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San Diego Chiropractic Care Center www.SanDiegoChiropracticCare.com 4419 47th St. San Diego, CA. 92115 619 282-0182 Dr. Alex Pozhitsky DC Patient Education Chiropractic Treatment of San Diego Sport Injuries: Prevention and Russian Flexibility Training by Dr. Alex Pozhitsky DC San Diego is a city of sun, surf, ideal weather,
and an active population engaged in a wide variety of sports
including running, soccer, tennis, golf, baseball, basketball,
and of course surfing. It is within these sports that I use
chiropractic to treat the vast majority of sport related injuries
and offer preventative advice for patients with injuries such
as back and neck pain, tennis elbow, rotator cuff tendinitis,
wrist strains, knee pain , calf and achilles tendon injuries,
ankle sprains, shoulder pain, wrist and hand pain, plantar fasciitis,
shin splints, hamstring injuries, and more. Although we rarely
see these types of injuries in the well conditioned professional
athlete, it is by far more common in the "weekend warrior"
who has failed to stretch, warm up, and who is in poor physical
condition to start. We are strong advocates of regular chiropractic care and Russian Flexibility Training for prevention of sport injuries. Common Sport Injuries Seen in my Chiropractic Practice: Running Injuries Running injuries are an unfortunate, but all too common, occurrence. These include hip bursitis, snapping hip syndrome, iliotibial band syndrome, pulled hamstring, patellofemoral syndrome, dislocating kneecap, plica syndrome, shin splints, stress fractures, exercise induced compartment syndrome, ankle sprain, achilles tendonitis, plantar fasciitis, overpronation, and arch pain. Hip & Thigh Injuries Hip Bursitis - Inflammation of the bursa over the outside of the hip joint, so-called trochanteric bursitis, can cause pain with hip movement. Treatment of hip bursitis is often effective, but the condition has a problem of coming back and sometimes becoming a persistent problem. Snapping Hip Syndrome - Snapping hip syndrome is a word used to describe three distinct hip problems. The first is when the IT band snaps over the outside of the thigh. The second occurs when the deep hip flexor snaps over the front of the hip joint. Finally, tears of the cartilage, or labrum, around the hip socket can cause a snapping sensation. Iliotibial Band Syndrome - The iliotibial band is a thick, fibrous band that spans from the hip to the shin; it lends stability to the knee joint, and is attached to muscles of the thigh. ITBS is caused when the band becomes inflamed and tender. Pulled Hamstring - A pulled hamstring is a common sports injury, seen most commonly in sprinters. A pulled hamstring is a injury to the muscle called a hamstring strain. Treatment of a pulled hamstring is important for a speedy recovery. Knee Injuries Patellofemoral Syndrome - Also called "Runner's Knee," problems associated with the patella, or kneecap, are common in runners. The term runner's knee may refer to several common injuries such as chondromalacia, patellar tendonitis, or generalized knee pain. Dislocating Kneecap - A dislocating kneecap causes acute symptoms during the dislocation, but can also lead to chronic knee pain. Patients who have a dislocating kneecap may improve with some specific physical therapy strengthening exercises. Plica Syndrome - Plica syndrome occurs when there is irritation of the lining of the knee joint. Part of the lining of the knee joint is more prominent in some individuals, and can form a so-called plica shelf. If this tissue becomes inflamed, it can cause knee pain. Leg Injuries Shin Splints - Shin splints, like runner's knee, is a term that describes a set of symptoms, not an actual diagnosis. Shin splint pain can be due to problems with the muscles, bone, or the attachment of the muscle to the bone. Stress Fractures - Stress fractures of the hip are usually seen in long distance runners, and much more commonly in women than in men. These injuries are usually seen in endurance athletes with deficient nutrition or eating disorders. Exercise Induced Compartment Syndrome - Exercise induced compartment syndrome is a condition that causes pain over the front of the leg with activity. Patients with exercise induced compartment syndrome may require surgery, call a fasciotomy, to relieve their symptoms. Ankle Injuries Ankle Sprain - Ankle sprains are common injuries that runners experience. Early recognition and treatment of this problem will help speed your recovery from ankle ligament injuries. Achilles Tendonitis - Achilles tendonitis is a painful condition of the tendon in the back of