Game On

Understanding what can be treated at home and what needs medical attention is key in keeping our bodies healthy and active. We checked in with Dr. Nicholas Sgrignoli, assistant attending physician in Primary Sports Medicine at Hospital for Special Surgery in Stamford to learn more about what to look for and how to know when it’s time to call someone like him. Primary sports medicine physicians are trained in primary care medicine with a specialty in non-operative sports medicine. They help patients with injury diagnosis, rehab, pain management and with safely returning to sports and leisure activities while closely monitoring medical conditions.

Is pain, especially with age, normal?
Overall, no, but there are different types of pain. Exercise-induced soreness is normal, but true pain that comes from an injury to a joint or tissue is not normal. In addition to injuries, pain is common among aging athletes and from degenerative joints and tendons, but it still isn’t normal and should be addressed.

How can someone decipher between occasional stiffness in muscles and joints and problematic pain?
With age, we find that muscles and joints become stiffer and lose elasticity in tendons which can lead to higher injury rates. I usually tell people that normal stiffness lasts for no longer than 10-15 minutes and goes away once they have loosened up. Persistent stiffness, that lasts for more than an hour in the morning, is more of a concern because it can be correlated to an inflammatory issue. Swelling, redness or warmth of the joints are all also things to look out for that may be signs of a problem.

How does someone who is injured know when it’s time to see a doctor?
Loss of strength, function or the inability to put weight on joints means you want to see a doctor right away. Any injury with symptoms and pain that is getting worse after a few days you would also want to have looked at. A muscle strain can take two to four weeks to heal but after a few days the pain should dissipate and your function should significantly improve. Overall, if the injury is limiting your activity or daily functions, it’s a good idea to have it checked out.

What are the signs that an injury may be a break? Is bruising/swelling indicative of the severity of the injury or not necessarily?
Swelling and bruising are extremely common for breaks, with that said, there isn’t always a telling correlation. You could have a break with little bruising or a significant amount of swelling with no break. There are two types of fractures: acute, which is sudden and typically occurs from a fall or sudden episode and stress, which is from overuse and repetitive motions like running or jumping. Acute fractures happen quickly, as opposed to stress fractures which get worse over days to weeks. With any injury, if pain is worsening and there is swelling or loss of function or pain during an activity it’s time to see a doctor.

What common injuries are you seeing lately? What activities are causing them?
People have continued to be very active with racquet sports throughout Covid. Activities like paddle and pickleball can bring patients in with tennis elbow and golfer’s elbow. We are also seeing a lot of plantar fasciitis from people that are working from home and spending most of the day walking around the house barefoot.

Does stretching before AND after exercising really matter?
There is actually no consistent research to show that stretching helps prevent injuries. With that said, a dynamic warm-up is definitely beneficial and important. You are much more likely to get hurt by jumping right into a sport with a cold, tight muscle. Any amount of stretching is most effective when your muscles are warm. So for a soccer player, doing lunges to activate muscles and work on lengthening as a warm up is better than just sitting down and doing a V-stretch. For those with tight muscles and asymmetric flexibility, stretching at the end of a sporting event would be best. One thing to note is that stretching should never be painful. You should feel the muscle but it shouldn’t hurt. I also don’t recommend bouncing, rather a slow controlled movement to release muscle tension.


HOW CAN WE PROACTIVELY AVOID INJURIES?

No. 1
WARM UP
Try to loosen up joints and muscles and break a small sweat before getting into a high-intensity phase. Spend at least 15 minutes trying to utilize the muscle groups that you’ll be using during the faster paced portion of your workout.

No. 2
TAKE TIME FOR RECOVERY
A lot of type-A athletes and high-intensity recreational trainers don’t think about recovery. Taking at least one day off a week is beneficial for adults and taking at least two days off a week is helpful for younger athletes. Ensuring that you are getting proper sleep, nutrition and hydration is also key.

No. 3
GO SLOW
Start new activities slowly and have recovery days in between to assess how your body is responding to new activity. Don’t go from doing nothing to trying to run three to four miles. If you haven’t run consistently, start with a walk or jogging training program.

No. 4
DON’T PUSH THROUGH PAIN
Many athletes are familiar with pain and used to playing through it but it will only make injuries worse.

No. 5
INCORPORATE VARIETY INTO EXERCISE
With a mix of cardio, strength and balance exercises you will be less likely to encounter overuse injuries. Try alternating your workouts throughout the week.

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