Summer Sports Injury Prevention

Whether it’s because you’ve only done indoor workouts or because your winter involved too much Netflix-meets-couch time, warmer-weather sports injuries are common and can even sideline the most well-intentioned weekend warrior during what’s arguably the best time of the year.

Here are some of the most common questions my sports medicine colleagues and I often receive about how to stay safe when exercising – seasonally or otherwise:

What sports injuries are most common in the summer?

When the weather warms up, athletes tend to want to go back to their sports quickly to make up for the time they were inside. But increasing intensity and volume is a recipe of injury. Even for those less seasoned athletes, repetitive motion, particularly when you aren’t used to it during the winter months, can increase your risk of:

  • Stress fractures
  • Swimmer’s shoulder
  • Pitching elbow
  • Runner’s knee
  • Jumper’s knee
  • Achilles tendonitis
  • Shin splints
  • Tennis elbow
  • Rotator cuff injury
  • Pulled groin
  • Knee injuries (torn ACL, torn meniscus)
  • Dislocations

What causes sports injuries?

There are many causes of sports injuries. Everything from insufficient warm-up and stretching, poor conditioning and training techniques to previous injuries that have not properly healed or intense, high-level competition from contact (football, basketball) and noncontact (tennis, gymnastics) sports can lead to accidents. Common behaviors that can cause injuries this season include:

  • Working out too hard and/or overtraining, injuries are more likely if you are working out too often and/or for too long
  • Leveling up too quickly, changing the intensity of exercise or training too fast
  • Wearing the wrong shoes, such as shoes without enough support, increase risk of injuries
  • Poor training and/or incorrect technique can be very unsafe and ultimately lead to accidents and/or injuries
  • Not stretching before and after exercise
  • Dehydration can cause a range of symptoms, such as headache, fatigue, confusion and dizziness

Prevent Common Exercise Injuries this Summer

To perform the way you want and protect yourself from injuries, you need to take proactive steps to prepare your body properly. That means spending time during the off-season diversifying the types of activities you do.
You need to make sure you work your body in different ways. It’s important to help decrease the stress caused by repetitive motions, which goes a long way toward preventing injuries.

Prepare in the Off-Season/Winter

For anyone with warmer-weather sporting events lined up, or have plans to take up new sports this season, make sure your winter and/or off-season includes exploring new exercises that activate your core and build strength in the upper and lower body with cross-training activities, such as:

  • Pilates
  • Yoga
  • Swimming
  • Aqua jogging
  • Weight training

For runners and triathletes, strength training is not intended to build the muscle mass like a weightlifter, but instead to develop strength, power and endurance. Strength training can improve running performance and decrease injuries.

Build Up Exercise Overtime

Start with shorter distances (or a shorter duration for your workout) and build up progressively from there. Make sure you don’t increase your mileage or duration by more than 10% a week, especially if you’re running.

For example, if you ran three miles, three different times this week, your total weekly mileage is nine miles. Don’t run more than 10 total miles the following week. Build from there. Doing too much too soon means you may have to sit out the first weeks of spring nursing an injury. No one wants that.

Duration Before Speed

Speed should be the last thing you try to tack onto your training if you just started out. Once you’re comfortable with the mileage and/or duration of your workout, tempo runs or interval training will be the next steps.

Establish a Good, Consistent Stretching Routine

Make sure you stretch regularly and that the stretching encompasses your whole body. There are a lot of resources online if you’re unsure where to start. For whole-body workouts, the seven-minute workout has been scientifically validated to demonstrate benefits.

Incorporate Activity into your Workday

That could mean taking the stairs at work, do a walking meeting (weather permitting), sitting on an exercise ball at your desk, or doing calf raises and lunges while you’re on a conference call (nobody is watching you and will not think you are an exercise freak). Short bursts throughout the day can help maintain flexibility and strength when you can’t go outside. The goal is to work hard and smart with your time.

When is it time to see a sports medicine physician for a sports injury?

My best advice is to listen to your body. Working out is not about fighting through pain. Muscle soreness and the sensation of a good workout is what we are looking for. If pain has been persistent for more than two weeks even though you’ve been resting, icing and limiting your physical activity, it’s time to have your injury looked at. Swelling and bruising could indicate a more serious injury.


