Now more than ever, athletes around the world are taking steps to advance themselves into becoming professionals. This has generally resulted in a huge increase in intensity levels within the sports field. However, what comes along with this influx of competitiveness is the growth of another field – the treatment and rehabilitation field of sports injuries. Safety procedures have increased as well as the measures taken in training and practicing. Because of the extreme competitiveness present today in sports, there is more pressure than ever to return from an injury to compete again as quickly as possible. With competitiveness becoming a stronger mindset of a team, there is more likelihood that an injured athlete’s position will be replaced, which is the stem of this pressure. Naturally, the field of sports treatment and rehabilitation is capitalizing off of this. Though for many, the road to recovery can be quite long and difficult, sports medicine advancements have played a part in getting athletes back on the field as soon as possible. However, returning too soon from an injury can have even more adverse effects on a player.
As far as frequency of injuries goes, even with the medical advancements in technology, there has been no decrease in sports-related injuries in the past 10 years (Dhillon, et al.). In fact, the changing of game intensities often times make the injury rates rise. The sport of cricket is a perfect example of this. In a study conducted by Orchard et al., it was found that hamstring and thigh injuries are the most commonly seen in cricket. However, it’s important to note that these lower body injuries can be attributed to a change in the game itself. By observing elite level cricketers, a change in injuries can be seen. Since the sport introduced the shorter Twenty20 (T20) format of the game, which is evidently more physically demanding, the athletes’ injuries themselves as well as the frequency of injuries has shifted. Expressed as a value out of 1000 days of play, T20 style resulted in 145 injuries over 1000 days, whereas first-class domestic cricket had only 112 incidents over 1000 days (Orchard et al.). This is because although per match domestic and international levels of first-class cricket produce fewer injuries, the matches are longer so their hourly injury rate is lower. The same study points out that over the past two years, thigh and hamstring strains have been the most common injury by far and are increasing in prevalence. This can, perhaps, be due to an increased amount of the T20 playing style. Overall, an increase of severity of injuries has caused the injury prevalence within cricket to increase steadily, partially due to tightly scheduled matches a month means a player will miss more games while recovering than in a more spread out schedule.
These predominant lower limb injuries, such as thigh or hamstring strains, are most often times seen with the highest incidence rate in the sport of football (Tirabassi et al.). In a study that looked at 15 NCAA collegiate sports and collected over 16 years of data, results found that football reported the most injuries, followed by competitive wrestling (Hootman et al.). The gap between football and other sports is quite large when comparing injury number, as the sport of football sees greater than 12 times the number of injuries than the 2nd most common sport (DeHaven and Lintner). An epidemiologic study on high school and collegiate football leagues showed that the majority of injuries occurred during competition rather than practice, and more so in college than in high school leagues (Kerr et al.). With rising concern and awareness about concussions, one might think head injuries would have a more significant percentage in football injuries reported, however the number of head injuries is probably underestimated (Dvorak and Junge). This is due to the fact that sometimes concussions, especially minor ones, can go undiagnosed and untreated. Of all sports-injuries looked at, >50% were lower body, predominantly involved with the knee and the ankle (Hootman et al.). In fact, for both sexes, injury location was the same – knee and ankle sprains and strains, however, women more frequently saw patellofemoral pain syndrome or similarly related injuries (DeHaven and Lintner). Overall, football injuries are the most common, as are lower limb sprains or strains.
Although football claims the highest number of injuries, NCAA men’s wrestling have the highest competition injury rate at 9.6 injuries per 1000 athlete-exposures (Jarrett et al.). An aspect that was particularly different than football, though, was the most common injury. Although knee and ankle sprains are still common in wrestling, a large part of injuries affect the shoulder and/or elbow regions of wrestlers. A study conducted by Otero et al. on NCAA wrestlers showed data of 101 shoulder injuries, 9.8% of the injury pool, which included 1034 over the course of August 2002-July 2011 (9 seasons) within one single program. Of these injuries, 23% of them required a surgical operation. There was also a large percentage of head injuries – 16.7% (Otero et al.). Weight class, age, and eligibility status did not affect the rate or type of injury. Overall, the wrestling data which was consistent with the football data was wrestlers were at a 4-fold higher increase to be injured in matches rather than practice. Football players, too, were more at risk while competing than practicing or completing conditioning/preseason workouts. Most wrestlers were hurt in takedowns and sparring (Jarrett et al.). Even though the type of injury may be different, wrestlers and football players run the highest risk for sprains, breaks, and strains based on the overall number of injuries and the overall rate of injuries. As far as treatment goes, methods remain relatively the same across the board, however there are sport-specific details that go into the healing process and that determine whether or not a player is ready to get back in the game.
Perhaps the most important aspect of sports rehabilitation is the rehabilitation and treatment team behind it, as well as careful attention to the overall goal at hand. The modern team usually consists of the athlete, the coach, a nutritionist, a sports psychologist, strength and conditioning coaches, as well as a physiotherapist and a sports physician (Dhillon et al.). This list may seem extensive and possibly even unnecessarily long, however it fulfills a very specific purpose in the healing process. The purpose is to use a biopsychosocial approach. By understanding the given sport’s demands on the body biomechanically and physiologically, specialists are able to better comprehend the mechanisms behind common injuries (Dhillon et al.). Healing is a complicated process because it’s not only a physical battle, but also a psychological and social problem (thus comes the biopsychosocial model). An important aspect to consider and monitor can be looking at diet, stress levels, self-esteem, and sleeping habits among other things within an athlete’s life (Rosen et al.). Another piece that is found to be very helpful is returning to baseline tests so that professionals can compare recovered athletes to their athletic state preinjury. This can also aid in making the decision of if an athlete is ready to return to competing. Overall, this is the final goal of rehabilitation – to return an athlete to his/her sport at a preinjury level. From there, a return should be gradual so as to prevent the injury from becoming recurring. Monitoring the physical load on athletes after this point is key (Dhillon et al.).
The rehabilitation process can be broken down into 3 distinct stages – the acute phase of healing, the re-conditioning phase, and the return. First, the acute phase; this involves healing the tissue and avoiding too much immobilization. This goes for most all ailments, caused by physical activity or otherwise.