Yearly Archives: 2018

Cheerleading Injuries & Tips to Prevent Them

Cheerleading injuries send thousands of patients to the emergency room every year. The activity is highly athletic, incorporating elements of dance, gymnastics and physical stunts. And although cheerleading isn’t typically considered a risky sport, severe injuries can result from participation.

Cheerleading Injuries & Tips to Prevent Them

Cheerleaders who understand and use proper techniques and observe basic safety rules have an increased chance at avoiding a debilitating injury.

Common Cheerleading Injuries

Cheerleaders can suffer injury to any part of the body, but the wrists, ankles, shoulders, head and neck are the most commonly affected.

Muscle strains are frequently seen in cheerleaders. Often, these occur in the hips, legs or lower back. Ligament sprains in the ankles and knees are also common. Any of these may happen when landing from a jump or during a swift directional change.

Hand and wrist injuries are also common in cheerleaders. Generally, broken, sprained or strained fingers, hands and wrists are the result of a fall onto an outstretched hand, also known as a FOOSH injury.

Cheerleaders are also at risk for overuse injuries. Continuous training and performances or competitions places repeated demand on the muscles, ligaments and joints. This repetitive micro-trauma eventually can lead to injury.

Causes of Cheerleading Injuries

Though some injuries to cheerleaders can only be described as accidents, most are related to poor training or physical conditioning. Common causes include:

  • Inadequate core and abdominal strength
  • Insufficient arm and shoulder strength
  • Poor flexibility and range of motion
  • Lack of experience with a particular skill
  • Performing skills above the current level of expertise
  • Lack of proper safety equipment

Tips to Prevent Cheerleading Injuries

In an effort to reduce the number of serious injuries suffered by cheerleaders, high school and college governing boards have imposed restrictions on how stunts are performed. Adhering to these cheer stunt restrictions — which include limits on pyramid height, the proper thrower-flyer ratio and the necessary number of spotters for high lifts — is an essential step in preventing cheerleading injuries.

Having a qualified cheer coach is equally important. Coaches who have been certified have the training to teach cheerleaders the right techniques and safety precautions. Without a good foundation of knowledge, stunts and high-level tumbling are more likely to lead to injury.

As with any other sport, proper physical conditioning can also help decrease the risk of injury. Experts recommend:

  • Resistance exercises for increased strength in the shoulders, stomach and lower back
  • Regular stretching, Pilates or yoga exercises to boost flexibility
  • Consulting with an athletic trainer or sports medicine specialist regarding personal strategies for injury prevention

In addition, cheerleaders frequently perform on surfaces with different levels of cushioning and stability, such as gymnasium floors, running tracks and football fields. For improved safety, tumbling and stunts should only be practiced on an even surface using the proper footwear and safety gear.

To learn more about how to prevent cheerleading injuries and other mishaps associated with sports performance, consult with a qualified physical medicine and rehabilitation specialist in your area.

Robert Engelen, DO
Dr. Engelen served as a Lieutenant in the Navy and operated as the medical officer for Marines in North Carolina and for a deployment to Afghanistan. He has served as a team physician for a high school and a Division II Collegiate athletic sports team in Pittsburgh, and currently serves as the team physician for West Jordan High School.

Dr. Engelen has a special interest in fluoroscopic procedures, diagnostic ultrasound and ultrasound guided procedures, regenerative medicine, biomechanical analysis, and treatment of all sports and spine injuries. His unique practice focuses on non-surgical treatments.

Facet Joint Injections for Neck & Back Pain

Cervical, lumbar and thoracic facet joint injections (also known as facet blocks) can be an effective option for the diagnosis and treatment of short- and long-term neck and back pain.

Facet Joint Injections for Neck & Back Pain

The facet joints, which connect the bones in the spine, may or may not be the source of a patient’s neck or back pain. For some patients, facet blocks alleviate discomfort and inflammation. For others, the procedure offers a diagnostic benefit.

When Doctors Recommend Facet Joint Injections

Facet blocks are often ordered as part of a diagnostic workup for neck and back pain. Essentially, the injections are used to determine whether the joints are the cause of a patient’s symptoms.

For many patients, identifying the reason for neck or back pain can be a challenge — clinical evaluation and imaging tests don’t always point to a clear cause. In these cases, facet blocks are often helpful in finding a diagnosis. And for some patients, the injections can be therapeutic, providing immediate and long-lasting pain relief.

