Main sporting injuries: risk factors and how to prevent them

“Sporting injuries” refers to a series of unforeseeable and sudden injuries that occur when performing physical activity. Sporting injuries may be related to the muscles, joints or bones, involving one or more anatomical structures.

Sporting injuries: which are the most frequent

The most frequent sporting injuries, divided by the affected part of the body, are:

Muscle injuries

These include:

1. Contractures: involuntary contractions or persistent, painful spasms. Contractures may be in a precise point, often in the so-called “trigger points”, or over an entire muscle area.
2. Sprains (muscular overstretching): a grade 2 injury, which causes muscle fibres to stretch beyond their normal physiological capacity. The muscles that are most likely to suffer from muscle sprains are those of the lower limbs, i.e. the thigh and the back of the leg.
3. Strains (muscle injuries): muscular injuries that lead to breakage of the fibres that make up a muscle, ranging from slight to serious. The areas most subject to straining vary, and are frequently found in all disciplines and the occurrence is calculated at 10% to 30% of all sports traumas.

The most affected areas of muscle injury in sports are the lower limb muscles, particularly the ischiocrural, adductor and quadriceps muscles and the calf.

Joint Injuries

This category includes:

1. Sprains: in this type of injury, the bone heads are stressed beyond the limit of normal joint flexibility, causing the overstretching of the capsular-ligamentous apparatus with partial or total lacerations of the capsule, ligaments, tendons or rupture of intra-articular menisci.
2. Dislocations and subluxations: the traumatic displacement of the joint, which occurs when the two bone heads in the articulation shift permanently beyond the physiological articular range. When there is a total dislocation of the joint surfaces we talk of complete dislocation, while subluxation occurs when the dislocation is partial.

The areas most subject to this type of injury are the shoulder, ankle, knee and elbow.

Bone Contusions

1. Contusions: an injury caused by a direct trauma to soft tissue (muscle fibres, connective tissue and/or blood vessels and nerves) or bone tissue, that does not result in serious damage to the surrounding tissue. Contusions are very frequent in contact sports, and in severe cases can cause bone fractures or muscle injuries.
2. Fractures: they occur when the injury exceeds the limits of resistance of the bone, interrupting its continuity and structural integrity.

Any bone can be affected, without any specific prevalence.

Main risk factors

While at sporting level it is not possible to determine risk factors for bone injuries, other than in exceptional cases such as osteoporosis, as concerns the muscles and joints a series of conditions increase the probability of muscle and/or joint injuries:

• Poor muscle flexibility;
• Physical performance beyond natural ability;
• Poor joint proprioception;
• Excessive physical/mental fatigue;
• A poor diet and/or hydration;
• Obesity.

By improving or resolving all these aspects, sports people can drastically reduce the risk of injury, or at least its severity, even though these injuries are unforeseeable and determined by external factors (a fall, impact, accident, etc.).

What can we do to limit the risk of sporting injuries?

As explained, in most cases a sporting injury is unforeseeable. It is not possible to prevent a dislocation or bone fracture caused by a fall or a direct injury, but often there is also nothing we can do to avoid muscle injuries.

However, this does not mean that we cannot do everything in our power to seek to avoid the injury or limit the related damage. Some precautions can certainly be useful, such as:

• Following a correct training programme designed by professionals;
• Gradually increasing performance without demanding too much of our own body;
• Training both muscle force and strength;
• Performing proprioceptive exercises to increase balance, stability and coordination;
• Improving joint flexibility and mobility;
• Following a correct diet and hydrating;
• Resting correctly.

First aid for sporting injuries: what TO DO and what NOT TO DO

If you suffer from one of the sporting injuries described above, the main symptom is immediate pain, which may be mild or very severe. To avoid aggravating the injury, the best thing to do in the event of a trauma is, in order:

1. Stop the physical activity.
2. Apply ice.
3. Rest the affected area.
4. Depending on the extent of the injury, go to the accident and emergency unit or the club/family doctor for a diagnosis.
5. In most cases, following a rehabilitation and ‘reathletization’ programme defined by a sports physiotherapist before returning to physical activity.

What on the other hand must we absolutely NOT do following a sporting injury?
It is absolutely forbidden to “grit your teeth” and continue with the physical activity. This can in fact worsen the injury, which could not only be aggravated in medical terms but also spread to the surrounding anatomical structures (such as ligaments, tendons and muscle groups).

Rest, recovery methods and times: can we recover 100%? Can injuries return?

In most cases, after a more or less lengthy recovery depending on the type of injury, it is possible to recover 100% of the anatomical structure and its functions. Some severe cases, on the other hand, such as some types of fractures, may not have full recovery, and the medical specialist will have to advise the patient on any limitations or changes to their sporting activities.

In any case, successful recovery from a sporting injury depends mostly on the rehabilitation programme. It is therefore fundamental to seek the assistance of a physiotherapist to define an appropriate programme.

As regards repeated injuries, on the other hand, these concern especially cases of severe distortions or dislocations. In fact, after these injuries, which damage some structures that stabilise the joint, such as the ligaments, joint instability may be persistent. This means, for example, that an ankle that has suffered a severe distortion will be more likely to suffer it again in future, or that a dislocated shoulder could come out of its seat more easily following other, even less severe, injuries. In this case, we have to inform the doctor, who may refer us to a physiotherapist for specific rehabilitation or an orthopaedic specialist to assess the need for surgery.