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Sports Injuries: When to See the Doctor

Those of us who exercise will, at some point, likely have aches and pains of one kind or another. A tennis player might wonder if he has tennis elbow, a cyclist’s knees become sore, a swimmer might find a shoulder aches, a runner has heel pain. Are these doctor-worthy pains, or should you just tough it out?

Paul D. Thompson, a cardiologist in Hartford Connecticut and a marathon runner, thinks most people should not go to the doctor at the first sign of aches or pains. He says, “I think most folks should not go, because most general doctors don’t know a lot about running injuries. Most docs, often even the good sports docs, then will just tell you to stop running anyway, so the first thing is to stop running yourself.”

Another doctor, Dr. Volker Musahl of the University of Pittsburgh medical centre and a triathlete, believes the same. Like Dr. Thompson, knows that he himself would patients treat sore knees or hamstrings with rest before doing anything else. So why not do that yourself?

Both of these doctors, however, are referring to the usual aches and pains that most people who exercise regularly occasionally feel. Major indicators that you need medical care include pain that gets worse over time, pain at night or when resting, swelling of the joints or bruises that don’t heal, or unstable joints such as knees or elbows that lock up.

The president-elect of the American College of Sports Medicine and director of the division of sports medicine at Ohio State University is Dr. Thomas Best. He thinks doctor visits are a good idea if you are not recovering from your injury or pain in your usual period of time. Some runners often feel sore after a 10-mile run, but if the pain goes away in a day or two, it’s probably nothing a doctor can do much about. “Know how you typically recover,” he says. “When you are not recovering as you typically do, that’s the first warning that something more is going on.”

The main reason for delaying or avoiding doctor visits for sports injuries is because there is very little doctors can do for them. Sports injuries usually involve pain or soreness, and the doctors don’t have a way to help you recover any faster than rest would help. In addition, the treatments that are available, such as cortisone shots for injured tendons, can relieve pain but actually slow the recovery process.

Some treatments have been proven effective, but many doctors don’t know about them and you can do them without a doctor’s prescription. Eccentric contractions, those in which a muscle works and lengthens at the same time, seem to help heal the Achilles tendon and tennis elbow more quickly. To do eccentric contractions for the Achilles tendon involves doing heel drops by standing on a step and dropping your heel, then raising it to step level and repeating.

Sometimes going to the doctor can reveal problems you didn’t know about and may not even want to know about. Scans can show various abnormalities that aren’t causing you any problems whatsoever. A recent study by Dr. Matthew Silvis, an orthopedists in Pennsylvania, involved scanning 21 professional and 21 college-level hockey players’ hips. Seventy percent of the athletes’ scans showed abnormalities, even though none of the players had pain or any notable discomfort. None felt their playing was affected in any way. However over half had tears in the cartilage that stabilises the hip, known as labral tears.

Dr. Musahl said, “M.R.I.’s are so sensitive. They frequently show little tears or fraying everywhere. And it is very, very common to have a small labral tear in your hip — it doesn’t mean you have to have the particular symptoms.”

About half of all middle-aged people have shoulder rotator cuff tears, but without any shoulder pain or symptoms or affectation of quality of life.

Dr. Best recommends visiting the doctor when your injury does not go away in the expected time. The doctor may be able to deduce the cause of the injury. A good doctor will watch how you move to see if he or she can observe biomechanical problems. If a doctor asks you, as a runner, to lie down on his table to do his exam, he’s not a very good doctor for sports-related injuries.

In general, however rest is always the best first step in treating most sports-related injuries. When rest doesn’t do the trick, then you might seek the help of a professional.

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