Doctor's Notes | Published September 19, 2011 | Written by Wayne J. Sebastianelli, MD

Tips for Preventing & Treating Common Fall Sports Injuries

Fall is a busy time here in Central Pennsylvania. School is in full swing again and many young athletes are back on the field, geared up and ready for fall sports. With the increase in activity, it's not surprising that local physicians also see a huge rise in sports injuries. While not all are avoidable, there are some things we can all do to better handle the demands we put on our bodies. Football, as one of the most popular sports played by young athletes, leads all other sports in the total number of reported injuries.

According to a 2007 study by the U.S. Consumer Product Safety Commission, more than 920,000 athletes under the age of 18 were treated in emergency rooms, doctors' offices and clinics for football-related injuries.

Concussions are a common football injury. And here's a key point: Unlike 20 years ago when a hard hit was referred to as a "bell ringer" -- a reason to sit on the bench for a bit -- that rule no longer applies. I believe coaches today do a good job of reminding players that they need to treat any injury seriously; sitting a game or two out doesn't mean the player isn't tough.

Unfortunately, while helmets are important, there are no concussion-proof helmets on the market. Any head trauma needs to be examined immediately by a physician.

When a physician sees a head trauma case, they will determine the best course of action and treatment and whether further neurological testing might be in order. Usually, the physician will recommend both physical and mental rest after a concussion.

That means a student recovering from a head trauma should refrain from just about everything, including video games and even reading.

The physician in charge will advise when normal activities can be resumed. Patients need to heed his or her directions closely; the last thing anyone wants is a second concussion.

ACL (anterior cruciate ligament) injuries are also common in both football and soccer. We hear a lot more these days about ACL problems, likely because there's better recognition of the injury across all athletics.

Since athletes today are involved in more complicated moves and advanced maneuvers, the knee is forced to move in ways it wasn't really designed for. This increases the risk of injury.
The key issues come down to training, conditioning and physiology. When conditioning, it's easy to focus on working the quadriceps, for example, rather than the hamstrings.

When one muscle (or set of muscles) is stronger in proportion to its balancing muscle (in this case the quadriceps and the hamstrings), it creates instability in the leg. Coaches and trainers will focus on all-around conditioning to keep the muscles in balance. Follow the regimes recommended and seek a physician's advice when needed.

For female athletes, there's an even greater increase of ACL injuries. In fact, it's been estimated that the increase in ACL tears in women is three to nine-fold.

Many young athletes haven't had the proper coaching or training -- for example, when playing basketball, a player may not know how to land properly after a jump shot. Coaching and training can help prevent knee injuries, so it's crucial that time is spent training properly.

Keep in mind also that there are many simple things to do at home that don't require fancy or expensive workout equipment. Think about the "Rocky" workout -- it's basic strength, endurance and speed training.

Lower extremity injuries -- sprains and strains -- are also common. While many lower-extremity injuries are treated by rest, ice and elevation, there is an increased chance of stress fractures with these kinds of injuries, so it's wise to be checked out by a healthcare professional for an injury that doesn't improve within a few days.

If your doctor recommends physical therapy or rehab, it's important to participate fully. It's easy to get discouraged or frustrated by the work, and often discomfort, of physical therapy, but it's a critical part of the healing process.

Attitude is everything in this area; try your best to show up and do exactly what your therapist recommends and when. You'll reap enormous benefits.

Finally, if your children participate in fall sports, make sure they have the appropriate and properly fitting gear. We see lots of professional athletes today competing with much less protective gear than they should have and that does influence younger players. Be sure your young athletes have the best protective equipment offered.

Wayne Sebastianelli, M.D. is board certified by the American Board of Orthopaedic Surgery; he practices at Penn State Orthopedics, State College, Pa., an organization affiliated with the Orthopedic Program and Surgery Center at Mount Nittany Medical Center. For more information, visit to www.mountnittany.org/orthopedics.

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