Injury Management and Prevention

Similar to nutrition and health, the area of sports injury management is prone to myths and misconceptions. Here is a list of good resources that I will add to. Also, consult this list of myths and misconceptions in physio – those treating sports injuries should be following evidence-based practices.

General Resources

Achilles/Ankle

Back

Low Back Pain

Study Finds Yoga Can Help Back Pain, But Keep It Gentle, With These Poses (NPR Health, June 20, 2017, reporting on Annals of Internal Medicine Yoga, Physical Therapy, or Education for Chronic Low Back Pain

Calf

Hamstring

Proximal hamstring tendinopathy

Hamstring strains

Plantar Fasciitis

Shin Splints

Exercises for Medial Tibial Stress Syndrome (AKA ‘Shin Splints’) (Tom Goom, Runningphysio.com)

Shoulder

Here’s a good video on evidence-based practice featuring Dr. Jeremy Lewis PhD, FCSP, Consultant Physiotherapist and Professor of Musculoskeletal Research.  Observing tissue damage or a tear on a test doesn’t always correlate to a specific diagnosis.  You shouldn’t rush to surgery because of test results.

Taping

Sports Nutrition to Prevent or Help Heal Injuries

Nutritional Support for Exercise-Induced Injuries. Nice review article summarizing the evidence to date about nutrition for sports injuries. (Kevin Tipton, Sports Medicine, November 2015).

Can what you eat help sports injuries? Muscle and tendon injuries are common in athletes, and new studies are uncovering new rehabilitation and and diet strategies that can help muscle and tendon heal faster.  Exercise physiologist Asker Jeukendrup summarizes evidence presented at a recent conference for muscle injury and tendon injury. (Asker Jeukendrup, Mysportscience.com)

Here’s a great video explaining this research and other nutrition strategies for injuries by the folks at  Guru Performance.

Sports Nutrition to Prevent Stress Fractures

Prone to stress fractures? Consider your sports nutrition.
Weight bearing exercise is generally good for bone health, because bone responds to the stress of exercise by becoming stronger.  But some athletes are more prone to stress fractures than others, especially athletes who aren’t eating enough for the demands of their sport.

Female athletes who are underweight and amenorrheic often have decreased bone mineral density and are at increased risk for fractures (reduced estrogen limits the amount of calcium absorbed and laid down in bone). Also, late menarche (more common in female athletes) has a negative impact on bone health and increases stress fracture risk.

Although a variety of factors contribute to fractures, recent research suggests that what an athlete eats before, during, and after exercise can influence bone turnover. Making the right choices could potentially offset bone loss and prevent stress fractures.

Carbohydrates during exercise might benefit bones.  It is already firmly established that eating carbohydrates helps endurance performance; this week a study published in the Journal of Applied Physiology looked at how carbohydrates (8% glucose solution, similar to most sports drinks) during exercise influence bone metabolism during a strenuous 2-hour treadmill run. Researchers found that compared to placebo, runners who ingested carbohydrates during their run had reduced markers of bone resorption (breakdown). The effect was small and requires further study, but if you’re someone who goes without food/carbs during long workouts (and are prone to stress fractures), it seems this would be an good strategy to adopt, especially since carbohydrates will help other performance measures as well.   (Journal of Applied Physiology, October 2015)

Another strategy for bone health is a calcium-rich meal before exercise. Athletes lose calcium through sweat during exercise, which puts them at risk for bone loss, especially if their activity is non impact since it doesn’t benefit bones. A study in female cyclists found that eating a dairy-rich meal 90 minutes before riding can counter bone loss.  The pre-ride calcium-rich meal keeps blood calcium levels stable, so your body doesn’t borrow calcium from your bones to replace what’s lost in sweat. (PLOS ONE, May 2015)

Tendon Injuries – General

  • Pro tips for treating tendon injuries. Tendenopathy is a general term to describe inflammation and microtears in tendons: they are common injuries that can affect many tendons, for example like achilles tendons in runners, elbows in tennis, squash players, and golfers, etc. Treatment options are numerous and vary in their efficacy.   Alex Hutchinson looks at the pros and cons of various treatments in his Globe and Mail column, and examines the issue in his Runner’s World column: The Great Tendinopathy Debate. It seems the most effective option might be “eccentric strengthening,” which is also the least invasive, and the cheapest. Eccentric strengthening involves exercises that contract your muscle as it lengthens. (Alex Hutchinson in Globe and Mail and Runners World).
  • 10 things not to do if you have lower limb tendon pain. Good tips based on the latest research in tendon healing.

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Updated May 27, 2017

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