The Facet Joint Injection Procedure

A facet joint injection is a straightforward, in-office procedure that typically takes about 15 to 30 minutes to complete.

Facet blocks are usually performed using a live X-ray, or fluoroscopy, to ensure accurate needle placement. Once the needle is in position, a small amount of contrast dye is injected to verify that the medication will remain inside the joint space. An anesthetic, or numbing agent, along with an anti-inflammatory corticosteroid medication is then slowly injected into the joint.

After the procedure, the patient rests in the recovery room for about 30 minutes. Then the patient is asked to perform movements and assume body positions that normally provoke neck or back pain.

Patients are also asked to record their levels of discomfort or pain relief in the first hours and weeks following a joint injection. A pain diary can help the doctor assess the injection results and plan future testing or treatment.

Interpreting the Results of Facet Joint Injections

Patients react to facet blocks differently, depending upon the cause of their neck or back pain.

For some, an injection provides immediate pain relief. However, this may be due to the numbing medication. So the diagnostic benefit isn’t fully realized until two to five days after the treatment, when the corticosteroid begins to kick in.

If at that point the patient notices long-lasting pain relief, the facet joints were the source of the problem. In that case, injections can be repeated up to three times per year to keep neck and back pain under control.

If the patient reports no lasting improvement in symptoms, their pain is not a result of damage, injury or stress to the spinal joints. To further narrow down the potential cause of neck and back pain, more testing will be necessary. Facet block injections should not be repeated in these patients — other pain relief treatment options should be used instead.

A sports medicine, orthopedic or physiatry specialist can tell you more about facet joint injections and determine if they may help relieve your back or neck pain.

Robert Engelen, DO
Dr. Engelen served as a Lieutenant in the Navy and operated as the medical officer for Marines in North Carolina and for a deployment to Afghanistan. He has served as a team physician for a high school and a Division II Collegiate athletic sports team in Pittsburgh, and currently serves as the team physician for West Jordan High School.

Dr. Engelen has a special interest in fluoroscopic procedures, diagnostic ultrasound and ultrasound guided procedures, regenerative medicine, biomechanical analysis, and treatment of all sports and spine injuries. His unique practice focuses on non-surgical treatments.

Prevent Lower Back Pain Caused by Cycling

Did you know you can prevent lower back pain commonly associated with cycling?

prevent lower back pain caused by cycling

Cycling is a frequently recommended low-impact cardiovascular exercise for patients with spine conditions and those recovering from sports injuries. But if you spend hours hunched over the handlebars, you may end up suffering from lumbar pain.

Fortunately, you don’t have to stop riding your bike to get relief. Whether you’re a casual bike rider or an avid cyclist, you can take a few simple steps to prevent lower back pain.

Assess Your Bike and Frame Fit

Are you riding the right bicycle?

Unless you’re into road racing, consider getting a mountain bike for shock absorption and a more upright posture when cycling. In addition, if your bike frame isn’t a good fit, riding can stress and create pain in your lower back muscles.

Visit a local bicycle shop for professional advice on choosing a bike. Ask the shop to make sure that your seat tube, top tube and head tube lengths suit your body dimensions.

Adjust Your Bike Position

The right bike setup can help prevent lower back pain associated with cycling. Adjust your saddle height, saddle angle and handlebars to comfortable positions that don’t force you to stretch and stress your spine when riding your bike.

Check Your Cycling Form

To get the most benefit from riding your bike and prevent back pain, you should review and optimize your pedaling and cycling form. Try to keep your chest up while riding, distributing some of your weight to your arms. Also remember to shift positions periodically.

For personalized guidance, consult with a sports medicine specialist.

Use Shock-Absorbing Accessories

Selecting gear that mitigates excessive force on your muscles and joints can help prevent back pain. Look for shock-absorbing seats, seat covers, cycling gloves and handlebar covers. For extra protection, consider adding front shock absorbers or full suspension shocks to your bike.

Work on Your Core Strength

If your core muscles aren’t strong, you may have impaired motor control or poor cycling movement patterns, which can place excess strain on your back. To help prevent lumbar pain, make sure your workouts include exercises that promote stability and core strength — ask a sports medicine specialist for recommendations.

