Sports Injuries Treatment Guide | Prime Health Guide

Overview

Sports injuries can happen to athletes of any age and ability, from Little League to the National Football League. Injuries can happen to anyone at any time, and they can range from minor to serious. They can be painful and quite frustrating. However, you don’t have to let them keep you out of an activity you love.

All athletes deserve the very best sports-related care and treatment that’s one-on-one and state-of-the-art. At Cleveland Clinic Sports Medicine Center, this involves conditioning to become stronger and faster, maximizing abilities, treating injuries if they do occur, and improving future performance.

Cleveland Clinic Sports Medicine is a unique center within the Department of Orthopaedic Surgery. Both our medical and surgical specialists use the latest diagnostic technology to evaluate your injury and develop a specialized care plan to return you to your activity as quickly as possible.

Cleveland Clinic Sports Medicine brings together top orthopaedic surgeons, primary care sports medicine physicians, physician assistants, physical therapists, athletic trainers, registered dietitians, radiologists and exercise physiologists to keep athletes of all ages and skill levels in the game.

Treating Children

Cleveland Clinic’s pediatric orthopaedic specialists are dedicated to helping injured children and adolescents return to an active lifestyle. Our team works hand-in-hand with experts from Cleveland Clinic Children’s — including physical therapists, child life specialists and pediatric anesthesiologists, rheumatologists and neurologists — to diagnose your child’s condition and develop the most appropriate treatment plan.

If your child is experiencing a joint, muscle or bone problem, it is important to bring this to the attention of your pediatrician or seek help from an orthopaedic specialist.

We know that children are not just small adults. Our staff feels strongly that the care of children’s orthopaedic problems differs immensely from adult orthopaedics — and we treat our patients according to their age, development and size. We pay special attention not only to their medical and/or surgical needs, but also the relationships among the caregiver, child and his or her family.

Overuse Injuries

Many athletes will experience at least occasional overuse injuries. These occur when the force applied to a part of their body, such as a muscle tendon, increases faster than the tendon is able to adapt to the stress. This leads to a breakdown of the tissue, resulting in pain and swelling.

Common areas for overuse injuries in the lower body are the Achilles tendon, shin, patellar tendon (front of the knee) and the hip. In the upper body, the rotator cuff or shoulder and the elbow are the most affected.

What are the symptoms of overuse injuries?

Common symptoms of overuse injuries include:

Decreased strength or speed
Muscle aches and soreness
Pain
Swelling

How do you treat overuse injuries?

If pain and/or swelling do occur, rest the area as much as possible. Over-the-counter anti-inflammatories may be used with ice and stretches to decrease pain and swelling. If symptoms persist, see a sports medicine specialist or your family physician. Stretches can be used in recovering from overuse injuries and, if done correctly, can also help prevent injuries.

How can you prevent overuse injuries?

Stretching prepares the muscle to accommodate the forces that will be placed on the tendon or body part. Stretches should be performed after warming up, such as taking a brisk walk or jog. Stretch both the upper and lower body by holding each stretch for 15 to 30 seconds, without bouncing, and repeat each stretch two to three times.

Gradual progression into an exercise program is advised. Overuse injuries are typically the result of doing too much too soon. Start slow and increase the intensity of the exercise by 10 percent each week. By following these guidelines, you can decrease your chance of experiencing an overuse injury and keep yourself in the game.

Bursitis & Tendinitis

Bursitis

Bursitis is the painful inflammation of the bursa — the fluid-filled sac that surrounds the rotator cuff and provides lubrication and protection from the overlying bony shoulder tip, called the scapular acromion. Bursitis is most often caused by repetitive motions (overuse), or repeatedly bumping or putting pressure on the area. Less often, bursitis is caused by a sudden, more serious injury.

What are the symptoms of bursitis?

Symptoms include pain (especially with movement), stiffness, swelling, tenderness, warmth and redness. Bursitis is diagnosed by a medical history and physical examination. X-rays may be needed if the inflammation is due to an injury to rule out other complications. A sample of fluid also may be taken and tested for infection.

How is bursitis treated?

Treatment for bursitis can include anti-inflammatory medications, injecting medications into the affected area, antibiotics and/or surgery to drain or remove the bursa. Your physician also may advise you on how to modify your activities to reduce stress on the area.

How can you prevent bursitis?

Since most cases of bursitis are caused by overuse, the best treatment is prevention. Avoid or modify activities that cause the problem.

