it’s a doctor or a physical therapist and then come on in and we can help sort it out and get you back onto the field playing better.

Host: Great information. Thank you so much Kyle, for coming on. People really want to get involved in sports and they want to work out. They just don’t want to have the aches and pains that go along with it. You’ve given us really good advice today. Thank you so much for being with us today. You’re listening to It’s Your Health Radio with Henry Mayo Newhall Hospital. For more information, please visit www.henrymayo.com, that’s www.henrymayo.com. This is Melanie Cole. Thanks for tuning in.