Consider Your Posture off the Bike

Do you spend a lot of your working hours sitting at a desk or in the car? Correcting your posture when you’re not on the bike can also help prevent back pain when you ride. Adjust your chair to allow for a straight spinal posture with no rotation or slumping. You might also want to invest in a McKenzie lumbar pillow to place at your lower back for added support.

For more tips and expert advice on the treatment and prevention of lower back pain from cycling, consult with a local sports medicine specialist.

Radial Tunnel Syndrome — Diagnosis and Treatment

Radial tunnel syndrome, much like the more common and well-known carpal tunnel syndrome, is a painful condition caused by nerve entrapment.

Radial Tunnel Syndrome — Diagnosis and Treatment

The radial nerve runs from the side of the neck, along the back of the upper arm and down through the forearm and hand. At the elbow, the nerve goes through a passage formed by bone and muscles called the radial tunnel.

Nerve entrapment can occur at five parts of the radial tunnel. In some patients, the nerve becomes pinched because the tunnel is too small. In others, entrapment is related to repetitive twisting, pushing or pulling movements, bending at the wrist or repeated gripping and pinching motions.

Symptoms of Radial Nerve Entrapment

Radial nerve entrapment symptoms include pain and tenderness on the outside of the arm. The pain typically starts near the bony part of the elbow joint and radiates through the forearm.

In many patients, pain worsens when the wrist is flexed or the palm is turned upward, and when holding an object with the wrist and elbow in a stiff, straight position. Fatigue and weakness in the forearm muscles may accompany the pain, and it may become difficult to keep the wrist steady with grasping and lifting.

Diagnosing Radial Tunnel Syndrome

Diagnosis of radial nerve entrapment begins with a detailed medical history and physical examination to pinpoint the source of the patient’s pain. But because the symptoms of radial nerve entrapment mimic those of several other hand, wrist and elbow conditions and injuries, diagnosis may require more than a consultation.

Often, diagnostic imaging tests — such as ultrasound, magnetic resonance imaging (MRI) and electromyography — are ordered to rule out lateral epicondylitis, osteoarthritis, elbow joint synovitis, muscle tears and other pathologies that cause forearm and elbow pain.

Treatment for Radial Tunnel Syndrome

Nonsurgical treatments are nearly always the recommended initial course of action for entrapment of the radial nerve. Options that can help relieve pain include:

  • Splinting or casting to immobilize the wrist
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Physical therapy exercises
  • Ultrasound massage
  • Nerve block to inject a local anesthetic

Many patients are able to alleviate their symptoms through these conservative measures. However, activity modifications — avoiding prolonged wrist flexion, forearm pronation and elbow extension — are crucial for successful nonsurgical treatment.

Although surgery may be an option for relieving persistent pain, it usually isn’t necessary or recommended. Surgical treatment is a last resort, considered only when symptoms don’t improve after several months of conservative care.

For more information on diagnosing and treating radial tunnel syndrome, consult with an experienced physical medicine and rehabilitation physician.

Ultrasound-Guided Joint Injections: What Should You Expect?

Ultrasound-guided joint injections are a safe, non-invasive approach to treating pain, inflammation and impaired mobility. The procedure is often recommended when other conservative treatments such as oral medication, joint manipulation and physical therapy have been ineffective.

Ultrasound-Guided Joint Injections: What Should You Expect?

Your physical medicine and rehabilitation physician is the best source of information regarding ultrasound-guided injections. But the following overview will give you a basic idea of what you can expect from this treatment.

How Are Ultrasound-Guided Injections Performed?

Ultrasound technology captures live images of internal body structures through the application of high-frequency sound waves. Although this imaging technique may be best known for assessing the progression of a pregnancy, physicians also frequently take advantage of the safe, non-invasive technology when performing joint injections.

Guided injections are much like conventional injections, but with one key difference — ultrasound provides the doctor with “X-ray vision” for performing the procedure.

Instead of relying on touch and experience to determine optimal injection placement, the physician uses the imaging probe to create a live video of the joint tissues. The clear, detailed images guide the insertion of the needle and the administration of the medicine.

What Are the Benefits of Ultrasound-Guided Joint Injections?

With experience, a skilled and trained physical medicine and rehabilitation physician can identify the proper placement for some types of joint injections without using imaging technology. However, doctors often prefer guided injections, as they offer several significant benefits.