Take it slow, gradually building up your activity level
Try to limit force and repetition
Stop if unusual pain occurs
Use cushions and pads to reduce pressure

Tendinitis

Tendinitis most often is caused by repetitive, minor impacts on the affected area, or from a sudden, more serious injury. Tendinitis can occur in almost any area of the body where a tendon connects a bone to a muscle. The most common places are the base of the thumb, the elbow, shoulder, hip, knee or Achilles tendon (connects the calf muscles to the heel bone).

Tendinitis is most common in people who do repetitive activities. This can include tennis, golf, skiing and baseball, as well as non-sport activities such as gardening, carpentry, shoveling and painting.

What are the symptoms of tendinitis?

The symptoms of tendinitis include pain at the site of the tendon and surrounding area. The pain may grow gradually or appear suddenly. Sometimes it limits motion in the shoulder, which is called adhesive capsulitis or “frozen shoulder.”

How is tendinitis treated?

Tendinitis treatment usually starts by having the person avoid activities that make it worse, as well as resting the injured area, icing the area and taking over-the-counter anti-inflammatory medicines.

If the condition does not improve in a week, see your doctor. You may need more advanced treatments, including corticosteroid injections to decrease the inflammation and pain, physical therapy and surgery (only for severe cases).

How can you prevent tendinitis?

You can help avoid tendinitis by learning proper posture positions for all activities. For example, learn to position your body directly in front of an object you want to pick up. Reach for the object by stretching your arm and hand directly forward toward the object. Never grab objects with your arm in a sideways position. If reaching for an object overhead, center your body and reach up and grab the item with both hands.

Elbow Injuries

Many sports can lead to pain in the elbow, either suddenly or over time. The following are some of the most common types of elbow pain.

Tennis Elbow (Lateral Epicondylitis)

Tennis elbow is a general term that may or may not be related to playing tennis. The condition typically is caused by “wear and tear” or overuse of the forearm muscles (wrist extensors) that results in pain at the elbow. It affects the outside (lateral) elbow, most commonly involving the area where the muscles and tendons of the forearm attach to the outside bony area (epicondyle) of the elbow.

It can affect the dominant or the non-dominant arm, or both. In addition to tennis, tennis elbow also is seen in golfers, bowlers, carpenters and even assembly line workers — anyone who uses their elbows for repetitive tasks.

What are the symptoms of tennis elbow?

Symptoms include pain that generally grows slowly around the outside of the elbow. Less often, pain develops suddenly. This pain is worse when shaking hands, squeezing objects, holding the wrist stiff or moving the wrist with force (such as when lifting or using tools like a knife and fork).

How is tennis elbow treated?

Treatment may involve rest, ice, anti-inflammatory drugs, cortisone injections, bracing and physical therapy. More advanced treatments (such as a patient’s own platelets, shockwave or surgery) may be recommended depending on the length and severity of the problem.

Typically, surgery involves removing or repairing the damaged tendon tissue. A splint will be needed for a week or two after surgery, followed by occupational therapy.

How can you prevent tennis elbow?

The best way to prevent tennis elbow is to stretch and strengthen your arm muscles to make them flexible and strong enough for your activities. Other tips include:

Use proper technique
Use the appropriate equipment for an activity
Alternate hands during activities, if possible
Strengthen the muscles in your arm, shoulder and upper back to take the stress off of the elbow

Golfer’s Elbow (Medial Epicondylitis)

Golfer’s elbow is a condition similar to tennis elbow that occurs on the inside, rather than the outside, of the elbow. The condition isn’t limited to golfers and involves wear and tear of the tendons that attach on the medial epicondyle, which is the bony bump on the inside of the elbow.

What are the symptoms of golfer's elbow?

Symptoms include chronic pain on or near the medial epicondyle, and are usually aggravated by flexing the wrist and/or rotating the forearm. The elbow may be tender to touch over the painful area, and movements that stress the involved tendons can make the pain worse.

How is golfer's elbow treated?

Most cases of golfer’s elbow can be treated with activity modification, non-steroidal anti-inflammatory drugs, occupational therapy, elbow or wrist splinting, and/or cortisone injections at the elbow.

Surgical treatment may be needed if conservative methods fail to provide relief. The procedure to remove or repair the damaged tendon is performed on an outpatient basis, followed by immobilizing the joint for several weeks and occupational therapy exercises.

How can you prevent golfer's elbow?

One of the best ways to avoid elbow problems is to strengthen your forearm muscles and slow your golf swing so there is less shock to the arm when you hit the ball. Strengthening exercises include squeezing a tennis ball, wrist curls and reverse wrist curls.

Little League Elbow

Baseball pitchers ages 10 to 15 can suffer from elbow pains due to a growth spurt of the growth plates in the bones around the elbow.

What are the symptoms of little league elbow?

