Ice pack, which is a form of cold therapy - is absolutely wonderful for relieving the pain of injured knees. However, there are some safety precautions that anyone using cold therapy should know and be aware of.

There are four stages to cold therapy:
1- A cooling sensation that lasts for several minutes
2- The cooling sensation will turn into a dull ache that lasts a few minutes
3- A burning sensation is the next phase and will usually last less than a minute
4- Numbness will set in.

When practicing cold therapy on an injury, the stages should be followed through to numbness because the ease of movement will return briefly and it will help reduce inflammation.

Reasons for a cold pack will vary but they can be used for injuries, when tendonitis flairs up, relief after surgery, sprains and soreness.

Never wear a cold pack when sleeping and if you are alone, have someone check on you after 15 minutes via phone or stop by if you’re using a cold pack. Prolonged exposure to extreme cold can damage tissues and slow down your healing if the treatment is overused. Also, if you suffer from any problems with circulation or are diabetic; consult your physician to make sure that cold therapy is okay for you.

Under the right circumstances, cold therapy is an easy way to get pain relief and help your body heal itself, just make sure that cold therapy is the right way to treat your injury and you’ll be back in the game in no time.

You know for 100% certain when you have a dislocated joint. In a nutshell, dislocations are joint injuries that force the ends of your bones out of their normal position. The cause of most dislocations is equally divided between falls or impacts to the body. When a dislocation occurs the joint is rigid and immobile. Areas of the body that are commonly dislocated include ankles, knees, shoulders, hips, elbows, finger and toe joints. A dislocated joint is swollen, painful and usually visibly out of place.

If you have dislocated a joint, get medical help. The treatment that you will be given will depend on the specific joint you have dislocated. For smaller dislocations such as finger, shoulder or toes bones, a manual manipulation (using the hands to move the bone back into position) will usually be done.

After repositioning, the joint will usually be in a splint or sling to keep it fully in place until the joint is healed. Most dislocations will function normally again in a few weeks. However, you need to be on the lookout for those areas of your body that have been previously dislocated as once you have a dislocation of the shoulder or knee, you are more likely to suffer a repeat of the same injury if an impact occurs on those joints. Wearing wraps, pads or other protective gear during participation in physical activities will help keep the odds in your favor that you won’t be repeating this adventure.

Sometimes sports injuries seem cruel. Last year’s MVP Jimmy Rollins was put on the disabled list for the first time in his career with a sprained ankle. It’s a bad blow for the Phillies and Jimmy as well. Jimmy’s game is boosted by his sheer ability to run so fast and a sprained ankle as put a definite damper on his game.

Jimmy Rollins himself was quoted as saying,”My game is speed and I don’t have much of that now”. For someone as fast as this player, a sprained ankle is akin to having an anchor tied to his leg.

Fortunately, immediate attention after the injury is the reason that Rollins will have a fast recover and get back in the game as soon as possible.

As far as regaining speed, in all probability, Rollins will regain his speed and strength if he follows a good regiment that includes regular strength training and practices stretching and warm-up before games or practice games so those muscles around the ankle area are good and warmed up before heavy game use.

I just read a great article in the HealthDay News, it read in short that if you’re an athlete or just a person that loves to exercise every day, in many cases you don’t have to completely stop exercising if you have a strained muscle, sprained ankle or foot injury.

In fact, “Exercise can definitely be beneficial for a person dealing with an injury. Depending on its type, the injured area should be moved and not left in place for a long period of time,” Colleen Greene, wellness coordinator with MFit, the University of Michigan Health System’s health promotion division, said in a prepared statement.

“Some people think they should just rest and not move at all with an injury. Doing that can actually be worse because — depending on the amount of time one does not move the appendage — the muscle might begin to atrophy,” Greene said.

As you know, if you are injured, the general rule of thumb for initial treatment is Rest, Ice, Compression and Elevation (RICE). Once you’ve done that, consult a doctor as soon as possible. If the injury is severe enough, you may be referred to a physical therapist or specialist trainer. They’ll help guide your recovery and offer tips on how to maintain strength while you heal.

The goal is always maintain strength, not to gain while you are in a recovery mode. The key is to rebuild what you’ve lost and don’t push it. Pay attention to any pain and if you experience it, slow down.

Remember that pain is always the indicator that you’re pushing too much. A little discomfort is to be expected when you’re recovering, but pain means stop and try something else. You want to recover not re-injur.

There are an average of 2 million sports-related concussions every year and according to a report from the U.S. Centers for Disease Control and Prevention, the majority of those injuries occurred playing football.