the ankle. Left untreated, Achilles tendonitis can lead to an increased risk of Achilles tendon rupture. Foot Injuries Plantar Fasciitis - Plantar fasciitis is a syndrome of heel pain due to inflammation of the thick ligament of the base of the foot. A tight, inflamed plantar fascia can cause pain when walking or running, and lead to the formation of a heel spur. Overpronation - Pronation is a normal movement of the foot through the gait cycle. When this motion becomes excessive, overpronation can cause a variety by altering the normal mechanics of the gait cycle. Shoes to control excess foot motion can be helpful for overpronators. Arch Pain - Arch pain is a common foot complaint. Arch pain, also sometimes called a strain, often causes inflammation and a burning sensation under the arch of the foot. Treatment of arch pain often consists of adaptive footwear and inserts. Soccer Injuries Ever since 1984, the year soccer passed baseball as the most popular team sport in the United States, participation in this sport has skyrocketed. With increasing numbers of children running and kicking their way down soccer fields across America, doctors of chiropractic are urging parents to take a step back and learn how to protect their children from the potential injuries this popular sport can cause. Although soccer can be a great overall sport for children, some youngsters are enduring mild to severe head traumas, neck injuries, damage to the cervical spine, headache, neck pain, dizziness, irritability, and insomnia as a result of their participation. Each year, in fact, youths under age 15 suffer more than 227,100 soccer-related injuries, according to recent reports. Tennis Injuries The most common injuries associated with tennis involve the: Elbow Tennis Elbow - Tennis elbow is a common injury and got its' name because tennis players tended to get it. It is inflammation or degeneration of the tendon that attaches to the bony bit (lateral epicondyle) on the outside of the arm or elbow. Shoulder Rotator cuff injury - The rotator cuff muscles control rotation of the shoulder. They consist of the infraspinatus, teres minor and supraspinatus which rotate the shoulder outwards and the subscapularis which is one of the muscles which rotate the shoulder inwards. These muscles are put under a great deal of strain especially in throwing events and racket sports where your arm is above your head a lot. A sudden sharp pain in the shoulder would indicate a possible rupture of a tendon, while a gradual onset is more likely to be inflammation. Biceps Tendonitis - The biceps muscle splits into two tendons at the shoulder. A long one and a short one. The long tendon runs over the top of the humerus bone (upper arm) and attaches to the top of the shoulder blade. Inflammation of this tendon is a fairly common complaint especially with swimmers, rowers, throwers, golfers and weight lifters. Knee Tennis leg / calf strain - The calf muscles consist of the Gastrocnemius which is the big muscle at the back of the lower leg and the Soleus muscle which is a smaller muscle lower down in the leg and under the Gastrocnemius. Either of these two muscles can be strained (torn). Symptoms include: A sudden pain at the back of the leg. Difficulty in contracting the muscle or standing on tip toe. Pain and swelling or bruising in the calf muscle. A sudden sharp pain in the calf muscle followed by difficulty using it usually a give away for a calf strain. The most common place to get this injury is at the muscle - tendon junction of the Gastrocnemius roughly half way between the knee and the heel. You can test for this by contracting the muscle against resistance with the legs straight. Pain is felt midway up the calf muscle. Jumpers' knee - The patella tendon (or ligament as it is sometimes called) connects the kneecap to tibia bone. Under extreme stresses such as those involved in jumping a partial rupture can occur. This can often lead to inflammation and degeneration of the tissue. Inflammation can also result from overuse. Injury to this often affects athletes involved in jumping or throwing sports. Weight lifters, Tennis and Badminton players can also be affected. Rest in the early stages is important. What are the symptoms? Pain at the bottom of the kneecap especially when pressing in. Aching and stiffness after exertion. Pain when you contract the quadriceps muscles. Thigh Muscle strain - There are five adductor muscles, the pectineus, adductor brevis and adductor longus (called short adductors) go from the pelvis to the thigh bone and the gracilis and adductor magnus (long adductors) go from the pelvis to the knee. The main function of