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Sports & Pain


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

How to Prevent Football Injuries

When you hear the term “football injury,” the first thing to come to mind may be an on-field collision, fall, or other split-second traumatic injury. But in fact, there are many muscle and tendon injuries football players face that are overuse injuries that happen over time. However, there are ways to prevent football injuries like these.“Our bodies are designed to work anatomically in a number of ways, and our bodies are also wonderful compensation machines,” Dr. Williams explained. “That means your body is great at using short-term strategies to avoid or prevent some kind of injury, usually without your even realizing it. The problem is, those strategies can be problematic in the long run, since they can lead to overuse injuries.”

How to prevent football injuries

Focus on proper biomechanics

– Everything is connected, and if your body’s mechanics are out of alignment in one area, it can cause injury elsewhere. For example, “Core and hip stabilization is key to preventing knee and ankle injury, and scapular thoracic stabilization is critical to preventing shoulder injury,” Dr. Williams said. Talk with a sports medicine specialist about evaluating and correcting ongoing biomechanical issues.

Get enough rest

Fatigue is more than just feeling tired after a two-a-day. It’s a deeper sense that your body’s resources are depleted, which can slow down recovery and healing. When you’re working hard on the practice field, prioritize rest off the field to help your body cope.

Warm up right

Avoid prolonged stretching of cold muscles before a workout. That outdated idea can actually increase injury risk. Instead, do some dynamic warm-ups, light versions of the activity you’ll be doing. You could start with a slow jog, followed by throwing and catching the football.

Strengthen that core

A strong core sets the stage for proper form from head to toe, because the core muscles stabilize the limbs. Remember, the core is not just the back and abdominal muscles at the surface. It’s also little-used muscles deep within the torso and abdomen that need attention.

Stay hydrated

Hydration is the foundation on which the rest of the workout is built. Being dehydrated can reduce performance, leading athletes to push themselves too hard and increasing injury risk. Talk with your sports medicine provider, your coaches, and your trainer about how to assess your hydration each day.

Don’t overtrain

When it comes to an intense sport like football, the pressure to overtrain can be huge. But more is not always more. Pushing yourself too hard can lead to exhaustion and poor form, making overuse injuries worse or increasing your risk of a new injury. Make sure your body has the time it needs to fuel up, hydrate, and rest to promote recovery. Your performance will be stronger in the long run.


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Preventing Injuries While Golfing

Golf is a popular sport and offers a range of health benefits. Regular golf can help improve stamina, cardiovascular fitness and muscular endurance. For example, the average golfer playing an 18-hole game walks about seven kilometers. While the risk of injury from playing golf is low compared to other sports, common golf injuries include injuries to the lower back, shoulder, elbow, wrist, head and eye.

Risk factors for golfing injuries

Some of the factors that can increase your risk of a golfing injury include:

  • Time spent playing – generally, the more often you play, the higher your risk of injury. Golfers who spend more than six hours per week in competitive play are at increased risk of overuse injuries, as are professional golfers.
  • Unsupervised children – injuries to children under the age of 10 years are often the result of inadequate adult supervision (for example, children getting hit in the face by swinging clubs).
  • Incorrect technique – examples include poor swing style and hitting the ground instead of the ball. Incorrect technique dramatically increases the risk of injury. Golfers who perform correct technique are less likely to injure themselves.
  • Failure to warm up and cool down – warming up and cooling down are extremely important to reduce the risk of muscle and joint injuries.
  • Previous injury – golf can aggravate existing injuries.

