Straining and spraining for better sports injury treatments

We’re pretty spoilt for sport in Australia. Whether you participate or spectate, there’s almost an endless number of choices.

During the winter, football dominates the media. The primary local codes AFL and rugby league take more column inches of the back pages of the papers than probably all the other sports put together; and with the Rugby World Cup later this year, there’s increasing interest in the third game with the oval ball.

Not surprisingly, where there’s serious risk of contact in sport, there’s serious risk of injury; so the teams which finish at or near the top in September are likely to be the teams which treat their injuries most effectively – or better still, prevent them occurring in the first place.

It’s the so-called soft tissue injuries which occur most often; and while it’s the high profile players who hit the headlines when they’re suddenly out of action, in fact it’s the amateur sportsmen and women among us who suffer the most. We just don’t prepare well enough – injury prevention is not a sufficiently high enough priority.

Sports injuries don’t have to happen. Most injuries suffered by amateur athletes are preventable. Some injuries, such as tennis elbow, are caused by faulty movement, but most sports injuries occur because the muscles are not conditioned.

Roger Federer has won five consecutive Wimbledon titles, chiefly because of his amazing talent. But his fantastic fitness and freedom from even niggling little injuries, have undoubtedly helped him stay number one.

To help us better understand the prevention strategies and to choose the most appropriate treatment, if an injury does occur, pharmacists around Australia have fact cards available on sports medicine topics such as Exercises for Flexibility and Sprains and Strains. They are part of the Pharmacy Self Care health information program developed by the Pharmaceutical Society of Australia.

A strain occurs when muscle fibres are torn or stretched and twisted beyond the normal limits. Sometimes just a small number of fibres are damaged; pain occurs but no loss of strength. But sometimes a complete tear of the muscle occurs, requiring more intensive therapy. Muscles often affected are the hamstring (back of the thigh), quadriceps (front of the thigh), the calf muscle and the groin.

Joints are held together and stabilised by ligaments. A torn ligament is called a sprain. Common sites for sprains are the ankle, wrist and thumb. The most severe of torn ligament injuries may require surgical re-attachment.

First-aid for a strain or sprain involves using the RICE protocol. That is, Rest from activity for 28-48 hours; application of an Ice pack (wrapped in wet toweling to prevent direct contact with the skin); the application of a Compression bandage or elastic stocking; and wherever possible, Elevation of the injured area. More details about the RICE protocol are given on the Sprains and Strains Fact Card.

During the period of RICE treatment it is also important to avoid certain things, namely: heat, which increases bleeding, alcohol, which increases swelling; massage, which can increase both bleeding and swelling; and exercise, which may worsen the injury.

Non-steroidal anti-inflammatory medicines such as diclofenac, ibuprofen and naproxen products – all now available without prescription – can help reduce the pain and swelling. But these medicines are not suitable for everyone. Check with your doctor or pharmacist before using them.

Similarly, anti-inflammatory creams and gels may be helpful. However, heat rubs and liniments should be avoided during the first 48 hours or while the injured area is still painful, swollen or warm.

Remember, you don’t have to be in the Tour de France to fall off your bike. Similarly, if you’re a weekend golfer or netball player, you’re still at risk. However, prevention strategies will reduce the risk appreciably. Warm up before and cool down after exercise. Use the correct footwear and the recommended protective equipment, maintain adequate nutrition and hydration, and check out more simple self-help tips on the Pharmacy Self Care fact cards.