  • Improved accuracy — Shoulder, wrist, hip, knee and ankle joints are complex anatomical structures, and the area that needs to be treated may be just a few millimeters in size. With ultrasound guidance, pain and anti-inflammatory medication can be injected into the ideal spot for long-lasting symptomatic relief.
  • Improved safety — After more than 20 years of use, ultrasound imaging is known to be safe. And since the physician can see exactly where the needle is going, the risk of complications from improper placement is greatly decreased.
  • Reduced procedural pain — Ultrasound-guided injections are typically considered quicker and less painful than conventional injections.

How Long Is the Recovery from Ultrasound-Guided Injections?

Before scheduling you for a joint injection, your physician will provide you with specific information and instructions for your recovery.

Most patients are instructed to rest the affected joint as much as possible during the 24 to 48 hours after an injection. The medication can take a few days to begin working and getting adequate rest can help patients achieve the maximum benefit from the procedure.

In addition, patients should be aware that pain may increase during the 12 to 48 hours following a joint injection. The needle can create additional inflammation in the affected area, which may lead to heightened pain. If this happens to you, applying ice and taking your regular pain medication should be enough to provide relief. However, you should contact your physician if these measures are inadequate or if you become concerned about your pain level.

Ultrasound-guided joint injections are not a cure-all, and they may not be appropriate or effective for some patients. Your physical medicine and rehabilitation physician can tell you more about the results you can expect from ultrasound-guided joint injections.

When Is a Physiatrist the Right Choice for You?

A physiatrist, also known as a physical medicine and rehabilitation physician, may be the helpful to you if you suffer from acute or chronic muscle or skeletal pain.

When Is a Physiatrist the Right Choice for You?

Physiatry is a relatively new medical specialization involving the diagnosis, treatment and management of physical disabilities caused by injury or illness. Unlike other medical professionals with similar specialties that focus on a cure, however, a physiatrist is also focused on improving the patient’s quality of life.

Seeing an experienced physiatrist can help put you on the path to pain relief and improved mobility, and let you get back to enjoying an active life.

What Types of Treatment Does a Physiatrist Provide?

A physiatrist doesn’t perform surgery. Instead, treatment for acute and chronic pain is typically conservative and may involve one or more of the following protocols:

  • Ultrasound-guided joint or spinal injections
  • Nerve conduction studies
  • Peripheral or spinal nerve block, stimulation or ablation procedures
  • Prolotherapy, or regenerative injection therapy
  • Physical muscle and joint manipulation
  • Non-invasive spinal procedures
  • Orthotics, such as braces or splints
  • Electrotherapies, such as neuromuscular electrical stimulation (NMES), therapeutic ultrasound or transcutaneous electrical nerve stimulation (TENS)
  • Physical therapy
  • Acupuncture, biofeedback or other alternative therapies

What Conditions Does a Physiatrist Treat?

A skilled physiatrist can successfully manage many different chronic and acute injuries and conditions.

Physical medicine and rehabilitation physicians can help decrease pain and improve mobility in patients with both short- and long-term physical and cognitive disabilities and impairments.

An experienced physiatrist can provide:

  • Musculoskeletal care, including treatment for osteoarthritis, rheumatoid arthritis, osteoporosis, lumbar disk disorders and sacroiliac joint dysfunction
    Medical rehabilitation following joint replacement, fracture, stroke, spinal cord injury or cancer treatment as well as for prosthetics, fall prevention and age-related physical impairments
  • Treatment for overuse and sports injuries, such as concussions, strains, sprains, ligament tears, sciatica and tendinitis
  • Neuromuscular rehabilitation and management for fibromyalgia, degenerative joint disease, peripheral neuropathy and other painful conditions

How Can a Physiatrist Help You?

A physiatrist treats the patient as a whole, rather than focusing attention on one particular area or part of the body. The goal of treatment isn’t to cure the medical condition; rather, physical medicine and rehabilitation physicians work to alleviate pain and restore or improve mobility.

Patients who see a physiatrist can achieve a greater quality of life, as expert care enables them to function at the highest level possible, given their physical impairments.

In many cases, a physiatrist supervises and coordinates interdisciplinary care for patients. Medical specialists who may be involved include physical therapists, occupational therapists, orthotists, prosthetists, cardiologists, rheumatologists and neurologists.