Repetitive throwing can result in inner elbow pain, weakness in the wrist, swelling and warmth. An X-ray may be needed to rule out any other complications that would require surgery.

How is little league elbow treated?

Treatment includes rest, ice and bracing. Stretching and strengthening exercises can then help regain function. Recovery may take a few days to a few months, depending on the level of injury.

How can you prevent little league elbow?

Little League elbow can be prevented with proper strength and conditioning exercises, and staying within age guidelines for the types and counts of pitches thrown.

Dislocation & Fractures

Dislocation

A dislocation is when a bone moves or is pushed out of place due to injury. This is most commonly seen in the elbow or shoulder.

Elbow dislocations are usually caused by a fall on an outstretched arm or another direct blow, such as a car accident. Most elbow dislocations are posterior, meaning the forearm bones are pushed backwards and out of position from the humerus (upper arm bone).
Shoulder dislocation happens when the upper arm bone (the humerus) comes out of the socket of the shoulder joint. This usually happens when the arm is outstretched and then turned, popping the humerus out of the socket. This is most common in sports like football, wrestling and skiing.

What are the symptoms of dislocation?

Symptoms of a dislocation include obvious deformity, as well as pain, swelling and loss of motion. The joint should be immobilized in the position in which it is found and the person taken to an emergency room right away, where the joint can be manipulated back into position by a physician.

How is dislocation treated?

The arm will need to be kept in a sling for several weeks. Occupational therapy exercises are recommended to regain range of motion and decrease the risk of repeat dislocation. Surgery to align the bone, fix broken bones or repair ligaments may be needed in the case of more severe dislocations. Recovery depends on the extent of the surgery and type of procedure performed.

How can you prevent disolocation?

To prevent a dislocation, take precautions to avoid falls, play safely and avoid recurrence. Preventing injuries means reducing the force of impact — recognize and avoid hazards on the field, and use appropriate equipment and protective gear.

Fractures

A fracture, also known as a broken bone, is a condition that alters the contour in the bone. There are many types of fractures. Fractures often occur when there is a high force or impact put on a bone. Fractures are common (more than 1 million every year in the United States). Medical care is needed immediately after a bone is fractured.

Young athletes are at particularly high risk of fractures because their bones are still growing. A fracture through the growth plate can be a very serious injury that can stop the bone from growing properly. These fractures can require surgery.

Fractures can be closed (the skin is intact) or open, also called compound (the skin is open and risk of infection significant). In some fractures, there is a gap between the two ends of the bone. These often require surgery. A partial fracture is an incomplete break of a bone. A complete fracture is a complete break of a bone, causing it to be separated in two or more pieces.

What are the symptoms of fractures?

In general, symptoms of fracture include pain, swelling, bruising, redness, stiffness and difficulty using the body part where the fracture occurs. A physician may order X-rays, MRI or CT scans to confirm a fracture and determine the severity of the injury as well as any other related injuries.

How are fractures treated?

A bone fracture is most commonly treated by the use of a cast and/or splint to immobilize the bone in order to promote bone alignment and prevent use of the bone. In some cases when the bone is small (toes or fingers), no cast is needed and the fracture is immobilized by wrapping. Medication also may be prescribed to ease the pain of the fracture. Traction – which uses a system of pulleys and weights to stretch the muscles and tendons around a broken bone – may be necessary to treat a fracture.

If a fracture is bad enough, surgery may be required. Hip fractures almost always require surgery since non-operative treatments require the patient to be immobile for a very long time and often result in poor functional outcomes. Internal and external rods and/or pins may be used to hold the bone in place to promote bone alignment.

The amount of time it takes for a fracture to heal varies based on the location of the fracture, the severity of the break and the person’s age and overall healing abilities. The average is about six to eight weeks.

Treating Fractures in Children

Fractures are perhaps the leading reason for referral to pediatric orthopaedic surgeons. Fractures in children are extremely common and, fortunately, most heal very well with standard techniques.

Despite the relatively straightforward nature of fracture treatment in children, the growing skeleton presents unique challenges to the treating physician.

Often fractures in children are treated well with brief cast immobilization. The length of time needed to heal fractures in children is often less than a comparable fracture in an adult. Not only do children’s fractures heal more quickly than adults, they have the unique capacity to “remodel,” or grow straighter with time. Consequently, perfect alignment is not always essential, and in some cases is detrimental to the final outcome.

Sometimes surgery is necessary for fractures. Fractures that typically do better with surgery include open or compound fractures, displaced growth plate fractures, and fractures that involve the surface of a joint.

