Treatment of Sports Injuries (Care of the Young Athlete)

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There is often more than one way to effectively
treat an injury. Treatment programs are always adjusted to meet the individual
needs of the athlete and the unique requirements of the athlete’s sport
or activity.

The following is information from the American
Academy of Pediatrics summarizing general rehabilitation principles and the
importance of each phase of the treatment program. While each injury has
specific requirements for rehabilitation, the general principles of
rehabilitation apply to all treatment programs.

Rehabilitation Principle Why It’s Important
1. Confirm the diagnosis. The success of any rehabilitation program depends on an accurate
diagnosis. If a swollen joint is being treated as a sprain when
it is really a fracture, treatment may not only be ineffective
but harmful. With a valid diagnosis and treatment, symptoms
should improve in a natural and predictable way.
2. Treatment must address effects and causes of injury. The effects of an injury usually include pain; swelling; and
loss of joint motion, muscle flexibility and strength, speed,
agility, and/or coordination. A comprehensive rehabilitation
program must help reduce pain, restore movement and strength,
and correct functional deficits. It is also important to
identify and address the causes of injury. Causes of injury can
include poor training, incorrect technique, equipment failures,
and individual factors related to flexibility, strength, joint
stability, and alignment.
3. Rehabilitation happens in 4 phases.

There are 4 phases to all
rehabilitation programs that should be completed in the
following order:

1. Rest, protect injured area,
control swelling and pain.

2. Restore joint motion and
muscle flexibility.

3. Restore muscle strength,
power, and endurance.

4. Restore function
(coordination, balance, agility, sport-specific skills).

When treatment does not follow a
proper order, the results may not be as good and the overall
recovery time will take much longer.

4. Rehabilitation should not be painful. The “no pain, no gain” approach to injury
treatment is a certain way to achieve “no gain.”
It is normal to have some lingering discomfort from the injury.
However, efforts to bear weight, move a stiff joint, or exercise
an injured muscle should not cause more pain. Pain or swelling
that increases usually means the rehabilitation is moving too
rapidly or the exercise is being done improperly. Any increase
in symptoms during rehabilitation means you need to check with
your doctor. The rehabilitation prescription may need to be
changed or further testing may be needed to confirm that the
diagnosis and treatment plan are correct.
5. Use available resources. Relying solely on pictures or descriptions of rehabilitation
exercises can be misleading. To be sure that the prescribed
rehabilitation exercises are being done correctly, it may be
helpful to have the exercises reviewed by a certified athletic
trainer or physical therapist at your school or in your
community. A gym, health club, or fitness center often has
exercise equipment that can be used for injury rehabilitation as
well as general fitness or cross-training. Personal trainers and
fitness instructors can also help with general fitness and
maintenance exercises, but they are not qualified to diagnose
injuries or prescribe rehabilitation.
6. Return to play depends on restoring normal function. Returning to play following an injury requires not only time for
the injury to heal but also restoring the body’s ability
to meet the physical requirements of the sport. All sports
require a certain amount of joint mobility, muscle flexibility,
and muscle strength. There may also be a need for speed, power,
endurance, agility, balance, or sport-specific skills. Even when
athletes are pain-free after an injury, they should not return
to their sport until they are able to meet the requirements to
practice and compete in the sport.
7. Maintenance therapy should continue after return to
Once an injury has been rehabilitated and the athlete has
returned to play, there are usually a few exercises or ongoing
precautions that are helpful in maintaining the recovery and
preventing reinjury. This may include flexibility or
strengthening exercises, use of protective equipment (such as
tape, braces, or orthotics), or continuing with modifications of
training or technique. Once athletes have been cleared to return
to play, they should know which precautions and exercises should
be continued long term as well as when, or if, they need to
check back for follow-up care.
8. When in doubt, ask. Every injury is different and every athlete is unique. If
treatment is not progressing smoothly or something unexpected
develops, let your doctor know. If you are working with a
certified athletic trainer or physical therapist, they may also
be able to help you with questions about rehabilitation
exercises, protective equipment, functional testing, maintenance
therapy, or the need for follow-up care.