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PhysiotherapySports medicine

Exercise is good for you no matter who you are, irrespective of age, sex, ability or disability. For some exercise may be a stroll while for others it may be competitive sport.

Exercise helps us to:

  • relax
  • enjoy ourselves
  • improve general health and fitness

There is evidence to show that regular light exercise:

  • helps our immune system
  • improves our psychological wellbeing
  • helps us to focus better at work
  • improves our self-confidence

Most injuries are not serious and heal quickly ─ especially if treated properly and promptly. Some require a longer period of rehabilitation or specialist attention. Many can be prevented by proper training, good technique and using the correct equipment.

 

Different types of injury

Injuries while exercising roughly fall into two categories, those of:

  • sudden or ‘acute’ injuries like a sprained ankle or torn muscle
  • over-exercising injuries like shin splints or runners knee.

These may be due to:

  • high intensity training
  • poor technique
  • biomechanical factors
  • equipment

Preventing injury

Physically demanding sports require preparation and gradual training to improve fitness and performance and to avoid injury. Rest and recovery is equally as important to allow the body to recuperate, refuel and repair. Tiredness increases the risk of injury.

Weight training increases muscle strength and should be started in a gym under supervision to avoid injuring muscle, spine and knees.

Warming up & stretching 

Muscles and tendons work more efficiently when warmed up. This is important for performance and to reduce the risk of injury. Be prepared to warm up for at least 10 minutes before training or competing.

Stretching is best done after the muscles are warm or at the end of a session, and doing this regularly will gradually improve suppleness. Stretching before exercise when muscles are cold has not been shown to improve flexibility and can reduce the force of muscle contraction and performance.

 

Good technique 

Good technique when exercising or playing sport:

  • maximises performance
  • significantly reduces the risk of injury

A coach qualified in your sport is the best person to advise on technique, warm up, training and warm-down.

Right equipment 

Appropriate footwear along with protective equipment such as gum-shields, helmets and shin pads all help prevent unnecessary injury.

Do not use old or broken equipment.

Age 

The general health benefits of exercise mean that as we get older the risks of inactivity are higher than the risks of injury. Whilst we all lose muscle mass and take longer to recover from injury as we age, light exercise regularly can maintain strength, co-ordination and balance. Good muscle strength in the legs and body can improve symptoms of arthritis and lower back pain considerably.

 

Acute injuries 

Sudden or ‘acute’ injuries to joints, muscles, tendons and ligaments cause swelling, bleeding and pain. The immediate treatment of these injuries is:

  • Protect the injured part
  • Relative rest for the injured part (but you can still keep fit)
  • Ice to soothe and reduce swelling
  • Compression dressing or bandage to reduce swelling
  • Elevation to reduce swelling and bleeding
  • Rehabilitation – taking the right steps to get back to normal

The cooling effect of ice can be applied by placing a wet towel over the injury and using an icepack, frozen vegetables or a cool drinks can for 10-20 minutes every two hours. Vigorous massage should be avoided since it will increase bleeding and swelling at this time. The faster swelling can be brought under control the faster you will get better.

Pain can be treated by taking paracetamol 500mg x two every four-six hours and/or ibuprofen 200mg xtwo every six-eight hours. These are safe, cheap and effective at reducing pain and treating inflammation.

After 24-48 hours the injured limb should be moved through its range of movement in order to encourage optimal healing. It can be gently stretched too to avoid it losing flexibility as it heals.

It is important with leg injuries to practice standing on the affected leg to regain normal balance as soon as you are able.

Physiotherapists sometimes use ultrasound or interferential to help reduce swelling.

Avoiding over-exercising 

Over-use injuries are even more common than acute injuries. Examples are repetitive strain injuries, tennis elbow, Achilles tendinopathy, runner’s knee and shin splints.

To avoid these:

  • start gently with any unaccustomed or new activity
  • increase any training regime gradually
  • have days off training to recuperate (ie train smarter, not harder)
  • use proper unbroken equipment and make sure it is your size (inc footwear)
  • check your technique is right, or ask someone to check for you

Nutrition and supplements 

A healthy sportsman’s diet is a healthy diet which includes:

  • an enjoyable variety of foods rich in starch and fibre
  • plenty of fruit and vegetables
  • some protein and not too much fatty or sugary food
  • a sensible intake of alcohol (14 units per week for women and 21 units for men)

Athletes exercising very often or strenuously use up a lot of energy. The best fuel is in the form of carbohydrate, which may form up to 60-70 per cent of the diet (in most of us it forms 30-40 per cent). Protein, although often thought of as being needed in large quantities ─ especially for weight-lifting, is not as important as people think and simple sources (ham, baked beans on toast) are generally just as good as expensive supplements, which have sometimes been found to contain banned substances.

If your diet is varied and contains all the major food groups in sensible proportion and amount, evidence shows no benefit from taking additional supplements both on performance and to protect against infections. The commonest deficiency seen in the UK is of iron in women, who may benefit from an iron-rich diet or supplements.

Drinking plenty of fluids during training and competition is essential for best performance and to avoid overheating. It is possible however to over-drink and cause electrolyte and heart problems, so drink sensibly according to thirst and urine output.

Recovery 

The body heals itself very well provided it is allowed to do so. This means it is important not to return to full competition or training until your injury is sufficiently healed. While rest is important in the first three-five days after an acute injury, but as soon as the swelling is under control and it is feeling better beginning gentle movement will aid recovery. Protect the Injured, Use the Uninjured.

The aims of recovery are to regain the full range of movement, strength and endurance of the muscles and joints injured. This will take work, and is not something anyone else can do for you, although a coach, trainer, physiotherapist or doctor may be able to help by checking you are doing exercises correctly and sometimes by giving additional treatment.

Using drugs to improve performance

“Drug misuse can often be harmful to the competitor’s health and severely damages the image of sport. The UK Sports Council is committed to ensuring a drug-free sporting environment for all competitors who, under pressure to achieve, commit to winning on their own merits and hard work.” UKSC

Using drugs and other artificial ergogenic aids are against the rules, ethics and spirit of sport. As a general rule, if a drug has been shown to improve performance then it is banned under international rules, and if it isn’t banned it has not been shown to improve performance. The one exception at the current time may be Creatine, which is not a drug but a food present in meat and fish. It has been shown to aid performance for some people involved in short, explosive sports, particularly if they have low body stores (ie vegetarian).

Medicines are closely regulated, but products sold as herbal or food supplements are not and have occasionally been found to contain undisclosed contaminants (such as anabolic steroids and other banned substances) that could result in disqualification if detected. The message here is use any supplements only if they are truly required and then with caution.

Seeing the doctor 

As for any condition that requires medical attention you can call the Health Centre (0115 84 68888) to make an appointment. The nurses can often treat minor injuries, you could make a routine appointment to see the doctor or there is always a duty doctor in working hours at Cripps Health Centre for emergencies.

The Emergency Department for serious injuries is located at the Queens Medical Centre close to the main University campus.

Physiotherapy 

Physiotherapy is something you can start yourself as soon as you have an injury and is not just what someone might do ‘for’ you but most importantly it is the movement and exercise that you do yourself to regain movement, strength, endurance and skill. A Physiotherapist’s role is to advise you on how to best look after your injury and tell you the exercises to do. They may also use their hands to massage or manipulate affected areas of the body or use tools such as ultrasound, interferential, and strapping to help recovery.