Sports Injury & Pain Management
Sport and physical activity is beneficial to overall health. However, for some people sport and physical activity participation can lead to pain and injury. Sports injury and pain management refers to the prevention and/or treatment of pain and injuries that most commonly occur during sports or exercise. Appropriate and effective management of pain and injury is crucial for a return to sport, prevent recurrence and improve performance.
Sports injuries and sport-related pain – is there a difference?
Did you know that pain can occur in the absence of tissue damage? While pain is common in sport and physical activity participation, it is not always associated with tissue damage. It is common to think that pain is an indication that a body part is damaged. This is true where there was a clear trauma such as spraining an ankle or knee when landing, falling from a bike, getting hit by someone causing a broken bone. In these instances tissue damage such as ligament tears or even a fracture can occur causing pain.
However, when pain occurs in the absence of a clear traumatic event, it often indicates that the tissues of a body part are sensitised but not necessarily damaged. We know that pain is influenced by several factors such as the amount of physical activity that one is doing (training load), a person’s level of strength and conditioning to tolerate such training load, levels of fatigue, sleep quality, mental health and how much weight a person is carrying around their belly. All these factors can interplay and lead to tissue sensitivity, inflammation and pain which is not directly correlated to the level of tissue damage or injury.
Why is this important?
Because this distinction can guide a person’s response to pain and the management they need to receive. For instance, when the body is damaged, protecting it for a short time, to allow for tissue healing, and then gradually building the bodies capacity to tolerate load is the fastest way to recovery. On the other hand, treating the body as if it is damaged (ie. resting and avoiding activity) when it is not, often leads people to over-protect it, lose strength and avoid physical activity unnecessarily, which can be detrimental and delay recovery and return to sport.
At Body Logic Physiotherapy, our job is to make an accurate diagnosis of your problem and design the most appropriate management plan.
Myths about rehabilitation exercise and pain
- Pain is always an indication that a body part is damaged
- Pain is always an indication that I should get a scan
- Scans always identify the source of the pain
- Pain means I should rest and protect the painful body part
- Pain is solely influenced by the health of my structure and the mechanics of my body
- Activities that provoke pain should be avoided
- Treatments targeting faulty structures (based on a scan) result in pain relief
- Perfect body mechanics and posture are needed to avoid injuries and pain
Facts about sports-related pain
- While pain related to a traumatic event can be associated with tissue damage; pain that occurs in the absence of trauma can occur in the absence of tissue damage.
- In the absence of a traumatic event, a scan is often not indicated
- In the absence of trauma, scans are usually poor predictors of pain
- Improving tissue tolerance to load (ie. graduated strengthening) and gradual return to sports and physical activity is paramount to build physical resilience.
- Lifestyle factors such as diet, sleep and general health, and sport-related factors such as training load and physical conditioning are all important for pain
- Mind-body factors such as mood, stress and anxiety affects the level of pain
- Passive treatments (ie. massage, dry needling, injections) targeting painful structures only result in short term pain relief, where active treatments (ie. movement control, graduated strengthening and conditioning) provide long term strategies for recovery
- A more holistic approach that targets contributing factors to a person’s pain, and that helps the person in pain take charge of their management is recommended
What is our experience with sports-related pain and sports injuries?
All our physiotherapists enjoy being physically active and partake in a range of sports including cycling, CrossFit, dance, football, track and field, cricket, netball, soccer, swimming, Brazilian Jiu Jitsu, mountain biking and hiking. We have a wealth of experience in many sports, having worked with numerous elite athletes and sporting teams including national teams and Olympians. These include:
- West Australian Institute of Sport and Australian Institute of Sport
- Athletics Australia and Western Australia
- Rowing Australia
- Independent Girls School Sports Association
- Cricket Australia
- Brazilian Jiu Jitsu
- WA Ballet
Injury prevention & screening
Prevention is always better than treatment. The latest research shows that back pain and lower limb injuries can be prevented with the right exercise programs. Based on this work we have developed an assessment and screening program which consists of a number of tests that are used at an elite level to identify:
- Areas that may impede performance or increase risk of injury.
- Identify appropriate loads and load monitoring to maximise tissue tolerance and capacity.
- Deficits in muscle power, endurance, flexibility and control.
