LIVING WELL

Playing through pain is only heroic if your name is Rocky Balboa, and immediate action can reduce recovery time. For starters, use the R.I.C.E method: rest, ice, compression and elevation. The moment you’re injured, stop all activity. Apply ice for 15 minutes at a time during the first 24 hours to reduce swelling and pain. Compression in the form of an elastic bandage, sling, cast or splint provides support and protects the injured area from further trauma. Elevating the limb (higher than the heart) decreases blood flow and swelling.

Over-the-counter, non-steroidal, anti-inflammatory drugs such as Advil, Aleve and Tylenol relieve inflammation and reduce pain. For more serious injuries, physicians may prescribe something stronger. The key is to act fast and get a professional opinion. Putting ice on a sprained ankle without first having a physician determine if it’s a complex or simple sprain could delay healing for weeks or months.

“Ninety-five percent of sports injuries don’t require surgery,” says Dr. David Rubenstein, director of Main Line Sports Medicine in Wynnewood. “What’s needed are accurate diagnosis, pain relief and rehabilitation to recover full range of motion, strength and endurance.”

According to Rubenstein, the main cause of long-term injury results from a patient’s unwillingness to follow through with rehab. “They say, ‘Hey, doc, I feel great. Why can’t I play?’ I tell them it’s like a pregnant woman wanting to deliver her baby after only five months because she’s feeling so good,” says Rubenstein, who is also head physician for the Philly Soul arena football team.

Weekend warriors and kids are more likely to try to tough their way through the pain and, in the process, risk permanent disability. Relying on those “good” feelings and engaging in activity before the body has time to fully heal can turn a simple sports injury into a major surgical problem.

For a fast and complete recovery, the key is motivation. “Professional athletes are highly motivated to cooperate with their trainer and physician and complete the rehab program because their multimillion-dollar careers depend on it,” says Rubenstein.

Rubenstein recalls an 11-year-old tennis player with a separated shoulder who called his office three times in hopes of getting permission to play in a tournament. “His parents were on the line, and I know they were counting on me to convince their son to stick with the rehab program,” he says.

“People want to get their game back too quickly,” says physical therapist Debbie Rasansky of Rasansky Physical Therapy in Bala Cynwyd. “Our goal is to teach you how to manage yourself and your injury without pain.”

With 325 people coming to her rehab center each week, Rasansky is quick to link particular sports with certain injuries. “Tennis players and golfers come to us with shoulder and back issues; soccer players with knee injuries; bicyclists with broken collarbones and lower back pain; joggers with runner’s knee.”

What about supposedly gentle, meditative activities such as yoga or Pilates? Rasansky rolls her eyes. “We see a lot of yoga injuries,” she says.

Rasansky works with clients one-on-one to develop a program that meets their specific goals. “A 50-year-old lawyer who plays racquetball once a week doesn’t have the same goals as an 18-year-old lacrosse player,” she says.

Rehabilitation treatments include a wide range of therapies and exercises. Electrostimulation uses a mild electric current to reduce pain, decrease swelling and prevent muscle atrophy. It doesn’t hurt—the sensation is pleasant, more of a tingle than a jolt. Ultrasound uses high-frequency sound waves to produce deep heat, stimulating blood flow and promoting healing. Thermotherapy utilizes heat in the form of hot compresses, pads or lamps to increase blood flow, speed healing and reduce pain. Traction gently decompresses the spinal column, relieving pinched nerves and reducing pain. Massage—or what Rasansky prefers to call “hands-on”—increases blood flow, lowers pain and relaxes muscles.

“If something hurts, we don’t do it,” says Rasansky. This applies to exercise equipment used to restore flexibility and strength, from the standard treadmill to the ATM-2. No, it doesn’t spit out cash. Short for Active Therapeutic Management Unit, the ATM-2 is a high-tech device that provides maximum support to the injured area while permitting the widest possible range of movement. It provides a safe, pain-free way to stretch and strengthen weak muscles.

NOT SURPRISINGLY, the more active you are, the more likely you are to experience a sports injury. For every 1,000 hours you play tennis, you can expect to be injured five times. Just walking? You’re likely to be hurt twice. But unless you’re a pro ice hockey player, many injuries can be avoided. “Most happen when players are fatigued,” says Charlie Dodds, owner of Rocket Sports, an indoor soccer and lacrosse arena in Wayne. “Parents tend to push their kids. Children are over-scheduled these days and don’t have enough time to play on their own without a coach.”

A children’s soccer coach, Dodds sometimes has to keep injured players out of practice so they’ll be able to play in games. “Parents don’t understand. They want their kids to play all the time,” says Dodds. “That leads to injury.”

Before and after practice and every game, Dodds asks himself if there’s anything he needs to know about injuries. He credits the hiring of full-time trainers at local schools, in addition to the coaches, as a major improvement in sports safety. “Trainers are getting kids back in the game faster and safer,” he contends.

Proper instruction in any sport or exercise regime lowers the risk of injury no matter how experienced you are. Overemphasizing the wrists during a golf swing can lead to golfer’s elbow, a strain of the muscles on the underside of the arm. In softball, the shoulder is in danger if you rely on arm strength and don’t build up your trunk, leg and hips. Most people learn weight training by watching others in a gym, often picking up bad habits in the process. In working with a specialist, you can set realistic goals, learn proper technique and avoid injury.

Unfortunately, most people don’t seek out a trainer for bicycling, the sport that accounts for the highest rate of traumatic head injury of adults and children. The majority of these injuries could be prevented by using helmets (you’d be surprised to learn how many children don’t wear them).

Headgear is also a key factor in preventing traumatic injury while playing baseball, softball, football and hockey, as well as horseback riding, skateboarding, skiing, wrestling and more. It’s also recommended for martial arts and soccer.

Warming up and cooling down are as important for your body’s maintenance as they are for your car. Try light aerobic and cardiovascular activity for 10 minutes before you stretch. Warm-ups and stretches should be sports-specific and focus on the muscles you’ll be using.

Sprain Stretch or tear of a ligament, commonly occurring at the ankle, wrist or knee, causing pain, inflammation or joint instability.

Strain Twist, pull or tear of a muscle or tendon, causing pain, spasm and loss of strength.

Runner’s knee Pain under the kneecap at front or side of knee.

Tendonitis Degeneration of a tendon—most often the Achilles connecting the calf muscle to the back of the heel. Common for both weekend warriors and professional basketball and football players.

Compartment syndrome When muscles swell causing interference with nerves and blood vessels. Generally caused by repeated hard blows or overuse.

Shin splints Pain along the tibia or shinbone in the front of the lower leg. Commonly seen in runners.

Acute fracture A break in the bone from a quick, one-time injury.

Stress fracture A break in the bone from repeated stress over time. Common in running and jumping sports.

Dislocations When two bones that come together to form a joint become separated. Frequently affecting hands and shoulders.

Acute Injuries occur suddenly during an activity, resulting in pain, swelling and an inability to place weight on a lower limb and move through a full range of motion.