For patients with chronic or acute pain due to injury or illness, a comprehensive approach to treatment can be the best way to achieve a successful outcome. To find out if physiatry is the key to managing your pain and improving your mobility, schedule a consultation with an experienced local physiatrist today.

Robert Engelen, DO
Dr. Engelen served as a Lieutenant in the Navy and operated as the medical officer for Marines in North Carolina and for a deployment to Afghanistan. He has served as a team physician for a high school and a Division II Collegiate athletic sports team in Pittsburgh, and currently serves as the team physician for West Jordan High School.

Dr. Engelen has a special interest in fluoroscopic procedures, diagnostic ultrasound and ultrasound guided procedures, regenerative medicine, biomechanical analysis, and treatment of all sports and spine injuries. His unique practice focuses on non-surgical treatments.

Early Sports Injury Treatment: How to Avoid the HARM Factors

Do you know the proper protocol for early sports injury treatment? You can safely manage many acute soft-tissue injuries at home, including muscle strains, ligament strains and tendon injuries, if you avoid the HARM factors for the first 72 hours.

Early Sports Injury Treatment: How to Avoid the HARM Factors

HARM stands for heat, alcohol, running and massage, all of which can compromise healing. Avoid:

Heat

Applying heat to a new injury can increase both swelling and bleeding. For the first few days, don’t use heat packs or deep heat creams. Hot baths, showers and saunas should also be avoided.

Alcohol

Consuming alcohol when recovering from a sports injury can lead to increased bleeding and inflammation. And alcohol consumption doesn’t just inhibit wound healing — it also increases the risk of post-injury infection.

Running

Running or engaging in strenuous physical activity too soon can aggravate an acute sports injury. To prevent the pain, bleeding and swelling from getting worse, avoid exercise until your physician gives you the go-ahead.

Massage

Massage to an injured area can irritate the damaged tissues and cause increased inflammation and bleeding. Indirect massage to the surrounding areas may be beneficial, but only with expert guidance on the proper techniques.

The PRICE Protocol for Early Sports Injury Treatment

Avoiding the HARM factors for the first few days is essential for the best chance at a quick and easy recovery. In addition, physical medicine and rehabilitation physicians advise following the PRICE protocol for faster healing from acute sports injuries.

The PRICE protocol is the recommended first line of care for soft tissue injuries to the muscles, ligaments and tendons. It involves:

  • Protection — Protect the injured area by limiting use and keeping weight off the affected appendage. This can help prevent further damage to the soft tissues.
  • Rest — Rest and avoid activities that aggravate the injury. This can encourage proper healing. Gentle strengthening and range-of-motion exercises may be beneficial when recommended by an experienced sports medicine physician.
  • Ice — Cold therapy, or applying ice for 10 to 15 minutes once every hour or two, can help minimize pain and swelling from an acute soft tissue injury.
  • Compression — Wrap the injured appendage with an elastic bandage or compression wrap to help reduce swelling and provide much-needed support to the damaged tissues.
  • Elevation — Elevate the injured area above the level of the heart to help decrease soft-tissue inflammation.

When it comes to managing acute soft tissue sports injuries, remember to avoid the HARM factors and to follow the PRICE protocol. For more information on early sports injury treatment, schedule a consultation with a local physical medicine and rehabilitation physician today.

Robert Engelen, DO
Dr. Engelen served as a Lieutenant in the Navy and operated as the medical officer for Marines in North Carolina and for a deployment to Afghanistan. He has served as a team physician for a high school and a Division II Collegiate athletic sports team in Pittsburgh, and currently serves as the team physician for West Jordan High School.

Dr. Engelen has a special interest in fluoroscopic procedures, diagnostic ultrasound and ultrasound guided procedures, regenerative medicine, biomechanical analysis, and treatment of all sports and spine injuries. His unique practice focuses on non-surgical treatments.

Is Your Knee Pain the Result of Fat Pad Impingement?

Do you suffer from anterior knee pain and inflammation? If so, fat pad impingement could be to blame.

Is Your Knee Pain the Result of Fat Pad Impingement?

Also known as Hoffa’s syndrome or fat pad syndrome, impingement is an injury in which the soft tissue that lies beneath the kneecap becomes pinched at the end of the thigh bone. The condition creates extreme pain below the kneecap and along the sides of the patellar tendon. Pain may worsen with prolonged standing or when the leg is straightened.

What Causes Fat Pad Impingement?

