Managing Muscle Strains in the Athlete
Dan Sweet, PT
Physical Therapist
UnityPoint Health - Des Moines Des Moines Outpatient Therapy West
If you are an athlete, parent of an athlete or a coach you probably have been challenged by muscle aches, pains, and strains common with all recreational and competitive sports. Determining the severity of the injury is sometimes difficult because the athlete doesn't want to be pulled from participation. However, it is often the most important factor to insure the safety of the athlete. The one common goal should always be to return the athlete to competition in the safest and most efficient manner.
There are many components to consider when evaluating an injury to determine the severity and/or ability to return to play. Initially you should consider the history and/or mechanism of the injury. Did the injury gradually build up, or did it occur on one specific moment in training? Injuries that can be isolated to one specific event generally indicate a more severe or complex injury. Gradual symptom onset typically indicates overuse type injuries, or injury due to training errors. If a collision occurred there is a greater probability for a variety forces and torques involved therefore more risk for injury. Is there any acute swelling? Significant, acute swelling is a sign that the body itself has recognized that an injury has occurred and it has started the inflammatory/healing response. Are they able to maintain full, fluent movement of the joint without pain or hesitation? Are they able to walk or run without hesitation or a limp? If an athlete is hesitant with movement of their body at game speed, they will be at a disadvantage when facing an opponent leaving them susceptible to re-injury, or a more significant injury. After considering the above factors, if you feel the athlete sustained a significant injury, you should seek medical attention through the school's athletic trainer, or physician's office.
After evaluating the injury, the focus turns to injury management. The initial goal is to reduce pain and swelling as well as maintain full, pain free range of motion of the affected joint and surrounding joints. Rest, ice, elevation and a compressive wrap may help with any swelling that may have occurred. Simple movements of the joint can be done in addition to gentle stretching to restore joint mobility. Promote weight bearing if this can be done without hesitation, instability or pain. Light to medium level cardio activities such as stationary bike, elliptical or water exercise can be done to promote early mobilization without directly stressing the affected area.
As the injury heals the athlete will become more comfortable with movements and use of the affected area. At this point you can continue to advance the intensity of cardio activities, progress stretching, and begin to incorporate "pre-game" warm up type activities or sport specific strength and conditioning. The athlete should continue to be monitored for any signs of hesitation with these activities and not be allowed to advance to more strenuous activity or contact if hesitation is observed. Throwing athletes should be evaluated with short toss before being progressed to long toss. Running/agility athletes should be evaluated with straight forward/backward movement before incorporating any cutting drills/activities. Jumping mechanics should be evaluated for body control before combining with running and more complex activities.
The recovery time frame from the initial injury to return to competition can vary from a few days to several weeks or months. It's dependent upon the severity of the injury and most importantly varies from athlete to athlete. It is important to allow adequate time for tissue healing, as well as a full return of strength and agility. Following a stepwise approach to any muscle strain will allow for a safe and efficient return to sport, and will contribute to greater longevity of the athletes career.
If you have any questions or need assistance in evaluating an injury or rehabilitating an injury feel free to contact an UnityPoint Health - Des Moines Des Moines Physical Therapist or Athletic Trainer.
Dan Sweet, PT
Physical Therapist
UnityPoint Health - Des Moines Des Moines Outpatient Therapy West
6001 Westown Parkway Suite 205
West Des Moines, IA 50266
(515)224-5225