Pediatric orthopaedic surgeons at Cleveland Clinic have implemented a unique program to help expedite prompt fracture care for children in Northeast Ohio. The same day fracture program allows patients urgent access to a pediatric orthopaedic surgeon. When families call 216.444.2606 before 1 p.m., children with fractures are seen the same day for immediate evaluation and management.

Growth Plate Injuries

The area of growing tissue near the ends of the long bones in children is known as the growth plate. Each long bone has at least one at each end that helps determine final length and shape. Growth plates close and are replaced by bone when growth is complete. Growth plates are the weakest areas of a child’s skeleton, making them particularly prone to injury. Trauma that would cause a sprain in an adult might cause a growth plate fracture in a child. Diagnosis involves a thorough physical examination and possibly X-rays or an MRI.

Treatment for growth plate injuries depends on the type of injury. The treatment steps are typically immobilizing the limb in a cast or splint, and avoiding using the limb. Surgery may be needed to put bones or joints back in their correct positions. Some exercises can help strengthen the affected area. When treated correctly, most growth plate fractures heal without any permanent effect.

Hip Labral Tears

Hip labral tears involve the ring of cartilage (labrum) that follows the outside rim of the hip joint socket. Labral tears occur through overuse injuries to the hip joint and labrum. They often go undiagnosed because symptoms are similar to soft tissue injuries, including hip flexor tendonitis and hip bursitis.

What are the symptoms of hip labral tears?

Hip labral tears can cause pain in the front of the hip, in the groin or on the side of the hip. This pain usually worsens with walking, pivoting or running. The pain also can occur at night and be associated with clicking, catching or locking, and stiffness or limited range of motion in the hip joint.

How are hip labral tears treated?

A combination of rest, anti-inflammatory medication and physical therapy is the first line of treatment for a labral tear. If these measures do not improve your condition, arthroscopic surgery could be an option.

How can you prevent hip labral tears?

Hip labral tears are caused by putting strain on your hips. To prevent this injury, condition the surrounding muscles with strength and flexibility exercises.

Meniscal Tears

A meniscal tear is a tear in the cartilages, or menisci, that are located between the femur and tibia bones in the lower leg. The menisci provide stability and help distribute body weight by keeping the bones from rubbing together. They help absorb pressure on the knee joint and help distribute nutrients into the tissues and cartilage that cover the femur and tibia bones.

A meniscal tear is caused by sudden twisting or other movements that may occur from sports or related injuries. These types of injuries are more common for people over 30, as the meniscus becomes less resilient with age.

What are the symptoms of a meniscal tear?

You might feel a “pop” when you tear a meniscus. Over a few days, your knee will gradually become more stiff and swollen. Other symptoms can include:

Pain
Swelling
Catching or locking of the knee
A feeling that your knee is giving out
Lacking full range of motion in the knee

How are meniscal tears treated?

Treatment for meniscal tears focuses on controlling pain and inflammation. The standard treatment is RICE — rest, ice, compression and elevation. Wrapping the knee in an elastic bandage and taking non-steroidal anti-inflammatory medication will also help keep the swelling down.

If the menisci are damaged, the knee can become very unstable and arthritis may result. Surgery may provide the best solution to preserving the knee from further damage and to improving mobility.

For severe pain, arthroscopic surgery can help identify the underlying cause. Arthroscopic surgery to repair meniscal tears is a safe procedure, allowing patients to maintain a normal and active lifestyle with greater comfort. Unfortunately, not all meniscal tears are repairable. The cartilage in the knee may have simply worn away over time, preventing the surgeon from repairing the remaining cartilage with sutures. In these cases, the surgeon will remove the torn cartilage and repair any other problems in the knee. Repairs tend to be most effective for people under the age of 30 who have the procedure done within the first two months after injury. Recovery time after surgery varies, but physical therapy is an important component of success.

How can you prevent meniscal tears?

Using the proper technique when exercising or playing sports can prevent meniscal tears.

Ligament Injuries

Ligaments are short bands of flexible connective tissue that connect two bones or cartilages, or that hold together a joint. We have many ligaments in our bodies. The ones that most commonly are injured in sports activities are in the knee and are the anterior cruciate ligament (ACL), the medial collateral ligament (MCL) and the posterior cruciate ligament (PCL).

ACL Injury

The ACL is one of the most important ligaments in the knee, connecting the thigh bone to the shin bone and preventing abnormal rotation of the knee joint. The purpose of your ACL is to keep your knee from giving out or shifting too far out of position.

What are the symptoms of an ACL injury?

An ACL injury occurs when the ligament is overstretched or torn. A tear creates instability in the knee, causing pain and difficulty walking, running, pivoting, jumping and landing. ACL tears are one of the most common injuries for athletes. If not treated, it can lead to both short-term and long-term problems.