Bicycling is another cause of concussions in kids and the most common cause is having an impact without the benefit of wearing a helmet. As more and more kids are participating in sports at younger ages, parents need to be alert to the signs of a concussion.

For the curious, a concussion is an injury to the brain typically caused by a blow or strike to the head that can cause a range of symptoms. It is an injury that temporarily interferes with brain function.

The symptoms of a concussion can be impairments to memory, judgment, speech, balance and coordination. There may or may not be a loss of consciousness accompanying the injury. The injured person could have a headache, visual problems and more. If you suspect your child (or anyone) has suffered a blow to the head and is exhibiting any of the above symptoms or irritability, headache, sometimes nausea or vomiting, ringing in the ears, poor concentration or really just seems “off” - get them to a medical professional as quickly as possible for an evaluation. Remember although someone can seem fine immediately after injury, the symptoms of a concussion may not rear its ugly head until a couple of days are the initial injury.

If your child receives multiple concussions, it many be time to pull them from the sports activity as there is preliminary evidence in current studies that indicates that repeated concussions can lead to a predisposition for Alzheimer’s.

Second-impact syndrome is a very dangerous possibility after a concussion. Simply put, if there is a concussion and the brain hasn’t healed from it and a second impact occurs, serious injury or even death can occur as serious brain swelling can occur.

Concussions are treated pretty much that same way intially. Treatment depends on the signs and symptoms the patient is showing. Quiet, bed rest, little to no stimulation or excitement and a cold compress if there’s a bump on the head in very short intervals to help with exterior pain.

You can’t really stop concussions from happening but you can minimize the risk by making sure the coaches your kids train with has appropriate coaching training and make sure your kids are always wearing the proper gear that fits for the sport they are participating in.

Bursitis is also known around the world as “Student’s Elbow” and it is a common complaint of both old and young and it centers in, yes the elbow.


The elbow pain of bursitis will originate from just below the tip of the elbow where there is a little sack of fluid that is called the bursa. The bursa has the all important job of lubricating the tissues in the joints and letting you move your elbow with ease.

However if you fall on your bursa or otherwise receive a direct impact, the bursa can become inflammed or even bleeding can occur. The result will be a lot of pain and some swelling on the bony area at the back of your elbow.

Common Symptoms of Bursitis Include:
* Elbow pain whether at rest or moving.
* A painful swelling on the back of the elbow.
* Limited mobility in the elbow.

Avoiding Bursitis
*Wear elbow pads if playing sports or riding a bike, skateboard or other activity where you can risk an impact on your elbow.
* Do not spend long periods of time leaning on the elbows.

If Bursitis Happens
* Rest and apply ice is about all you can do.
* See a sports injury professional if it becomes a chronic problem.

According to a study published in the February issue of Injury Prevention, of the sports injuries that occurred in United States high schools over a two year period from 2005-2007.estimates that more than 98,000 of those injuries were directly due to an action that was ruled as illegal by a referee, official or disciplinary committee.

The researchers in the Center for Injury Research and Policy (CIRP) at Nationwide Children’s Hospital conducted a study that analyzed data from the 2005-2006 and 2006-2007 for National High School Sport-Related Injury Surveillance. Through this study nine different common high school sports were included: boys’ football, soccer, basketball, wrestling and baseball and girls’ soccer, volleyball, basketball and softball.

The highest rate of illegal injuries were found for soccer of both sexes. Girls’ volleyball, softball and boys’ baseball had the lowest number of illegal injuries occurring. Interesting, a full 32% of the injuries related to illegal activity were to the head and/or face and 25% were concussions.

Christy Collins, Co-Author of the CIRP study reported,”Our research indicates illegal activity is an overlooked risk factor for sports-related injury and reducing illegal activity through enhanced enforcement of rules and targeted education about the dangers of illegal activity may reduce sports-related injuries.”

By definition, activities that were ruled illegal are not supposed to occur. Thus, injuries attributed to illegal activities should be largely preventable in high school sports.

Dawn Comstock of CIRP and Co-Author of the report commented,”Each sport has a unique set of rules developed to promote fair competition and protect participants from injury, thus, enforcing rules and punishing illegal activity is a risk control measure that may reduce injury rates by modifying players’ behavior.”

This study was funded in part by the Centers for Disease Control and Prevention (CDC) and will hopefully open both the eyes of both participants as well as coaches to the dangers of straying outside the rules and keep sports both challenging and safe activities.