Health and safety suggestions for golf

Suggestions include:

  • Make sure equipment, such as clubs and shoes, are professionally fitted.
  • Be SunSmart. Wear sun protective clothing, use SPF30+ (or higher) sunscreen and lip balm, wear an appropriate hat, seek shade where possible and wear sunglasses.
  • Insect repellent should be carried in your golf bag at all times.
  • Drink non-alcoholic fluids before, during and after the game. Take drinks with you in your golf bag to avoid dehydration during play.
  • Practice the rules and etiquette of the game. For example, make sure that no one is standing too close when you’re about to swing, and always call out ‘fore’ to warn others if your shot appears to be heading in their direction.
  • Obey all safety instructions when driving a motorized golf cart.
  • Postpone play if lightning strikes are possible.
  • Avoid placing hands in holes or areas where spiders or snakes might inhabit.
  • Supervise young children on the golf course at all times. For example, make sure they don’t stand too close when someone is teeing off and don’t allow them to fool around with golf clubs.
  • Get adequate rest between games.
  • Carry a mobile phone, wherever possible, in case of emergency.

Warming up before playing golf

Muscle strains and sprains are more likely to occur if you fail to warm up properly before play. A study of golfers undertaken by the Sports Injury Prevention Unit at Deakin University in Victoria found that less than three per cent of Victorian golfers warm up properly, while nearly half don’t warm up at all.

Suggestions include:

  • Walk briskly for a couple of minutes to raise your heart rate.
  • Warm up your neck and upper back by dropping your chin to your chest, gently rolling your head from side to side in slow half-circles.
  • Warm up your shoulders. Hold a golf club horizontal to the ground, keeping your hands about shoulder width apart. Slowly raise the club overhead, hold for a few moments and then lower. Hold the golf club in a similar way, but this time behind your back. Raise as high as you can, hold for a few moments, then lower.
  • Warm up your torso with side bends. Slide your hand down your leg to support the weight of your torso.
  • Twist through the waist – gently and slowly turn from one side to the other.
  • Go through the motions of swinging the club without actually hitting a ball. Begin with gentle half swings and work up to full swings over the course of a few minutes.

Cool down after the activity. Use the same range of stretches suggested above.

Take care of your back

Suggestions include:

  • Consider using a buggy to transport your clubs, or carry clubs using a supportive carry brace.
  • Carry out a general strength and fitness program that includes weight training or aerobic activities, such as walking or jogging, to improve muscle strength, flexibility and endurance.
  • Strengthen abdominal muscles to support your lower back. A Canadian study found that golfers with strong side abdominal muscles (obliques) have a reduced incidence of back pain.
  • Consider taking lessons with a PGA qualified coach to improve your technique to prevent injury and improve performance.

Suggestions include:

  • Don’t engage in long practice sessions, particularly if you are practicing the one shot over and over.
  • If you are practicing your putting, make sure you straighten up and stretch regularly.
  • Remember to bend your knees when picking up balls. Lift one leg off the ground as you lean over to counterbalance your weight.
  • Try not to use more force than is necessary for the swing, especially in the ‘follow through’ motion after the ball has been hit.

Treat a golfing injury promptly

Suggestions on what to do if you are injured include:

  • Stop immediately if injury occurs. Playing on will only exacerbate the injury.
  • All injured players, regardless of how severe the injury is, should seek first aid or prompt medical treatment of their injury.
  • Treat all soft tissue injures (ligament sprains, muscle strains, bumps and bruises) with rest, ice, compression, elevation (raise the injured limb above your heart) and referral to a health professional.
  • Injured golfers should not resume play until they have completely recovered from their injury.

Where to get help

  • Your doctor
  • Professional Golf Association coach
  • Physiotherapist

Things to remember

  • Common golf injuries include injury to the lower back, shoulder, elbow, wrist, head and eye.
  • Warm up thoroughly before play to reduce your risk of muscle and joint injuries.
  • Remember to bend your knees when picking up balls. Lift one leg off the ground as you lean over to counterbalance your weight.
  • Take golf lessons to improve your technique.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Top 5 Most Effective Evidence-based Treatment Options for Concussions

Article featured on Complete Concussion Management

Historically, patients with concussion were told to rest, rest, rest. And when that didn’t work, they were told to rest some more.

The research on concussions is evolving at an exponential rate and we are realizing that not only does prolonged rest not work; it can actually make you worse.

Sadly, many healthcare practitioners are not keeping up with the explosion in concussion research and are still telling their patients that the only treatment for concussion is rest. If you have fallen victim to this, you don’t need more rest; you need a second opinion.

