Transcription:
Non-Contact Injuries in Sports

Introduction: Progressive, respectful, mentoring, compassionate. These are the values of Palmdale Regional Medical Center. And now we proudly present Palmdale Regional Radio. Here's Melanie Cole.

Melanie Cole: Welcome to Palmdale Regional Radio. I'm Melanie Cole, and today we're discussing returning athletes to sports following non-contact injury. Joining me is Kenny Gardner. He's a Physical Therapist at Palmdale Regional Medical Center. Kenny, it's a pleasure to have you join us today. And I want to make clear to the listeners that we are talking about non-contact injury. So if they're thinking football or, you know, collision sports and baseball or a soccer or hockey or any of those, that's not what we're discussing here today. So tell us about some of the most common, no contact sports injuries that you see every day.

Kenny Gardner: Yeah. Well first thanks for having me Melanie. You know, being in physical therapy and having played sports myself, you see injuries left and right. Just cause that's what sports come with. First off, most common things you're going to see are typically ankle sprains, muscle strains. Those are your more common ones. Joint, you can have joint sprain kind of things, too, if those are your more common ones. On top of that, the ones that are typically more would require more rehabilitation or more intense you'll see ACL tears, a lot of people for those, the MCL, which is another ligament in your knees, very common Achilles tears, knee dislocations, meniscus tears, and labral tears. Those are probably the biggest and most common that you'll see on that list. But the most common of all of them is an ankle sprain actually.

Host: Interesting. I wouldn't have thought that an ankle sprain, but it does make a lot of sense. And there's a lot of conditions and factors, Kenny, that go into injury and chronic injury and what we're talking about, non-contact injury. And you mentioned girls soccer players and overuse injuries. Tell us some of the most common reasons whether it's a baseball player and throwing, or why soccer girls are so at risk for ACL. Speak about that a little bit.

Kenny Gardner: Yeah, of course. I mean, obviously you can't avoid stepping in a pothole but when it comes to injuries that are a little less, you know, there's nothing that really caused it in a sense. You're most commonly going to find muscle strength issues. So a lot of times we can get really strong, but we have to know how to use our muscles. And then we have to have the right muscles that are strong. And on top of that, we have to have the right amount of mobility. So it's almost like if you're very stiff and you try to move, you're almost fighting your own body, but if you don't also have the strength to match that, you're also going to run into a lot more issue. So the good example, right? I think we see a lot of times in women's sports and, you know, you look at like women's soccer, right? A lot of ACL tears and part it is genetic. Women's hips typically sit a little wider, which does change the angle on the knee a little, which means they are actually have to be stronger. So they're kind of put in a tough situation where there, a lot of times it comes from hip strength. So they have to spend a lot more time making sure they stay strong just due to, you know, the genetic makeup of how their body is built.

Host: That's so interesting. And, you know, we really want our kids and our youth athletes to be involved in sports. So important. Give us some of your best advice because if they get taken out and we all know athletes really are into it, and they don't want to be taken out sometimes even because of concussion, what do you want them to know about prevention before we get into a little treatment for those let's speak about prevention, what can they do to prevent some of these injuries from happening?

Kenny Gardner: Yeah. So there's a few things. I mean, honestly, one of the biggest things is warm up properly. It's really common. Cause the challenge is when you sports and even as you start to get past youth sports in some more higher level, one of the things you encounter is a lack of proper like preparation. And so you run into the issue of, you're not even prepared to do something and then you're trying to perform at a peak level. So without warming up, you actually are setting yourself up to really fail. It doesn't mean you will, but you're increasing your risk. On top of that, I kind of call it a don't get your sport tunnel vision. I was a soccer player. I love playing soccer. I was blessed that I got to play other sports, which helped. But a lot of times people focus on a single sport. So you have your baseball player who just plays baseball, not inherently wrong. But what starts to happen is your body will develop imbalances. So by cross training, weight training, making sure you're keeping your body balanced, you'll decrease your risk of overuse or overusing one part of your body that can increase injury.

