Sports Injury – Should You Play Through It?

What happens if you kid get injured in sports this Fall?

Fall is quickly approaching. This means the minds of parents are quickly filling with thoughts of how to juggle school drop off and pick up, homework, sports practices, and weekends filled with traveling for games and meets.

To put it another way…the start of a new school year and sports season can be a bit (or A LOT) stressful!

And despite all of the planning to manage all of the different schedules, one thing it is hard to be prepared for is a sports injury. Many parents have a hard time knowing if they should tell their kid to “Rub some dirt on it” (always with love, of course) and give them a few days to get back to normal or if it’s something more serious that needs to be checked out. So I’m here to take some of the guesswork out of what to do if your child experiences a sports injury!

Sports injuries commonly affect either muscles, tendons, ligaments, or bones and can vary from mild to severe in each tissue type. Below I’ll go over each type of injury and give some recommendations for conservative management options, or when a visit to physical therapy or the doctor might be needed.

Muscle Injuries

Muscle injuries compromise 10%-55% of all athletic injuries with the most common types of muscle injury being contusions (bruises) or stains. A muscle contusion can occur anywhere where there is a direct blow to that muscle, however, muscle strains typically occur in the quads, hamstrings, or calf muscles.1

Muscle injuries are graded on a scale from grade 1 to 3. A grade 1 injury results in mild pain and minimal loss of strength and range of motion. If your child suffered a grade 1 muscle injury their pain will improve over a few days and they will gradually return to full strength and range of motion within 1-2 weeks. If your child has a grade 2 injury, they will likely have more pain and a significant loss in strength and range of motion.

These types of injuries will usually require at least 2-3 months (can be more depending on how extensive the injury is) for full healing and return of range of motion and strength and will require physical therapy to support the healing process and for appropriate graded exercises to allow the athlete to return to sport. A grade 3 injury is a complete rupture of the muscle and requires medical attention immediately as surgery may be required.

It is important that athletes don’t play through these injuries because they can result in further damage and lead to a more chronic problem.2

Tendon Injuries

Tendons are a connective tissue that join muscles to bones and are subject to high levels of tension in sports that require explosive running and jumping such as football, gymnastics, track, basketball, volleyball, etc.

Tendon injuries can happen acutely or chronically. Acute tendon injuries usually come on suddenly with a specific mechanism of injury and usually result in swelling, pain, limited strength, decreased range of motion, and redness/warmth of the tissue.

Depending on the severity of the injury the athlete might require a week or two to regain full strength and range of motion, or it may take months for a full recovery for more severe injuries. If your athlete is only having pain during sport but is able to perform all other daily tasks and activities without pain they may be able to return to sport without difficulty after a week or two of rest. More severe injuries will require PT to support the healing process and for a personalized treatment program to allow a safe return to sport.

Chronic tendon injuries develop as a result of repetitive movements such as running and jumping and come on slowly over time. Chronic tendon injuries are a little trickier because they often are associated with other areas of weakness or stiffness. For example, someone who is experiencing chronic patellar tendon pain (just below the knee cap) may also have hip weakness and/or ankle stiffness which is leading to increased stress to the knee. These injuries will require a thorough evaluation by a physical therapist to determine the best course of treatment for the painful area and to identify other regions of the body that may be contributing to the problem.

Ligament Injuries

Ligaments are bands of collagen tissue that connect two bones together and provide stability to the joints that they cross. Ligament injuries are called sprains and are graded on a scale of 1-3 much like muscle injuries.

Grade I injuries cause microscopic structural damage that results in slight tenderness, but no joint instability. Grade II injuries result in a partial tear of the ligament with swelling and tenderness, but with mild or no joint instability. Grade III injuries are a complete rupture of the ligament with significant swelling and instability of the joint.3

Even mild ligaments sprains should be evaluated by a physical therapist to ensure a full return of strength and stability to the joint that the ligament supports. It is very common for many athletes to rush back to the sport after “just an ankle sprain”, but this can result in future sprains due to lack of control and support at the joint and turn into a more chronic problem.

Bone Injuries

A common type of bony injury amongst runners and jumpers is a stress fracture. These injuries are a type of overuse injury and are commonly seen in the foot and leg. The athlete will experience the most pain while participating in their sport and pain will subside with rest.

They also may be point tender over the bone that is injured. If you suspect that your child has a stress fracture, it is best to see your primary care physician for imaging to diagnose. They will then be placed on rest for 6-8 weeks and may have to use a walking boot or crutches.

Physical therapy will help to maintain strength and range of motion and to help transition the athlete back to sport gradually to avoid re-injury.

One last thing about deciding what to do when your child comes home with an injury. If you think that they should be checked out, don’t hesitate to take them to an expert to get evaluated! I have had a lot of parents tell me they weren’t sure if they were “overreacting” and I always tell them that it’s better to know for sure what’s going on and get all of the information they can to help their child.

Even a mild injury can lead to chronic issues if not taken care of properly.

So, go with your gut – we all know those parent spidey-senses are there for a reason!  

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