Most ACL tears are non-contact injuries. You can tear your ACL when you twist your knee too forcefully, or when you plant your foot and then suddenly change direction. Injuries often occur when the athlete needs to quickly change direction while in motion or hyperextends the knee while running. High-risk sports for ACL tears are football, basketball, soccer and volleyball.

How are ACL injuries treated?

Most ACL injuries can be diagnosed by a physical exam. An X-ray can rule out any injuries to a bone, while an MRI scan may be done to get a clear picture of the knee. An MRI allows the orthopaedic specialist to see all of the soft tissue of the knee. Any tear in the ACL will show up clearly on an MRI. If the athlete wants to continue in his/her sport, ACL reconstruction is typically necessary.

Each case is unique and will require consultation with an orthopaedic specialist who can examine the MRI to get a full picture of the ACL injury. Some cases require surgery to rebuild the ligament in the center of the knee with a new ligament, particularly in people who want to resume highly competitive athletic activities. The tissue for this can come from an autograft (your own body) or an allograft (donor tissue).

The procedure is usually done by knee arthroscopy, which involves using smaller, less invasive surgical cuts to insert surgical instruments and a small camera inside the knee. The camera is connected to a video monitor so the surgeon can see all of the ligaments and tissues inside your knee. Your surgeon will fix any other damage and will then remove and replace your ACL with tissue that will become your new ligament. Your surgeon will attach the new ligament to the bone with screws (or other devices).

How can you prevent ACL tears?

The best way to prevent ACL injuries is to stretch and strengthen the leg muscles, particularly the quadriceps and hamstrings. It also helps to wear the proper shoes for the sport.

MCL Injury

The MCL connects the thighbone to the lower leg bone along the inside of the knee joint. It stabilizes the knee joint and stops the knee from bending sideways. Athletes injure the MCL when they bend or change directions quickly. These injuries are most common in football, soccer and basketball players.

What are the symptoms of an MCL injury?

MCL injuries cause pain on the inside of the knee. You may see swelling and feel that your knee is giving out.

How are MCL injuries treated?

The first treatments for a MCL tear are similar to ACL: icing and resting the knee, as well as possibly wearing a brace. After the initial healing begins, patients will usually go to rehabilitation for exercises to strengthen the area and regain range of motion. Very serious injuries may require surgery.

How can you prevent MCL tears?

Properly warming up for activity is important in preventing MCL injuries. Add some balancing exercises to your warm-up. Stretching and strengthening the quadriceps and legs will go a long way in preventing injury, as will wearing the proper footwear.

PCL Injury

The PCL connects the femur (thighbone) to the tibia (shinbone) along the back of the knee. The PCL keeps the tibia from moving too far backward. The good news is that the PCL is not injured as often as the ACL because it is stronger.

Some PCL injuries can heal on their own, but it is always a good idea to have them evaluated by a sports medicine physician as more serious injuries will require physical therapy, and occasionally, surgery.

What are the symptoms of a PCL injury?

Symptoms of a PCL injury include difficulty walking/weakness, swelling around the knee and pain.

How are PCL injuries treated?

Adopt the RICE method – rest, ice, compression and elevation – to speed your recovery. Your doctor may recommend a brace to prevent your knee from moving. Physical therapy exercises can restore function to the knee and strengthen the leg muscles that support the knee.

Surgery may be recommended for athletes with combined injuries. This may involve rebuilding the ligament through a graft, which can take several months to heal. A joint aspiration procedure may be performed if you have significant swelling of the knee and involves using a syringe to remove fluid from the joint.

How can you prevent PCL tears?

Strengthening and stretching your quadriceps and hamstrings can help you avoid PCL injuries. It’s also important to use proper form during activities.

Lower Back & Knee Pain

Lower Back Pain

The back – especially the lower back – bears much of the body’s weight during sports activity. The most common cause of lower back pain is overstretched or injured muscles that support the lower back. Many times evaluation and treatment by your primary care doctor are all you need. But for severe or persistent pain, evaluation by a spine or pain management specialist is recommended.

What are the symptoms of lower back pain?

Symptoms of lower back pain include pain in the lower back that usually worsens with activity. You also may experience some pain in the buttocks and notice relief when resting. If your back pain does not improve or is associated with fever, chills or unexpected weight loss, call your doctor.

How is lower back pain treated?

Treatment involves a period of rest. Anti-inflammatory medications may be recommended to help reduce pain and swelling. Applying heat and ice alternately to the back is helpful to relax the muscles and decrease muscle inflammation.