And one of my another piece, sorry I was going for three points here. The other one is, is I like to address kind of, not just the younger athlete, but also the older athlete of, you know, we typically call them the weekend warrior. This is huge. I see so many injuries. You know, you think about the 35 year old to tears of the Achilles tendon who was a basketball player. And, you know, I always try to say you can't do intense exercise one time a week and expect that you can maintain that. If you're a desk job, for example, the best way to prevent is you have to stay active and you have to stay mobile, that way when you go play your Saturday basketball league or your Sunday soccer league, you're not increasing your chance of injury because you're actually staying in shape and not trying to go a hundred percent when you do that once a week. And your body's just doing nothing the rest of the week.

Host: That's really great advice as far as cross training and sports specific training, because we know that, you know, athletes and even you mentioned soccer, like to really focus hard on the sport that they're good at. That's common in tennis and really football, all of them. So sports specific, chronic overuse injuries are so common. When these injuries do happen, and you've given us great advice about cross training and getting involved in other things and stretching certainly, when these injuries do happen, what's the first line of defense? As you start to notice, someone's getting a little knee pain. If they're a runner, or they're starting to get a little bit of pain in their arm, if they play baseball or gymnastics, what do you recommend they do first?

Kenny Gardner: Yeah. You know, typically if it's something really minor, you're just kind of thinking, Oh, my knees, a little sore. I usually, and I've worked with a lot of these myself with athletic trainers. A lot of times we have an athletic trainer available and they are also equipped in many ways. And so they can sometimes provide guidance with those things, when things starts to progress or they don't go away or they're getting worse, or there seems to be no resolution. And or if you really want to make sure that you're not causing any issues, that's what I typically recommend. You start to go towards, so typically things will start with your medical doctor saying, Hey, I'm getting this knee pain. They'll usually say, okay, I'll refer you to a physical therapist. And that's where we come into. The mix is one of the things we're trained in that a lot of people don't know is we are trained in movement. I mean, that's one of our primary things. And a lot of times when you come into our clinic, what we can do is help to identify the limitations or the strength imbalances, or sometimes it really is just overuse.

And sometimes it's just basic education. It can be literally an hour visit with a physical therapist to just talk about, it's an education moment to say, Hey, you know, you really got to calm down with how much you're doing, which athletic trainers also can do to balance that out is to say, look, you're overdoing things. But then if it's more than that, that's where we have great availability of physical therapists and these trained professionals who are, I literally went to school to identify those limitations in the body and to find the weaknesses and the find the stiff areas and to work on form and how you move. So, yeah, that's usually the best starting point and sort of the order. Really, if it comes to like really big concern, I usually recommend going to a trained professional, cause it's easy to try to want to look at a YouTube video, right. And want to utilize a video that's available for you. And those don't always address the issue cause that might not be your problem.

Host: Absolutely great point. That's true. And a lot of people nowadays try and diagnose their own issues. If somebody knows what it is, what do you recommend as far as ice, heat, bracing, wrapping. And I know they can speak to their athletic trainer about some of these as well, but what do you recommend if somebody does have some of these, they want to wrap their shoulder or their wrist, whatever, what do you recommend as far as ice and heat, bracing, wrapping all those?

Kenny Gardner: Yeah. So this is where you'll start to get some different opinions and some different things. I mean, really when you look at the research, ultimately the goal of when you use ice is to typically decrease inflammation and to decrease pain. With heat, you're typically looking to increase circulation into the area and it helps to prepare. So typically more you'll want to heat before activity, ice after. That being said that the, the true benefit of heat and ice is not dramatic. So it is not a solution. So I always try to educate well to say, ice there is a definite place for it, and it should be used in certain ways, but to be careful sometimes, and this goes with braces as well. A brace is what it's doing is it's replicating stability, right? It's replicating what you should have because you don't have it. But the longer that you have a brace, the more you become reliant on it and you'll actually get weaker.

Your joints can actually get more, have other issues because you're not using your own body. So there's the whole rice discussion. So this is a kind of put them together. There's the rice discussion, which is rest, ice, compression, and elevation. There's a newer acronym that I saw it was the acronym M E A T, MEAT to put it into a simple term is it's more dealing with that. Our bodies naturally have inflammation and it's dealing more with movement and to exercise and to stay active. And then, you know, with those things we can, I would like to combine them. If somebody has a bunch of inflammation in a joint, I try to say, Hey, let's put some ice on there to address that. Cause it's going to be limiting us from progression. If I throw heat on there, well, it's going to increase circulation. So that's another area that typically with just soreness after a game or something, yeah. He throw an ice pack on there. It's totally fine. But when it comes to bigger issues and bigger injuries, I typically recommend though, it seems basic. You could be limiting yourself in how fast you recover by using the wrong one at the wrong time.