The soft tissue under the kneecap can become impinged due to a forceful, direct blow to the front of the knee. This may occur during a fall, a football tackle or a motor vehicle accident, for example.

Certain physical conditions and characteristics may increase the risk of Hoffa’s syndrome. Patients with a history of hyperextending the knee are more likely to suffer this injury, as are patients who have tight quadriceps muscles. Osteoarthritis, scarring in the soft tissues of the knee and a forward-tipping pelvis can also boost the chance of this painful injury.

How Is Fat Pad Impingement Diagnosed?

A thorough physical examination along with an assessment called “Hoffa’s test” may be sufficient to provide a definitive diagnosis of this condition. This test involves placing pressure on the patellar tendon while the patient straightens the affected leg. If this action causes knee pain, the patient probably has Hoffa’s syndrome.

Anterior knee pain can be caused by many conditions and injuries, including patellar tendonitis, stress fracture, a meniscal tear or bursitis. For this reason, an orthopedic medicine specialist may request an MRI or other imaging tests to arrive at a diagnosis of Hoffa’s syndrome.

What Are the Treatment Options?

Most patients with Hoffa’s syndrome find relief from knee pain and tissue inflammation through conservative treatment; surgery is rarely required.

A physical medicine and rehabilitation physician may recommend a number of non-invasive measures in treating fat pad syndrome. Some of those options include:

  • Resting the affected leg
  • Avoiding activities that stress the knee
  • Using cold therapy to reduce inflammation and alleviate pain
  • Taking nonsteroidal anti-inflammatory drugs (NSAIDs) for relief from pain and swelling
  • Getting electrotherapy treatments, such as ultrasound or a TENS unit
  • Doing physical therapy exercises for improved muscle strength and flexibility
  • Taping the upper part of the kneecap to give the soft tissues underneath more space

To determine whether you are suffering from fat pad impingement, schedule a consultation with a local physical medicine and rehabilitation physician today for an evaluation of your anterior knee pain.

Robert Engelen, DO
Dr. Engelen served as a Lieutenant in the Navy and operated as the medical officer for Marines in North Carolina and for a deployment to Afghanistan. He has served as a team physician for a high school and a Division II Collegiate athletic sports team in Pittsburgh, and currently serves as the team physician for West Jordan High School.

Dr. Engelen has a special interest in fluoroscopic procedures, diagnostic ultrasound and ultrasound guided procedures, regenerative medicine, biomechanical analysis, and treatment of all sports and spine injuries. His unique practice focuses on non-surgical treatments.

Stress Fractures — What Athletes Need to Know

Stress fractures are among the most common sports injuries, occurring when muscle fatigue sets in. Fatigued muscles cannot effectively absorb added shock, so any overload is transferred to the bone. This can cause a tiny crack — a stress fracture — to develop.

Stress Fractures — What Athletes Need to Know

If you’re an athlete, you may end up facing this sports injury sooner or later if you aren’t careful — or even if you are.

What Causes Stress Fractures?

Often, these sports injuries result from increasing the intensity or amount of physical activity too quickly. Using improper equipment, like the wrong shoes for your sport, and getting active on an unfamiliar surface may also contribute to the development of a stress fracture.

Which Athletes Are Most Susceptible to Stress Fractures?

The weight-bearing bones of the lower leg are most often affected by these sports injuries. Research shows that athletes whose sports involve the foot repeatedly striking the ground — like basketball players, track and field enthusiasts, tennis players and gymnasts — are more likely to develop stress fractures.

What Are the Risk Factors for Developing Stress Fractures?

Anyone who participates in repetitive sports activities can suffer a stress fracture, but female athletes seem to be at a greater risk. Menstrual disturbances, decreased bone density and caloric restriction may be to blame. Muscle weakness and leg-length differences can also increase an athlete’s risk.

How Is a Stress Fracture Diagnosed?

A thorough medical history and physical examination are necessary for diagnosis. A stress fracture may be suspected for pain that occurs during physical activity and subsides with rest. X-rays are typically ordered for confirmation, but since these sports injuries may not appear on regular X-rays for several weeks, a CT scan or MRI may be recommended.

How Are Stress Fractures Treated?

