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How to Avoid Sprains, Strains, Fractures

Peter F. DeLuca, MD

Paul A. Marchetto, MD

Eagles team physicians from the Rothman Institute at Jefferson offer tips for reducing risk of common sports injuries. 

Thomas Jefferson University Hospital, through the Rothman Institute at Jefferson, serves as an orthopedic facility of the Philadelphia Eagles. Peter F. DeLuca, MD, is Head Team Physician and Head Team Orthopedic Surgeon, and Paul A. Marchetto, MD, is Team Orthopedic Surgeon. Dr. DeLuca has been with the Eagles since 1997, Dr. Marchetto since 2002. In addition to their long hours (during the week as well as on game days) with the Eagles and their practices at the Rothman Institute, both of these sports medicine specialists often work with other sports teams, at public schools and universities.

Here are tips from Dr. DeLuca and Dr. Marchetto for reducing risk of common sports injuries – particularly sprains (which affect ligaments), strains (tears in the muscles and/or tendons) and fractured bones – and for treating them when they do occur.  

• Get a physical. Make sure your heart, lungs and the rest of you body are up to handling vigorous activity associated with your chosen sport(s).

• Train pre-season. Whether you’re a student athlete or an adult participating in a weekly league, start training – with a coach, if available; otherwise, on your own – a month before the season begins.

“For example,” Dr. Marchetto advises, “high school football players should start running and doing calisthenics by early August to increase aerobic capacity and strength sufficiently. Cross-country runners should start training early enough to build up the strength necessary to endure four to five miles; otherwise, they’ll be more prone to stress fractures during the season.”

Just because you’ve been training for one sport doesn’t mean you’re ready to play another one without pre-training, Dr. Marchetto also notes: “For example, high school football ends on Thanksgiving, and basketball starts the following week, but each requires unique training regimens for the different muscles and activities involved. For a month toward the end of football and prior to the start of basketball, students who play both sports must make the time to do the specific training required for each.”

• Stretch every day, regardless of age, but warm up first.  If muscles and tendons are tight, they’re more prone to injury, so you have to stretch them for flexibility. But don’t stretch right away. “Just as you have to warm up salt water taffy to stretch it out properly, you have to warm up your body for five to 10 minutes to stretch your muscles and tendons,” Dr. DeLuca says. “Ways to warm up your body include riding a stationary bike, jogging in place or walking on a treadmill.

“Once you’re ready to stretch,” he continues, “do it slowly and hold the stretch for at least 15 seconds; anything short of that will not stretch out the tendon.”

“Children often believe they don’t have to stretch,” Dr. DeLuca adds, “but actually, they probably have to stretch more than anyone else because they’re growing. Bones grow faster than muscles and tendons, which stay a little bit tighter and shorter and are more prone to injury, as are the growth plates to which the tendons are attached.”

• Do balance exercises to avoid ankle sprains. If you have access to a trampoline, stand on it with one foot and catch a ball thrown to you by someone; otherwise, throw a ball against a wall and catch it while standing on one foot. Put paper cups down in a semi-circle on the floor, then lean over and pick them up while standing on one foot. Or, stand on a balance trainer, which is available at sporting goods stores. Alternate the foot you stand on while doing any of these exercises.

• Stay well hydrated. When athletes are even a little dehydrated, they’re more prone to muscle and tendon injuries, resulting in ankle and elbow sprains and hamstring, calf and groin strains. So, drink plenty of fluids before (two to four hours), during and after a game.  And not just plain water: “That can actually dilute your system and lower your sodium, making you more prone to injuries, instead of less prone,” Dr. DeLuca warns. “Drink an electrolyte-based sports drink such as Gatorade or Pedialyte.”

• Avoid overuse. Overuse of shoulders and other muscles and tendons, from playing multiple sports or one sport throughout the year without taking a season off, causes injuries, Dr. Marchetto advises: “All athletes, regardless of age, need time for rest.”

What to do when inury occurs:

• Stop playing! If you feel or hear a pop, tearing sensation or crack, or if you can’t put your weight on an injured lower extremity, get out of the game. (On the other hand, if you’re able to run and the pain is minor, you may be able to continue to play.)

• Apply ice and elevate. Never apply heat, which brings too much blood to the injured area and increases swelling.

• Immobilize properly. If you have access to the proper item to keep the injured body part from bending – for example, a stirrup-like splint for an ankle, a foam wrap with Velcro straps for a knee – use it. But make sure the body part is immobilized in its current position; don’t manipulate it, as that may aggravate a fracture.

• Go to an emergency room for x-rays. If you suspect the injury may be a fracture, have it x-rayed immediately.

• Use anti-inflammatory medication.  Over-the-counter medication like Motrin® or Aleve® will provide temporary relief from pain.