Surgery for low back pain is only considered when nonsurgical treatment options fail after six months.

How can you prevent lower back pain?

Prevention is the most important management technique for low back pain. Controlling what factors you can may help you avoid or recover quickly from back problems. Your exercise program should include improving your posture, toning your abdominal muscles and increasing your flexibility.

Knee Pain (Chondromalacia Patella)

Chondromalacia patella (knee pain) is the softening and breakdown of the tissue (cartilage) on the underside of the kneecap (patella). Pain happens when the knee and the thigh bone (femur) rub together, causing swelling and pain. Abnormal kneecap positioning, tightness or weakness of the muscles associated with the knee, too much activity involving the knee, and flat feet may increase the likelihood of chondromalacia patella.

What are the symptoms of knee pain?

Symptoms include a dull, aching pain felt behind, below or on the sides of the kneecap. A feeling of grinding when the knee is flexed may occur. This can happen doing activities like walking down a flight of stairs or running downhill. It also can happen upon standing up after sitting for a while.

People who are at risk for developing chondromalacia patella include runners, soccer players, bicyclists and anyone who exercises often. Overweight individuals and females are at higher risk.

A doctor may be able to diagnose this condition by examining your knee to determine the cause of pain. If the diagnosis is not clear, a doctor may order blood tests, a knee X-ray, an MRI or arthroscopy (a tiny, flexible camera is inserted into the knee to see exactly what the cartilage looks like) to be certain.

How is knee pain treated?

Rest is the best first step. Other ways to treat the symptoms include icing the area for 15 to 20 minutes, four times daily, for several days. Also, taking pain relievers such as ibuprofen, naproxen and aspirin, or using topical pain medication such as creams or patches may help.

How can you prevent knee pain?

Change up your exercise routine and throw in exercises to stretch and strengthen the quadriceps and hamstring muscles. Weight loss, special shoe inserts and the right kind of shoes also help.

Individuals suffering from knee pain caused by chondromalacia patella often make a full recovery. Recovery can be as fast as a month or may take years. Many long-term recoveries occur in teenagers because their bones are still growing. Symptoms tend to disappear as they reach adulthood.

Plica

Plica syndrome of the knee occurs due to injury or overuse. Synovial plicae are normal structures found in many (but not all) knees that can become painful if overused. Causes can include repetitive stress, trauma or other knee problems.

What are the symptoms of plica?

Symptoms can include knee pain (often or occasional), clicking in the knee and problems with the knee locking temporarily or giving way. Using the knee often can make it worse.

Tests such as MRI can help diagnose plica syndrome, but arthroscopy is the best way to be certain if a person has it.

How is plica treated?

Most plica injuries are resolved without surgery. The key is reducing inflammation by limiting activities like running, biking or stair climbing.

How can you prevent plica?

Some cases will improve with stretching and strengthening exercises. Wearing a patellar knee sleeve during sporting activities can help, as can nonsteroidal anti-inflammatory medications. Surgery may be needed when symptoms are severe and long-lasting.

Plantar Fasciitis

Plantar fasciitis is inflammation, irritation or tearing of the plantar fascia – the tissue that runs along the bottom of the foot. Unsupportive footwear is the primary cause, but a high arch, flat feet, tight calf muscles and training errors can also cause plantar fasciitis.

What are the symptoms of plantar fasciitis?

The primary symptom of plantar fasciitis is pain in the bottom of the foot from the heel into the arch. It is especially painful when you get up in the morning and after you sit for a while. The discomfort may be present at the start of a run, subside during the run, and then recur later.

How is plantar fasciitis treated?

During a flare-up, apply ice for 20 minutes two to three times a day, stretch your calf muscles and take anti-inflammatory medications. In severe cases, a cortisone shot may be necessary.

How can you prevent plantar fasciitis?

The best way to prevent plantar fasciitis is stretching. Stretch the plantar fascia by grabbing the toes, pulling the foot upward and holding for 15 seconds. To stretch the calf muscles, place your hands on a wall and drop the affected leg back into a lunge while keeping the heel down. Hold for 15 seconds and repeat three times. Replace your shoes every 400 to 600 miles, and consider adding arch supports to your shoes.