This includes a biomechanical video analysis of your sport if appropriate (e.g. running, rowing, cycling).
We can then provide a specific program aimed at both reducing the risk of pain / injury, as well as enhancing athletic performance in your sport or activity. Our screens require roughly one hour to complete.
Upon completion, you will receive a full report on the findings from the screen, and we will also liaise with your coach, parents, personal trainer, or doctor as required.
Diagnosis
At Body Logic, we perform a thorough and detailed assessment to ensure accurate diagnosis and identification of key contributing factors.
In order to make an accurate diagnosis we will first take a comprehensive history in order to identify the key factors linked to your pain. This will include your pain history, your pain experience, how it impacts you, your training program, and other factors that can influence pain such as your sleep, mood, stress and general health if relevant.
Based on this we will conduct a thorough examination to:
- Identify the pain related structures
- Determine whether pain is related to tissue damage
- Biomechanical assessment
- Tests to determine levels of tissue sensitivity, muscle control, mobility, strength, endurance.
Back pain is a common problem in athletes. Here’s how you can manage it:
Investigations
Sometimes further investigation is needed in the diagnostic process when specific pathology is suspected. In those cases, if further imaging is required, we can refer you directly for these investigations and then create a plan around managing those specific tissue insults to get you back to physical activity.
Individualised management plans for sports injuries
With all pain problems and injuries that are assessed, the physiotherapists at Body Logic ensure you are left with a clear understanding and plan of how to work towards changing these issues.
Our management plans include:
Education – knowledge is power
- Developing a clear understanding of your pain condition is the key to success. Each person has different contributing factors that can be targeted in a personalised way. These can be factors related to our body (e.g. our control of our body, strength, agility, coordination, fitness) as well as our mind (e.g. thoughts, perceptions and emotions).
- Rehabilitation programmes that gradually progress your mobility, movement control, strength and conditioning to keep you active and/or return to your sport. These may include:
- Motor control exercises that target the way we control our body.
- Stretches/mobility exercises.
- Strength and power work with body weight, resistance bands, weights, gym equipment.
- Proprioception and balance activities.
- Cardiovascular components with bike, treadmill/running/walking, rower, swimming, or whatever works best for each specific case.
- Sports specific activities to help retrain the injury ready for return to sport.
- We will provide an estimated time frame required for return to sport.
Hands-on treatment
Depending on your problem the physiotherapist may use targeted hands-on treatment as a part of your management. This can sometimes help improve mobility, reduce muscle tension or ease soft-tissue pain in the short term. At Body Logic Physiotherapy this is used as an adjunct to above management strategies.
The different types of hands-on treatment we may use include:
- Massage including deep tissue, myofascial release and trigger point work. Self-massage to continue treatment effects outside of the consultation.
- Dry Needling is a technique to treat pain arising from pain sensitive muscles, involving the placement of a needle into a tender and / or tense point.
- Mobilisation or manipulative movement of the joints through gentle or firm oscillations.
- Muscle stretches and mobility work to increase flexibility. Our Physiotherapists will demonstrate different ways you can become more independent with some of these techniques.
Lifestyle strategies
We can provide you with strategies to help you sleep better, be more resilient to stress and maintain a healthy body weight – this can assist you to build mental and physical resilience. If required we will refer you to healthcare professionals that are specialised in these areas such as dieticians, psychologists etc.
- Sleep management
- Sleep and pain often have an intertwined relationship with pain disturbing sleep and impacting on sleep quality and / or duration which in turn increases pain and reducing pain thresholds in otherwise healthy people.
- Athletes who sleep less than eight hours per night have been shown to have an almost two-fold increase in injury risk!
- Relaxation strategies to assist with stress coping
- Mindfulness and relaxation strategies can improve tolerance to stress and resiliency as well as positively impact sleep and reduce pain.
Who can benefit?
- Whether you’re a weekend warrior, compete at an amateur or sub-elite level, or are on the cusp of making it at the elite level, you can be assured that you are receiving the same level of care as some of the nation’s greatest athletes.
- Whether your pain / injury results from trauma/accident, poor/incorrect technique, pushing beyond your tissues’ tolerance (over-doing it), improper equipment or lack of conditioning, we can help to optimise your performance.
If you are experiencing sports-related pain, get in touch with our friendly team today!
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