Host: Wow. That's really, really important information. So does weight training and we've mentioned sports specific and cross training is weight training, a plus or a minus when you have joint pain or injuries from chronic overuse, do you want people to steer clear of the weights that I know you want them to see a professional because that's really the only way they're going to get truly better, but they're always looking for other things that they can do, whether it's dry needling or physical therapy, but they also want to know if they can lift weights.

Kenny Gardner: Yeah. Well, I'll tell you something. I lift weights. So hopefully it's good, right? No. yeah, there's definitely, you'll encounter some challenge with that and I know there's different viewpoints on those things. It honestly what it comes down to is it's a very variable answer for my athletes that I work with. I do recommend that they maintain a level of strength, your muscles help to support your joint. Now, how you achieve that, there's a lot of different ways. And so I try not to get too specific. It does get pretty per person with some of these things because as your weight increases with lifting, any small flaw in your form becomes more exacerbated and increases your risk of injury more dramatically. So a good common exercise we see is called a dead lift. For those who don't know what it is, you can obviously go look online, you'll see a lot of different ways it can be done.

That move done in properly is extremely, extremely challenging on the back and can put a lot of stress there. So if I have someone who has poor form with a dead lift, I would say, do not lift weights, doing a dead lift. So you have to be careful with just saying, Hey, yeah, go weight, lift to help. But our muscles are what support our body and provide strength when we move. It's what gives us explosiveness. It's what gives us stability. So I do actually support the use of lifting and using, but within the range, I mean, if you're a soccer player and you weighed 260 pounds and you're 4% body fat, so you're just pure muscle, you actually can run the issue of having that much pounding of weight on your body, won't be good. But then you put that guy in on as a tight end on a football team. He's exactly what you should look like. Right. So there really is a balanced per sport.

Host: Well, there certainly is. So wrap it up for us. Give us your best advice for returning athletes to sport, following non-contact injury and really how is returned to play after an injury determined? What do you want to tell these youth athletes and their parents about returning to play and when they need to see a professional?

Kenny Gardner: Yeah, yeah. I mean, in all actuality it's, if there's ever concern there's people available. And so if there's ever even a doubt, I typically recommend it. It can very simply be one visit to your physical therapist. It could be an hour session just to real quickly. And just to get an assessment on something to say, Hey, like, this is something that, because part of what we do is we provide an assessment to say, do you even need physical therapy? But yeah, so it depends on the severity of an injury. But really there's a lot of different avenues from athletic trainers to PTs and surgeons. When it comes to more intense injuries, you typically go through your medical doctor who we are connected with as well as physical therapists. We are the ones who typically provide the assessment for the medical doctor. So we work as a team. But really when it comes to returning to sport, it depends on what you're trying to do. But I typically advocate for patients. People really, really, I mean, if I have a 13 year old, who's dying to get back to this sport, I honestly make sure to educate on patients, every single visit.

I was an athlete. I ignored some of the stuff I was told sometimes. And I, I mean, it's slowed my ability to get back to my sport quickly. And so we need to build ourselves on patients to make sure that we are fully prepared to return to what we were doing because with a non-contact injury, if you got hurt previously, that means you weren't in a proper place previous. So if you recover back to where you were, you're still in a place where you have too many deficits and you need to actually regain and improve beyond where you were. So really it's patients and making sure you're totally prepared, which sometimes requires medical advice. And sometimes it does require just listening to your body.

Host: Well it certainly does. And what great advice we got here today, Kenny, thank you so much for joining us today and sharing your incredible expertise. And that concludes another episode of Palmdale Regional Radio. With Palmdale Regional Medical Center, please visit our website at palmdaleregional.com for more information, and to get connected with one of our providers. Please remember to subscribe, rate, and review this podcast and all the other Palmdale Regional Medical Center podcasts. Physicians are independent practitioners who are not employees or agents of Palmdale Regional Medical Center. The hospital shall not be liable for actions or treatment provided by physicians. I'm Melanie Cole.