Rest from the physical activity that led to the stress fracture is essential for the sports injury to heal. Most athletes need to take a six-to-eight-week break from their usual workout and training. Some may also need to wear braces or shoe inserts to encourage proper healing. A gradual return to sports is advised, as resuming activities too soon can cause the injury to worsen or lead to chronic problems.

Can Stress Fractures Be Prevented?

Not every stress fracture is preventable, but sports medicine physicians recommend that athletes follow these practices to avoid injury:

  • Gradually build up time and intensity when participating in new sports activities.
  • Cross-train, engaging in more than one sport and adding exercises to boost muscle strength and flexibility.
  • Eat a healthy diet, incorporating foods rich in calcium and vitamin D
  • Stop sports activity immediately and rest when any pain or swelling occurs, and see a sports medicine physician if symptoms persist.

When athletes recognize the symptoms of stress fractures early and follow the recommended treatment plan, recovering and returning to sports is much less of a challenge.

Robert Engelen, DO
Dr. Engelen served as a Lieutenant in the Navy and operated as the medical officer for Marines in North Carolina and for a deployment to Afghanistan. He has served as a team physician for a high school and a Division II Collegiate athletic sports team in Pittsburgh, and currently serves as the team physician for West Jordan High School.

Dr. Engelen has a special interest in fluoroscopic procedures, diagnostic ultrasound and ultrasound guided procedures, regenerative medicine, biomechanical analysis, and treatment of all sports and spine injuries. His unique practice focuses on non-surgical treatments.

Concussion Recovery: 5 Steps to Returning to Sports 

Concussion recovery takes time, which means returning to sports must be a gradual process that’s done under close medical guidance.

Concussion Recovery: 5 Steps to Returning to Sports 

With some sports injuries, you can return to activity once pain and inflammation have disappeared and you’ve regained your strength and range of motion. Head injuries are different, however, and athletes who suffer a concussion should only return to sports activities under the expert supervision of a local physiatrist or physical medicine and rehabilitation physician.

Safely returning to sports following a concussion can take days, weeks or even months. Once you have the blessing of your doctor, the five steps below are commonly recommended for athletes in concussion recovery.

Step 1: Light Aerobic Exercise

Performing light aerobic exercises that increase the heart rate is the first step in concussion recovery. Athletes can prepare for returning to sports by walking, taking a light jog or riding an exercise bike for a short time.

Step 2: Moderate Sports Activity

As concussion symptoms begin to improve, athletes are encouraged to perform moderate physical activities. These may include brief periods of running or using a moderate-intensity stationary bike. Weightlifting can be added to the exercise routine, but lifting times and weights must be modified to accommodate the concussion.

Step 3: Heavier, Non-Contact Sports Activity

Once they are further along in the recovery period, athletes who’ve suffered a concussion can boost their activity levels by engaging in heavy non-contact sports. At this point, sprinting, running, using a high-intensity stationary bike or performing non-contact sport-specific drills is recommended.

Step 4: Full-Contact Sports Practice

The next step in concussion treatment for athletes is to return to full-contact practice. Participating in normal training helps get athletes ready for returning to sports but doesn’t have the added pressure and stress of competition.

Step 5: Return to Regular Sports Activity

If normal, full-contact practice and training activities are well-tolerated, athletes can take the final step in concussion recovery and return to their regular sports activities. This includes competition, if applicable, as the injury is considered fully healed.

Additional Safety Guidelines for Concussion Recovery

Athletes must be mindful of their concussion symptoms at all times during the recovery period. If symptoms worsen, it should be considered a sign to slow down and quit pushing so hard to get back to regular sports activities.

In addition, athletes should only move on to the next recovery step if their current level of activity causes no new symptoms. And if any symptoms return or new ones appear, the athlete should stop the activity and consult with an experienced physical medicine and rehabilitation physician. After getting more rest and approval from a physiatrist, activity can resume at the previous step in the concussion recovery process.

Robert Engelen, DO
Dr. Engelen served as a Lieutenant in the Navy and operated as the medical officer for Marines in North Carolina and for a deployment to Afghanistan. He has served as a team physician for a high school and a Division II Collegiate athletic sports team in Pittsburgh, and currently serves as the team physician for West Jordan High School.

Dr. Engelen has a special interest in fluoroscopic procedures, diagnostic ultrasound and ultrasound guided procedures, regenerative medicine, biomechanical analysis, and treatment of all sports and spine injuries. His unique practice focuses on non-surgical treatments.