While it is true that during the early stages following injury, moderate rest is still important, that timeline seems to be getting shorter, with longer duration rest creating worse outcomes for patients. So, if you have been resting for more than a week, and are still having significant symptoms, it’s time to switch it up. More rest is likely contributing to your ongoing symptoms.

If not rest, then what?

The top 5 most effective evidence-based treatment options for concussion:

1. Exercise Therapy

Following concussion, animal (and many human) studies have demonstrated a reduction in blood flow to the brain in the early stages. Recent research has found that these blood flow changes may persist for some time following injury due to ongoing dysfunction in the Autonomic Nervous System (ANS). The ANS consists to two opposing sides that tend to work in opposition to one another.  The Sympathetic Nervous System is also known as the “Fight, Flight, or Freeze” system – this side of the ANS is responsible for increasing our heart rate, dilating our blood vessels to pump blood to our muscles, release adrenaline, dilate our pupils, and get us ready for action.  Our Parasympathetic Nervous System on the other hand is our “Rest & Digest” system – this side of the ANS is responsible for lowering our heart rate, increasing our digestion, activating our metabolism, and helping us to be relaxed and calm.

These two systems can be thought of like a teeter-totter.  When one is up, the other is down.  They fluctuate their dominance throughout our days but the system should maintain a harmony and balance.

Concussion creates an imbalance in the ANS with most suffering from high “Sympathetic Tone” – this means that we are stuck in a fight or flight state.  Our heart rate tends to be elevated and doesn’t respond well to increased demands, blood flow to our brain is not as responsive, our digestion shuts down sometimes leading to stomach pains, food sensitivities, and increased inflammation, our anxiety levels increase, we may get lightheaded more easily, and we suffer symptoms with increased cognitive and physical activity.

The good news is that this problem can be tested for and rehabilitated very easily; provided you know what you’re doing!

The mainstay rehabilitation for this problem actually goes against conventional thought: exercise!

Researchers at the University of Buffalo have published numerous studies demonstrating complete symptom resolution and improved brain blood flow (as measured on fMRI) through a specific graded exercise program alone.

More recent evidence suggests that exercise might even help speed recovery in the early stages after concussion!

It is important to see someone who knows exactly what they are doing with this protocol. Testing with a trained professional must be done first to establish set points as well as your specific program.  There is also more to balancing the Autonomic Nervous System that must be taken into consideration as well.

2. Manual Therapy & Neck Rehab

With every concussion, there is also a whiplash.

Studies have demonstrated that the acceleration required to cause a concussion is somewhere between 70 and 120 G’s (where G = force of gravity = 9.8m/s2). Whiplash, on the other hand has been shown to occur at only 4.5 G’s.

It is therefore conceivably impossible for a concussion to occur without also causing a sprain or strain injury to your neck! In fact, a Canadian study found that 100% of the time, these injuries are happening together.

What becomes even more confusing is that the signs and symptoms of whiplash and neck dysfunction are the exact same as concussion! Headaches, cognitive and emotional problems, balance problems and dizziness, eye movement control problems, and brain blood flow abnormalities43 have all been shown to occur in whiplash and neck pain patients.

There is actually no way to tell if the symptoms are coming from your neck or from your concussion except with testing (some specific tests that we won’t go into here). In fact, most of the patients healthcare practitioners see in this category don’t report any neck pain; which makes this all the more confusing for practitioners. In a recent unpublished study with the University of Buffalo, the researchers found that there was absolutely no difference in the symptoms that whiplash patients report and the symptoms that concussion patients report.

Concussion is an injury that typically resolves quite quickly in most people (symptoms generally disappear for 80-90% of patients within 7 to 10 days); however, whiplash symptoms can linger for up to a year or more.

So, if you are still having concussion symptoms, even if you don’t have neck pain, you may actually be suffering from symptoms that are coming from your neck; which are easily treated with manual therapy and rehabilitative exercises.

3. Diet/Nutritional Changes

With injury to any tissue, there is inflammation; concussions are no exception with several studies demonstrating increased inflammatory markers following injury.