So you went and injured yourself…is it from the pick-up basketball game the night before or a marathon concert of Guitar Hero? Either way you are in pain and need to know what to do. That’s where I come in.
 
If you know specifically what happened and/or how it happened, it’s always helpful. But for those of you who don’t have any idea, don’t worry…we can help you too. Here are some things to note: 
 
1. Does it look deformed? If your foot is facing the opposite direction of what it is supposed to, leave it the way it is, call 911 and wait for the ambulance. If it’s just a dislocated finger, an ambulance probably isn’t necessary. General rule of thumb is to wait for a medical professional to put the joint back into place. It’s never a good idea to do it yourself because you run the risk of more damage. If you can see the bone sticking out of your leg/arm because it’s broken through the skin, also call 911. Excessive swelling can also make an area looked deformed but look closely because a dislocation or severe fracture should be quite obvious.
 
2. Is it swollen? Swelling always means something is going on inside. Don’t freak out because your right knee is a centimeter bigger than your left. The swelling you need to worry about is when one knee (or ankle, or wrist, or…) is obviously, noticeably larger than the other one.
 
3. Can you move it? I don’t mean it’s physically possible for you to move a fraction of an inch but you are in excruciating pain the whole time. In this case if you can move it a little but it hurts, that’s a positive sign. If you can’t move it at all whether it’s because of pain or not…GO TO A DOCTOR!
 
Now we’ve narrowed it down a bit so what do you do? The acronym you need to know is RICE: Rest, Ice, Compression, and Elevation. Rest seems like commonsense but some people ignore this part. In some cases just taking a few days to rest will do more good than anything else you can do. Ice is always a good choice. There are very few injuries that shouldn’t be iced. If you are suffering from frostbite…don’t take this advice. Otherwise, ice should be your best friend. Compression is really only necessary if there is swelling but it’s not going to hurt either. Remember compression that is TOO TIGHT could cause further injury or delay healing. I usually recommend keeping the ace wrap on at all times except when showering, icing, or sleeping. And finally elevation…also mainly important when there is swelling involved. If there isn’t any swelling or it’s particularly difficult to elevate (like your back), than it’s not necessary. Elevating an injury means above the heart, not just a foot off the floor.
 
Ibuprofen (Advil, Motrin, etc), acetaminophen (Tylenol), or naproxen (Aleve) will help with the pain but will also help with any inflammation or swelling that you may have. I don’t think overdosing on meds is particularly good advice but if you have swelling, even taking 2 pills (200 mg per pill = 400mg total) 3 times a day for a few days will help with that inflammation.
 
With any injury severity is the key. If you aren’t sure or you try these things for a couple days and it’s not getting better or it gets worse, go see a doctor. It’s probably not necessary to go to a doctor and pay a $50 co-pay for a minor ankle sprain that you can walk on but with a slight limp. Hopefully these tips will help save you some $$$!
 
~ Missync MS, ATC, LAT ~

Heel pain.  We have all had it at one point in time, and it can be a pain (no pun intended) to get rid of it.  Many people do not understand how or why their heel hurts.  There are many conditions out there that result in heel pain.  Today we will discuss one of those conditions and provide treatment suggestions.

Plantar Fasciitis

On the bottom of your foot there is a strong and dense structure of connective tissue known as your plantar fascia.  It extends from the base of the heel to the beginning of your toes.  The plantar fascia serves two purposes: it provides static support for your arch and it acts as a shock absorber for your foot.  During high-impact activities, the plantar fascia can suffer micro trauma from repetitive heel strikes.  When this happens, patients will feel pain at the base of heel.  Those who have flat feet or pronated feet, tight calf muscles, or abnormally high, rigid arches may be predisposed to plantar fasciitis.  It is commonly seen in sports/activities that have repetitive impact such as running, long distance walkers, dancers, tennis players, or even those who are on their feet for extended amounts of time daily.  The pain can vary, but most active individuals will find the pain to be very debilitating.

The good news is that plantar fasciitis can be resolved by conservative treatments.  The bad news is that it can sometimes take months before the symptoms are fully resolved.  Should you have plantar fasciitis, here are some treatments that you will find to be beneficial:

Stretch your plantar fascia and Achilles tendon daily.

Plantar fascia stretch – Sit with your knees bent and your heel flat on the floor or table.  Use your hand to bend your toes up toward the ceiling.  Progress into dorsiflexing your ankle and then bending your toes upwards.  Hold this position for about 10 seconds.  Repeat 10 times. (This is a good one to do before you get out of bed in the morning)

Seated plantar fascia stretch – While seated, place your toes into hyperextension.  Hold for 30 seconds.  Repeat 10 times.

