By consultant Dr. Peter Kryger, specialist in rheumatology, Hvidovre Hospital
Simply straining your body is the cause of many injuries. Here is some good advice on treatment and prevention.
Around two thirds of all sports injuries can be avoided. Most injuries are not due to accidents such as falls or collisions between participants, but to simple straining. When a joint, a muscle or a tendon is strained, your body reacts with an inflammation – a reaction similar to that caused by a bacterial infection. In the case of a sports injury there are no bacteria involved, but the inflammatory reaction is initiated by the strain. The inflammation is a necessary element of the body’s defence and a precondition for the regeneration of the strained, damaged tissue.
An inflammation gives rise to:
- Swelling due to effusion of the fluid in the tissue.
- Redness and a hot sensation, caused by increased blood flow.
- Pains and tenderness due to the swelling.
- Reduced function due to pain, stiffness and swelling.
A vicious circle!
If exercise and straining continues, the inflammation and consequently the pain will increase – you get into a vicious circle − the circle of pain.
A strain injury will often start insidiously, with pain and stiffness in the morning, and wear off after a few warm-up exercises, only to return with increased intensity if you continue to exercise. To break the circle of pain you should take a break and allow the region affected to rest. Pain is a warning signal, a sign of an injury that is developing.
In the case of acute strain injuries, the treatment consists of what is known as the RICE principle.
These four letters stand for:
- R: (rest), make sure that the injury is rested,
- I: (ice), keep the injury cold. Place an ice pack on the injured area, wrapped in a cloth. This brings down the swelling and reduces the pain.
- C: (compression), put pressure on the injured area using an elastic bandage. This restricts the swelling. After a few hours you can use a support bandage instead. The bandage must not be bound so tightly that the blood supply is restricted.
- E: (elevation), raise the injured arm or leg. Your arm can be elevated in a sling. Your leg should be placed on a table, supported by a couple of cushions. This reduces the swelling and the accumulation of blood.
How joggers injure themselves
The following section deals with three common strain injuries suffered by joggers:
Jogger’s knee:
On the outer side of the thigh there is a powerful ligament that runs from the hip down to the tibia just below the knee. Too intensive jogging will often strain the ligament at the point where it runs over the knee joint. This is often referred to as jogger’s knee, even though it is not the actual knee joint that is affected. Jogger’s knee can be prevented by wearing good running shoes with air in the sole and good supports for the inside of the foot. It is a good idea to relax the thigh muscles both before and after jogging. Most injuries will fade away when you take the pressure off the leg. If the problem still persists after one month, you should seek medical attention.
Jumper’s knee:
If you have pain below the knee cap in the tendon between the lower leg and the knee cap, this is what is known as jumper’s knee. The pain is caused by tearing of the tendinous fibres where they are attached to the knee cap. The strain causes discomfort and usually occurs in connection with running and jumping. Blood supply to the tendons is generally poor, and the injury takes a long time to heal. The body takes longer to heal tendon tissue than a broken bone. The best treatment is to reduce the strain.
You must take it easy for up to a couple of months, keeping in shape by swimming or cycling, for example. The exercise should not cause pain, and you should seek medical attention if the pain persists after 6-8 weeks.
Achilles tendon injury:
The tendon in the heel is called the Achilles tendon. The Achilles tendon is the tendon for the peroneus. It is attached to the heel bone and makes sure that the peroneus can bend the foot downwards. If the tendon is strained there is an inflammatory reaction, in particular in an area 3-4 cm above the heel bone.
This strain is seen in particular in people who are not used to exercise, but who step up their jogging too quickly. A strain will cause pain, swelling and tenderness in the tendon. Initially the pain is experienced after exercise, and fades gradually when you rest and warm up. In the event of continued severe strain, possibly in the mistaken belief that the condition has to be “exercised away”, there will be constant pain and swelling. You must stop exercising, relieve the tendon or put an insert in your shoe to increase the height of the heel by a couple of cm, and buy footwear with a heel insert that acts as a strong shock-absorber. If the condition does not improve after a month, you must seek medical attention. |