Concussion results in a metabolic dysfunction (read: energy deficit) in the initial stages, which is why strict rest used to be prescribed early on; the thought was – anything that burns energy, such as thinking or physical activity, could increase symptoms.  As mentioned above however, rest is no longer considered an effective treatment for concussion.

It is important to note however that the majority of studies examining this metabolic disruption show a recovery between 22 and 45 days after injury. In other words, beyond a 3-6 week period, there is little metabolic explanation for your symptoms; unless of course you did not rest in the initial stages and/or received a second concussion soon after the first.

Treatment options for both of these things can include simple dietary changes such as avoiding pro-inflammatory foods (red meats, refined sugars, white breads and pastas, artificial sweeteners) and replacing them with healthier options such as fruits and vegetables, fresh caught fish (salmon, mackerel, herring), and good fats (coconut oil, flax seed, almonds). These changes may help to offset an ongoing inflammatory response and reduce your symptoms.

Another option would be to speak to your doctor about a short course of anti-inflammatory medications. Note that we say “short course” as, over a prolonged period, these medications can begin to harm your stomach and gut leading to ulcers.

4. Vestibular and Visual Rehab

Dizziness is one of the most common ongoing complaints of patients with persistent symptoms. This may be due to a number of overlapping issues such as problems with the balance centres of your brain, your visual system, and/or problems with the muscle and joint sensors of your neck.

Visual system problems may also be one of the causes of ongoing cognitive complaints such as trouble with concentration and/or memory. If you find yourself reading a passage and then having to re-read it several times before you understand what it is saying, you might have a problem with how your eyes are moving or working together. Testing for each of these areas requires extensive knowledge of each of the systems and how they may interact. If you have not had extensive testing of these systems, then you are in the wrong place!

Following a thorough assessment of these areas a proper rehabilitation program can be set up. The research on rehabilitation for these areas is extensive with numerous studies showing resolution of dizziness, and visual abnormalities with a fairly short course of treatment.

5. Education and Reassurance (due to Psychological Comorbidities)

It has been well established that patients with a pre-existing history of depression and/or anxiety tend to have prolonged symptoms. Not only that, the symptoms of these and other mental health conditions can result in, or mimic, the same symptoms of concussion (dizziness, mental confusion, concentration problems, sadness, emotional outbursts).

Many of these issues can begin before or after the concussion, which may be due to the concussion itself, or a direct result of being mismanaged by someone giving you improper advice. In other words, being told to sit in a dark room, avoid all social contact, not go to work or school, and not do any physical activity for months on end may be causing to the very anxiety, depression, and symptoms that you are attempting to stop.

Studies examining the overlay of mental health and concussion are endless (so much so that I won’t even begin to start referencing them), and mental health will always be a big part of concussion management. In most cases, patients often feel much better following some education and reassurance. The Ontario Neurotrauma Foundation recently demonstrated to be one of the best evidence-based treatment options for preventing long-term symptoms was patient education and reassurance!


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

High School Sports Injuries

High School Sports Injuries

Article Featured on AAOS

Every year, millions of teenagers participate in high school sports. An injury to a high school athlete can be a significant disappointment for the teen, the family, and the coaches. The pressure to play can lead to decisions that may lead to additional injury with long-term effects. High school sports injuries can cause problems that require surgery as an adult, and may lead to arthritis later in life.

When a sports injury occurs, it is important to quickly seek proper treatment. To ensure the best possible recovery, athletes, coaches, and parents must follow safe guidelines for returning to the game.

Read more

ACL Injuries in Children and Adolescents

ACL Injuries in Children and Adolescents

Article Featured on Nationwide Children’s

It has been frequently emphasized that children are not simply “small adults.” Children and adults are different anatomically and physiologically in many ways. Knee injuries in children and adolescents frequently demonstrate these differences.

Read more

A Guide to Safety for Young Athletes

A Guide to Safety for Young Athletes

Article Featured on AAOS

For young athletes, sports activities are more than play. Participation in athletics improves physical fitness, coordination, and self-discipline, and gives children valuable opportunities to learn teamwork. Read more