Injury treatment

October 07 2015

Unfortunately, sporting injuries are fairly common. However, if you do injure yourself it’s important to find the right treatment to help get you back on the road to recovery. Sports physiotherapist Paul Martin has worked with Olympic, Paralympic and World Champions in sports from athletics to squash and we spoke to him recently about sports injuries and treatment. Read more about Paul and the other English Institute of Sport (EIS) coaches here.

How do injuries occur?

Despite trying to cover all bases, injury is often a part of an athlete’s career. Injuries tend to occur when load exceeds the tissue’s capacity to absorb the work it is subjected to.

This can mean:

  • Volume of training (especially during increases in training volume that the body struggles to adapt to – sport specific and/or gym-based)
  • Overload of specific tissue due to stiffness in other areas (e.g., stiffness in the joints of the foot can lead to forces being resolved around the shin, which can lead to stress responses in the bone)
  • Rapid changes in training intensity
  • New/unusual movement patterns or technical changes which may put more strain on previously less-loaded structures
  • And external trauma (e.g., blunt force, slipping).

What should I do if I get an injury?

Firstly, get assessment and advice on the problem itself. A qualified physiotherapist will determine which structures are affected, why the injury occurred, how to overcome the injury and how to help prevent it happening in the future.

As far as training is concerned, think about any other areas you can work on while your injury compromises certain activities. If you have an ankle injury, for instance, is there some scope to work harder on your trunk control that you know you need to improve? What are your options to maintain cardiovascular fitness? Are there technical elements of your sport you need to maintain whilst you are injured so that on your return you are close to performing at your pre-injured level?

Make sure you understand any exercises or stretches you are given, why you need to do them, as well as frequency and intensity. If you understand why you need to do the work and how it will contribute to your recovery, the process will seem more meaningful for you.

What will treatment consist of?

This is highly specific to the injury and will vary depending on the desired outcome. For example if there is swelling as part of the injury, depending on the source and extent of the swelling, one of the first priorities will be to control and reduce the swelling, ease any associated discomfort and protect the area from further damage.

Pain and swelling have pretty immediate negative effects on muscle function, so it is important to address these initially. Once under control, beginning a structured programme to address the compromised muscle activity will be key – missing this part out can lead to a risk of the injury returning when you go back to sport, as the area will be less able to tolerate the loads applied to it.

Treatment to address weakened muscle involves gradually reloading the injured tissues to re-establish tolerance to loading.

Most sports will have a robust ‘return to train’ and ‘return to play’ strategy that athletes will need to complete (especially after a prolonged time out) before they can re-start integration back to training for performance. 

One of the basic tenets of any treatment or rehabilitation strategy should be based around your return to what you need to achieve, whatever the level, whilst addressing any predisposing factors which led to the injury.

What is prehab?

Prehab is a group of exercises designed to improve conditioning and control around vulnerable areas of the body relative to your sport. It is aimed at reducing the risk of injury due to overuse or overload.

These exercises will vary from sport to sport, and even within sport depending upon position, technical requirements or vulnerability to specific loading. They are often undertaken consistently (either as part of warm-up for training, daily as an adjunct to other work or a set number of times per week to be most effective) and may not change much with respect to load or repetitions over some time.

The content may vary following reassessment of goals or as part of return to train/play protocols, but they are designed to reduce the risk of injuries as a result of normal increases in training loads.

These programmes are designed to reduce the risk of injury, however, because many injuries result from external sources, there is no such thing as a complete injury prevention programme.