these muscles is to pull the legs together. They are also used quite a lot in sprinting, playing football, horse riding and hurdling. A rupture or tear in the muscle usually occurs when sprinting, twisting or when kicking something that doesn't move. Symptoms include: Tightening of the groin muscles that may not be present until the day after competition. A sudden sharp pain in the groin area or adductor muscles. Bruising or swelling (this might not occur until a couple of days after the initial injury) Inability to contract the adductor muscles A lump or gap in the adductor muscles. Pulled Hamstring - A hamstring strain or a pulled hamstring as it is sometimes called is a tear in one of the hamstrings muscles (Semitendinosis, Semimembrinosis and Biceps femoris). It often results from an overload of the muscles or trying to move the muscles too fast. Symptoms include: A sudden sharp pain at the back of the leg. Muscles going into spasm. Swelling and bruising. If the rupture is very bad you may feel a gap in the muscle Back Lumbago - Lumbago is the term used to describe general lower back pain. The exact cause of the back pain is often unknown. The pain can come on after lifting things, or overuse (see weak back) or it may come on without previous exercise or training. Symptoms include: Pain in the lower back which does not radiate down the legs. Stiffness in the back especially in the morning. Scoliosis - Scoliosis is a sideways curving of the spine that can often result in an 'S' shape or 'C' shape in the spine. If someone runs there fingers down the spine either side of the vertibrae they will leave two red lines. It is often easier to see the curving of the spine in these red lines.Scoliosis is often a result of an imbalance in the muscles caused by one sided activities such as throwing or racket sports. Children can develope it through carrying heavey bags on one shoulder all day at school. How can you prevent scoliosis in young people? Avoid carrying heavy bags on one shoulder. Get a rucksack type bag and wear it properly or regularly alternate carrying arms and shoulders. If you are a one sided sports person e.g. Javelin thrower, hurdler or tennis player, at the end of each practice make sure you throw a few times with your wrong arm or hit a few balls with the other arm. Get into the habbit - it will be worth it in the long run. What can the athlete do about it? Keep supple and strengthen the back. See a sports injury specialist like your chiropractor who can advise more on specific rehabilitation exercises. Golf Injuries An overuse injury occurs more frequently in those individuals lacking adequate flexibility and strength of the stomach, shoulder and elbow muscles. They occur when the forces of an activity exceed the muscle's ability to absorb the force. When this occurs, it is the tendon that is overstressed. Impingement syndrome is the most common injury of the shoulder, occurring in the front arm at the end of the swing. Golfer's elbow occurs in the dominant arm as the club head strikes the ball or ground. For back injuries, these are generally only strained muscles but in more severe cases, the lumbar disc can become irritated or ruptured. Shoulder Impingement is an inflammation of the shoulder's rotator cuff tendons. This inflammation is caused from the "pinching" of the tendons between the bones of the shoulder. For golfers, this most often occurs in the front region of the arm and is felt at the finish of the swing. Strong rotator cuff muscles are the best way to prevent this from happening. Back Injuries are one of the most common injuries in golf involve the lumbar, or lower, back. The rotational stresses of the golf swing place considerable stress on muscles and bones. Poor flexibility and muscle strength can cause minor strains of the back that can easily become severe injuries. Golfer's Elbow is an inflammation of the tendons on the inside of the elbow. This is commonly caused from the elbow absorbing the club's impact onto the ground such as taking a divet. It is easily preventable with proper treatment. Baseball Injuries Shoulder and elbow injuries occur frequently in the throwing athlete, particularly in baseball players from Little League to high school level. Shoulder instability is one of the most common conditions in the throwing athlete and is usually the result of an imbalance that exists when the structures in the front of the shoulder are too loose and the structures in the back of the shoulder are too tight. This imbalance often occurs in combination with weakness of the rotator cuff and scapula (shoulder blade) muscles. Players complain of pain in the front or back