Rotator Cuff Injuries

The rotator cuff consists of four muscles and cord-like tendons, tightly enclosed within the shoulder joint. Rotator cuff injuries are the most common causes of shoulder pain and activity restriction at all ages, and include:

Tendinitis — The mildest rotator cuff injury is tendinitis (tendon inflammation). Tendinitis can develop with repetitive overhead activities, such as playing tennis, pitching, raking, shoveling or painting. Osteoarthritis can also cause it. It produces pain like a toothache radiating through the upper arm that can awaken you from sleep. Reaching overhead or behind your back is painful.
Tear — A torn rotator cuff, sometimes called “pitcher’s shoulder” or “tennis shoulder,” is the most common cause of shoulder pain. The rotator cuff tendons can split or tear suddenly with injury, or slowly through wear and tear. Untreated tears can weaken the arm, make it difficult to raise and visibly shrink muscles. Pain occurs during motion and also at night.

A thorough history and physical exam will often lead to a correct diagnosis. X-rays will often show changes on the arm bone where the rotator cuff muscles attach, but an MRI can provide a definitive diagnosis. This test clearly shows the muscles and indicates if the muscle is inflamed, injured or torn.

What are the symptoms of a rotator cuff injury?

The classic symptoms include a toothache-like pain radiating from the outer arm to several inches below the top of the shoulder. Pain also may occur in the front and top of the shoulder. Raising the arms overhead or reaching behind the body tends to aggravate symptoms.

How are rotator cuff injuries treated?

Stop or markedly decrease any activity that requires the use of the shoulder at or above shoulder level. Ice and anti-inflammatory medication can help. An exercise program designed to maintain flexibility can help, as can avoiding carrying heavy objects with the affected arm. Stretching while in a hot shower also can help. If shoulder pain becomes more severe, prescription-strength medication or a cortisone injection may help.

If symptoms persist, surgery to remove a spur on the acromion (part of the shoulder blade) can increase the space available for the inflamed tendon and may prevent further fraying or complete rupture. If an MRI shows a complete muscle injury, surgical repair may be required.

The time for complete recovery can range from two to four weeks for a first-time mild episode treated properly, to several weeks or months for chronic or recurrent cases or in people with more extensive surgery.

How can you prevent rotator cuff injuries?

You can take steps to prevent some rotator cuff problems:

Maintain strength and flexibility in your shoulder muscles
Don’t lift objects that are too heavy
Don’t try to catch falling objects
Don’t keep your arms out to your side or raise them over your head for long periods of time

Shin Splints

A shin splint injury is characterized by pain in the shin while engaging in sports activity like running. Shin splints are common among new runners or those returning to running after an extended absence. Shin splints are a sign that you’ve done too much, too quickly. Other contributing causes include incorrect shoe type, change in running surface, flat feet, tight calf muscles, training errors, poor running form and weak hip muscles.

What are the symptoms of shin splints?

The pain may first start after running but then progress to persistent pain. Pain happens in the front or inside of the lower leg along the shin bone and can be sharp or dull and throbbing.

How are shin splints treated?

Rest
Ice
Decrease mileage and cross train with biking or swimming
Take anti-inflammatory medications
Stretch calf muscles
Strengthen hip abductors and hip extensors
Modify training schedule and avoid hills

How can you prevent shin splints?

Prevent shin splints by finding shoes that are appropriate to your foot type and training intensity, and replace your shoes every 400 to 600 miles. Prescription orthotics may be necessary if foot mechanics cannot be controlled with a shoe alone. You should also increase your mileage gradually.

Sprains & Strains

A sprain is a stretch or tear in a ligament, the band of connective tissue that joins bones. Areas most at risk for sprains include ankles, knees and wrists. A strain is a twist, pull or tear of a muscle or tendon, the cord of tissue connecting muscle to bone. It can result from overstretching or overcontraction.

Signs of a sprain include tenderness and pain, bruising, swelling and muscle tightness. Symptoms of a strain include pain, muscle spasm and loss of strength.

Treat a muscle strain or sprain with rest, ice and anti-inflammatory medications. A compression bandage can help reduce swelling.

To prevent strains and sprains, warm up and cool down properly. Balance exercises can strengthen the muscles around the ankle.

Ankle Sprains

Acute ankle sprains are the most common athletic injury. They account for 85 percent of all ankle injuries. Basketball is one of the most common sporting events where ankle injuries occur.

What are the symptoms of ankle sprains?

Symptoms include acute pain in the ankle, swelling (inner and/or outer ankle), discoloration to injured area after a day or two, and inability to bear weight.

How are ankle sprains treated?

Treatment can include rest, ice, compression and elevation of the foot. Your doctor may order an X-ray to rule out a fracture.

How can you prevent ankle sprains?

Stretching and strengthening exercises can help you avoid ankle sprains. Wearing shoes that fit properly helps too. Prevent recurrent ankle sprains with preseason strengthening, pre-game stretching, ankle braces, taping and high-top shoes.

