Sports Medicine Injuries

Sports injuries occur when playing indoor or outdoor sports or while exercising. They can result from accidents, inadequate training, improper use of protective devices, or insufficient stretching or warm-up exercises. The most common sports injuries are sprains and strains, fractures and dislocations.

Some of the measures that are followed to prevent sports-related injuries include:

Follow an exercise program to strengthen the muscles.
Gradually increase your exercise level and avoid overdoing the exercise.
Ensure that you wear properly-fitted protective gear such as elbow guards, eye gear, facemasks, mouth guards and pads, comfortable clothes and athletic shoes before playing any sports activity, which will help reduce the chances of injury.
Make sure that you follow warm-up and cool-down exercises before and after the sports activity. Exercises will help stretch muscles, increase flexibility and reduce soft tissue injuries.
Avoid exercising immediately after eating a large meal.
Maintain a healthy diet, which will nourish the muscles.
Avoid playing when you are injured or tired. Take a break for some time after playing.
Learn all the rules of the game you are participating in.
Ensure that you are physically fit to play the sport.

Some of the common sports injuries include:

Shoulder Injuries

Severe pain in your shoulders while playing your favorite sport, such as tennis, basketball and gymnastics, may be caused by a torn ligament or dislocation of the shoulder bone. This may result from overuse of your shoulder while playing sports. Simple pain or acute injuries may be treated with conservative treatment, while chronic injuries may require surgical treatment.

Knee Injuries

The anterior cruciate ligament (ACL) is major stabilizing ligament in the knee, which may tear with overuse while playing sports. The ACL has poor ability to heal and may cause instability. Other common sports injuries in the knee include cartilage damage and meniscal tear. Knee injuries during sports may require surgical intervention, which can be performed using open surgical or a minimally invasive technique. I will will recommend physical therapy to strengthen your muscles, improve elasticity and movement of the bones and joints.

Sprains and Strains

This is adjusted for this website using, PEACE & LOVE framework published by Dubois and Esculier in the British Journal of Sports Medicine (2020), current data on NSAIDs and soft tissue healing, and the shift away from prolonged rest.

What Are Sprains and Strains?

Sprains and strains are among the most common soft tissue injuries in active people.

A sprain is an injury to a ligament — the tough tissue that connects bone to bone and stabilizes your joints. Sprains are graded by severity: Grade I involves microscopic tearing with mild symptoms, Grade II is a partial tear, and Grade III is a complete rupture. The ankle, knee, wrist and thumb are the most commonly affected joints, though any joint can be involved.

A strain is an injury to a muscle or its tendon. Strains follow the same grading scale. They are most common in the hamstrings, quadriceps, hip flexors and back, though the shoulder and upper extremity are also frequent sites in throwing athletes and overhead sport participants.

What Causes Sprains and Strains?

These injuries happen when a joint or muscle is forced beyond its normal range of motion. Common causes include:

Sudden changes in direction or speed during sport
Falls or direct collisions
Repetitive overuse without adequate recovery
Inadequate warm-up or muscular fatigue, which reduces the body's ability to absorb load safely

Symptoms

Sprains typically present with:

Pain at or around the joint
Swelling
Bruising
Tenderness to the touch
Reduced range of motion or instability

Strains typically present with:

Pain directly in the muscle or at the muscle-tendon junction
Swelling
Muscle spasm or weakness
Bruising (in moderate to severe injuries)

Immediate Care: The PEACE & LOVE Framework

The old approach — Rest, Ice, Compression, Elevation (RICE) — has been replaced by a more evidence-based model. Current evidence supports the P.E.A.C.E. & L.O.V.E. protocol, which emphasizes natural healing processes and early active recovery over passive rest.

PEACE — The First 1 to 3 Days

P — Protect: Limit painful movement for the first one to three days to avoid further damage. This does not mean complete immobilization. Brief protection prevents ongoing injury while allowing healing to begin.
E — Elevate: Keep the injured limb above heart level when possible to reduce swelling.
A — Avoid Anti-Inflammatories: Evidence shows that selective COX-2 inhibitors can negatively affect healing of musculoskeletal soft tissue. Inflammation is a necessary and normal part of tissue repair. Suppressing it in the early phase may slow your recovery. Acetaminophen can be used for pain management if needed.
C — Compress: An elastic bandage or compression wrap helps manage swelling and provides gentle support.
E — Educate: Understanding your injury is one of the most important steps. An active recovery is almost always superior to passive treatment. Knowing what is happening in your tissue — and what to expect — leads to better outcomes.

LOVE — After the First Few Days

The management of soft tissue injuries should not focus only on short-term damage control. Long-term outcomes depend on treating the whole person, not just the injury.

L — Load: Begin gentle, pain-guided loading as soon as possible. Movement is medicine. Early loading stimulates tissue remodeling and restores strength faster than rest alone.
O — Optimism: Mindset matters. Patients who expect to recover well tend to recover better. Fear of movement slows rehabilitation.
V — Vascularization: Low-impact cardiovascular activity — walking, cycling, swimming — increases blood flow to healing tissue and supports recovery without stressing the injured area.
E — Exercise: Exercise therapy reduces the risk of a recurring injury and should be introduced progressively, starting with range of motion and advancing to strength, stability and sport-specific training.

A word on ice: Ice can help with short-term pain control, but it should not be used for extended periods. Icing reduces the inflammatory response your body needs to repair tissue. If you use it, limit application to 10 to 15 minutes at a time with a towel between the ice and your skin. Never apply ice directly to bare skin.

Diagnosis

Diagnosis begins with a thorough physical exam. I will assess the injured area, test range of motion and evaluate joint stability. X-rays are typically ordered to rule out a fracture. MRI may be recommended for moderate or severe injuries to better characterize the extent of soft tissue damage before a treatment plan is finalized.

Treatment

Treatment depends on injury grade and the specific structure involved.

Grade I and most Grade II injuries are managed non-operatively with a structured rehabilitation program focused on mobility, strength and proprioception.
Bracing may be appropriate for short-term support but should not substitute for active rehabilitation.
Physical therapy is recommended for moderate to severe injuries and is a critical part of any complete recovery.
NSAIDs can reduce pain in the short term but should be used with caution. In vitro studies have shown that NSAIDs have a harmful effect on biological processes involved in tendon healing and regeneration, including tenocyte proliferation and collagen synthesis. Discuss the risks and benefits with your surgeon before starting them.
Surgery is reserved for complete ligament or tendon ruptures that do not respond to conservative care or in cases where joint instability significantly affects function.

Recovery

Most Grade I and Grade II injuries show meaningful improvement within two to four weeks with appropriate, active rehabilitation. Severe injuries may require three to six months or longer depending on the structure involved.

The single most important principle in recovery is this: complete rest is not the answer. Immobilization leads to stiffness, muscle atrophy and prolonged dysfunction. Early gentle loading and movement, progressing gradually, consistently leads to faster and more complete recoveries than prolonged rest. Return to full activity should be guided by your symptoms, functional testing and clinical judgment — not a fixed calendar.

If you are not improving as expected, or if your injury involves significant instability, a pop at the time of injury, or inability to bear weight, you should be evaluated promptly by an orthopedic specialist.

References: Dubois B, Esculier J. Soft-tissue injuries simply need PEACE and LOVE. Br J Sports Med. 2020;54:72–73. Solaiman R et al. The effect of NSAID use on soft tissue and bone healing in the knee: a systematic review. Ann Joint. 2024. Grooms DR et al. Neuromechanics of ACL injury and rehabilitation. J Orthop Sports Phys Ther. 2017.