Plantar fascia stretch on wall – Place your heel on the floor and your toes on a wall.  Lean forward.  Hold for 30 seconds.  Repeat 10 times.

Calf stretch – Using a step, stand with your toes just on the end of the step with your heels hanging off.  Lower your heels while keeping your knees straight.  Hold 30 seconds.  Repeat 10 times.  Repeat stretch with your knees bent.

Change work out shoes regularly.  Shoes will break down over time.  If you have poor biomechanics, your shoes will begin to show the abnormalities.  Shoes are generally made with proper support, but usage wears down the support.  By changing your shoes regularly, you can get the support you need.

Ice massage.  This works wonders, and it is very simple to do.  One of the most beneficial ways to do this is to fill a plastic bottle with water and freeze it.  Take the frozen bottle and roll the bottom of your foot over it for approximately 5-7 minutes.  It may hurt at first, but as your foot gets cold it will feel great.  Please be careful not to hurt yourself from prolonged periods of cold!!

Use a night splint.  A night splint is a device that keeps your ankle dorsiflexed and your toes extended while you sleep.  During the night, your foot can spend hours in a position that causes pain.  This is why you may have a lot of pain when you first walk in the morning.  Wearing a night splint will keep your foot in a comfortable position that will decrease your pain in the morning.  They can be purchased from pharmacies that have orthopedic supplies, or you can find them online as well.  They range from about $30-$60, but it may be worth it.

And finally….

Take some time to rest.  It is something that can be very hard for some to do, but it is very important.  Time will heal almost everything.  Allow your body the proper amount of time to heal.  In the meantime, there are plenty of others ways that you can be active without being on your feet.

I hope this helps!  Next time I will discuss another common reason for
heel pain.  Until next time.

Corey H

The USA is a sports overloaded country. There are millions of kids every year who participate in some form of organized sport and a large number of them get injured. Coaches can play a huge role in not only the prevention of injuries, but also the return to play. Some coaches or organizations are blessed to have Certified Athletic Trainers working with them (Ok, so I’m a little biased.) Many other coaches, on the other hand, have to go it alone. It was this aspect that got me thinking…Do coaches really know what they are doing in terms of injury prevention or care? I would say most likely, no, but it totally depends on the coach. Back in the day, you had the old school coach who said “water breaks show weakness”. Well that’s just crazy. Any sane person knows that dehydration can lead to a whole host of problems and anyone who is exercising (particularly in hot or humid conditions) is going to sweat and they need some way to replenish that fluid. Studies have shown that athletes (or the active population) need to drink approximately 8 oz (some studies will say different amounts) for every pound of weight lost during exercise to replenish your system. Sports drinks are a good alternative to water if you prefer but good old fashioned water works too. You also have the old school coaches who say “rub some dirt on it”. I’d like to think that this was more of a joke and was basically telling the kid to suck it up but you never know. Putting dirt in an open wound…NEVER a good idea (just wanted to throw that out there in case anyone was unsure.)
 

My personal pet peeve is when teams jog, stretch, shoot (or something), so the players are all nice and warmed up and then the coach comes in and sits them down to talk about plays or the practice plan for the next 20 minutes. That whole process of jogging and stretching and what-not was just eliminated because the coach wanted to talk. Coaches…I beg you…talk before they warm up or after practice or talk for a shorter amount of time. Once an athlete is warmed up, those effects only last about 15 minutes or so if the athlete just sits around. If you absolutely MUST talk for 20 minutes, please give them time to warm up again. Making you’re your athletes are warmed up prior to exercise (not just at some point that day) will help decrease the chances of an injury, specifically muscle pulls.
 

Other good suggestions for coaches who want to move into the 21st Century:
 

1. Pick up any loose equipment around the playing surface. Balls, bats, jump ropes, etc lying around can lead to ankle sprains if an athlete were to land on it.
 
2. Give adequate water breaks…especially if it’s hot or humid outside (even for indoor sports)
 
3. Don’t move a joint if it looks deformed (like a dislocation). If you aren’t trained to reduce dislocations…DON’T. Just because you’ve done it once to yourself or a friend, doesn’t mean that you should attempt it on a player.
 
4. If you suspect an injury, seek professional medical help. Not all ankle sprains are the same or should be treated the same.
 
5. You are responsible for injuries that happen whether they were preventable or not, so don’t just ignore them.
 

~ Missync MS, ATC, LAT ~