Groin Strains

Lower abdominal (groin) strains usually begin gradually and are often found in sports that require a lot of twisting and turning, such as football or tennis. It is an overuse injury and since the abdominal muscles are constantly used, rest is often necessary.

What are the symptoms of groin strains?

Symptoms include pain during activities such as sprinting (not light running), striking a ball, and sometimes while laughing, coughing or sneezing. Some people will have stiffness in the area after sitting for a long time.

How are groin strains treated?

Treatment involves compressing the area to minimize movement and swelling. Adductor (groin) stretches and abdominal strengthening exercises are recommended, as is rest with periods of gentle stretching. You should see your physician if pain does not subside within a few weeks.

How can you prevent groin strains?

You can prevent groin strains with light stretching of the groin and abdominal muscles daily as well as strengthening exercises for the abdomen and back. Rest if you feel pain.

Hamstring Injuries

One of the most common and troublesome injuries seen in sports is the hamstring strain. The hamstring is a group of muscles located on the back of the thigh. The main job of the hamstring muscles is to allow the leg to bend and extend. Hamstring injuries can occur in a number of ways; the most common is through overstretching.

A mildly strained hamstring that is not treated properly and allowed to heal sufficiently may result in recurring strains of that hamstring. Common causes are training too hard, not warming up enough before exercising and having had a previous hamstring injury.

What are the symptoms of hamstring injuries?

Symptoms include pain suddenly radiating to the thigh, pain upon touching the thigh muscle, an inability to bear weight or walk, spasms, or muscle soreness, especially upon bending the knee.

How are hamstring injuries treated?

Treatment includes rest, ice, compression and elevation, and reducing activity until the soreness is gone. Doing gentle range-of-motion exercises can help you maintain flexibility, as can physical therapy for strength and flexibility exercises.

How can you prevent hamstring injuries?

You can prevent hamstring pulls by warming up for at least 10 minutes before exercising, stretching and eating a balanced diet.

Patient Services

MyChart

MyChart is a secure online tool that provides personalized health information from the privacy of your home at any time, day or night. Learn more or login now.

Virtual Visits

You can now stay connected to your healthcare team through virtual visits, using your smartphone, tablet or computer.

Why go virtual? It's an easy, convenient and secure way to see your provider face-to-face without having to leave home. This saves you travel time, parking fees and time spent in the waiting room — and you can also have a loved one or caregiver join you. If appropriate, you can also get a prescription sent to the pharmacy of your choice.

Many insurance companies cover the cost of virtual visits, so check with your insurance company ahead of time. Interested in getting started? Call your provider to find out what virtual visit options are available.

Learn more about virtual visits for scheduled appointments.

Virtual Visits with Orthopaedics

New patients with common knee injuries or knee pain.

Established patients scheduling follow-up care appointments such as:

Post-Surgical & wound check visits
Fracture care follow-up
Injection follow-up
Musculoskeletal injury follow-up
Per-operative teaching prior to surgery

Ask your physician if a virtual visit follow-up appointment is right for your follow-up care.

Virtual Second Opinions

If you cannot travel to Cleveland Clinic, help is available. You can connect with Cleveland Clinic specialists from any location in the world via a phone, tablet, or computer, eliminating the burden of travel time and other obstacles.

If you’re facing a significant medical condition or treatment such as surgery, this program provides virtual access to a Cleveland Clinic physician who will review the diagnosis and treatment plan.

Following a comprehensive evaluation of medical records and labs, you’ll receive an educational second opinion from an expert in their medical condition covering diagnosis, treatment options or alternatives as well as recommendations regarding future therapeutic considerations. You’ll also have the unique opportunity to speak with the physician expert directly to address questions or concerns.

Learn more about virtual second opinions.

Appointments

Ready to schedule an appointment with a specialist?

If you would like to set up a consultation with a sports medicine specialist, please call:

Cleveland Appointments: 877.440.TEAM (8326).
Akron Appointments: 330.344.2663.
Canton Appointments: 330.489.1362.
Dover Appointments: 330.343.3335.

Same-day appointments are available for urgent sports injuries at multiple locations throughout Northeast Ohio.

Why Choose Us?

At the Orthopaedic & Rheumatologic Institute, we offer patients the most advanced treatments for any type of sports injury. Our institute uses a multidisciplinary team approach, bringing all of the experts that you need together under one roof, including top orthopaedic surgeons, primary care sports medicine physicians, physician assistants, physical therapists, athletic trainers, registered dietitians, radiologists and exercise physiologists.

Being part of Cleveland Clinic means you have easy access to any of our other specialists to manage any related conditions. Our experienced team works closely together and helps develop an individualized plan to best meet your needs.

Resources

Sports Injuries