of the shoulder, which is the result of an unstable ball and socket joint that actually allows too much movement of the joint during the throwing motion. Basketball Injuries Basketball is one of the most popular sports in the United States and throughout the world. Basketball injuries can be separated into two general categories: overuse injuries and traumatic injuries. Overuse injuries Injuries caused by stressing an area over and over until it is damaged and begins to hurt are described as overuse injuries. One such injury is patellar tendinitis, or "jumper's knee," which is characterized by pain in the tendon just below the kneecap. Achilles tendinitis is another common overuse injury in basketball players. This injury of the tendon connecting the muscles in the back of the calf to the heel bone causes pain in the back of the leg just above the heel. Some basketball players overuse the tendons in their shoulders. The rotator cuff of the shoulder is composed of four muscles. The tendons that attach these muscles to the shoulder bones can become inflamed and painful, particularly when you do repetitive overhead activities, such as shooting the basketball. Tramatic Injuries Traumatic injuries are those caused by a sudden forceful injury. Some of the more common traumatic injuries in basketball are jammed fingers. The severity of a jammed finger can range from a minor injury of the ligaments, which connect bones, to a broken finger. Splinting may be needed to allow the injured finger to heal. Another type of traumatic injury is a muscle pull or tear. In basketball players, these injuries occur primarily in the large muscles of the legs. To prevent them, stretch your thighs and calves well and do warm-up exercises before playing. The most common basketball injury is the ankle sprain. This injury often occurs when a player lands on another player's foot or the ankle rolls too far outward. When this happens, the ligaments connecting bones and supporting the ankle are stretched and torn. The ligaments can tear partially or completely. To treat your sprain, your doctor prescribes a short period of immobilization, keeping the joint still, so the ligaments can heal. After immobilization, you begin special exercises to strengthen the muscles that help hold your ankle in place. If your muscles and ligaments are not strong enough to prevent reinjury, you might need surgery to repair the damage and to help stabilize your ankle. Knee injuries are some of the most serious basketball injuries. One type of knee injury is a sprain. A knee sprain is a small tear in the ligaments or joint capsule that is not severe enough to cause your knee to give way. A more severe injury is a complete tear of one or more of the ligaments that support the knee. The anterior cruciate ligament (ACL) is one of the more commonly torn ligaments in the knee. After an ACL injury, some players can participate in sports again without surgery. But they must do special exercises to strengthen their thigh muscles, and they must wear a brace on their knee. Strong thigh muscles give stability to the knee that the torn ACL cannot. Surfing Injuries Contrary to popular belief shark attack is not the most common surfing "injury", instead musculoskeletal sprain/strain is the most common type of chronic surfing injury, and the shoulder is the most common affected joint. Soft-tissue injuries comprise the second-largest category, ranging from contusions to acute strains or sprains to the lumbar and cervical spine, shoulder, knee and ankle. Also, acute musculoskeletal injuries will usually result from a wipeout. Contact with the ground surface – whether it be reef, rock or sand – can cause injury, the type and extent depending on the surfer’s position and contact area. Common injuries include over-flexion of the cervical or lumbar spine forced shoulder depression and contralateral lateral flexion of the cervical spine resulting in traction to the brachial plexus landing on the point of the shoulder causing trauma to the acromio-clavicular joint or in adolescents fracture to the clavicle or the shoulder being forced into anterior subluxation. Acute knee and ankle, ligament and joint surface injuries can result from a big drop at take-off. When standing up on fast, steep waves, the surfer’s feet can leave the board and then find it again at the bottom of the wave. If the surfer becomes unbalanced for whatever reason, he/she can land off-centre, putting excessive rotational or medial/lateral force through knees or ankles. Overuse injuries of the shoulder, neck, back and elbow are common and relate to prolonged time spent paddling, tummy down, on a board. |