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    Sports Injuries – Knowing How To Treat, When To Get Medical Care

    Daren Vertein, RN, FNP-BC 03/21/2017

    Any sporting event, practice or training can lead to injuries. Some injuries are minor, but others need urgent medical care. Below we discuss helpful information about how to handle a variety of common injuries resulting from nearly any sport.

    Daren: I’ve been a nurse practitioner at Deaconess Urgent Care for a few years, with a long nursing career prior to that. I enjoy the variety of urgent care—I never know what’s going to come through the door. Deaconess Urgent Care provides walk-in care (and a small number of appointments) for individuals with mild-to-moderate injuries, illnesses and other issues that need immediate medical care, but aren’t serious enough to warrant a visit to the emergency department.

    James: I’ve been practicing in sports medicine for 21 years, and have taught as well. Over the years I’ve been a certified athletic trainer with several Division 1 colleges, the Harlem Globetrotters and numerous other organizations. I enjoy helping people get back into play and on the field. Orthopaedic Associates Walk-In/Urgent Care services are for anyone who has some type of joint, muscular/skeletal, etc. physical injury. Sports injuries are common causes of these, but anyone who is active can have something happen. We also treat injuries related to everyday accidents as well.

    General Guidelines – How to Know When Someone Should Receive Medical Care After An Injury

    James: At the high school and college level, most athletic events will have a certified athletic trainer attending at the sideline. His or her expertise is valuable in this situation, because as health care providers, they’re trained to assess and even triage injuries, and can provide some on-site care at the moment. They can also help to quickly make the decision on whether the athlete needs more extensive medical care.

    Both: Overall, here is a list of indications and symptoms that should send someone to urgent care:

    • Not being able to bear weight on a foot/leg.
    • Inability to grasp with hand.
    • Loss of strength or function.
    • Skin color change.
    • Significant change in appearance, such as loss of alignment, major swelling.
    • If questioning whether a cut or gash needs closure, it’s best to be seen.
    • Overall, if basic first aid doesn’t seem to help resolve or at least improve the issue, then more advanced care should be sought.
    • Beyond that, anything that doesn’t start to improve within 24 hours should be taken seriously.

    There are some injuries that require an immediate trip to the Emergency Department.

    • Any loss of consciousness, even briefly
    • Suspected concussion, especially if nausea and vomiting are present (as IV fluids are often needed)
    • Breathing problems
    • Broken bones protruding through the skin.
    • Dislocated joints.

    Common Sports Injuries
    Both: The number one sports-related injuries that we see are related to strains, sprains and other muscular/tendon/ligament issues. They happen to nearly every joint in nearly every sport.

    James: Here are some guidelines on how to handle at home appropriately:

    • The number one thing that should be done within minutes of a suspected sprain or strain is to apply an ice pack. Ice can help prevent secondary injury that results from the quick inflammation and swelling.
    • Ice should be applied for 20 minutes, and then the injury should rest for two hours, then repeat this cycle for up to 2-3 days.
    • The “formula” for addressing a strain or sprain is “RICE”—Rest, Ice, Compression, Elevation.
    • An elastic bandage around the injury can help keep the swelling down. Note: Apply just enough tension to help with compression—be careful that it’s not too tight.
    • Helping a sprain or strain involves not using the injured body part. (If the ankle is involved, crutches should be used.  If the elbow/shoulder is sprained, a sling may be needed.)
    • Anti-inflammatories, such as ibuprofen or naproxen, can be helpful for reducing pain and inflammation as well. (Use only as directed on package/by physician.) However, if after 2-3 days of this type of care, the injury isn’t improving or seems to be worsening, a visit to Orthopaedic  Associates urgent/walk-in care may be appropriate.

    Addressing Chronic/Recurring Pain
    James: Many athletes have “that pain that keeps coming back.” Because many sports have repetitive motions, these types of chronic/recurrent injuries are common.

    In the event that a significant “flare up” happens, the RICE (rest, ice, compression and elevation) applies, along with anti-inflammatories as appropriate.

    Because a lot of tendonitis issues result from overtraining or overuse, rest may be the most important way to address these problems. Give your body time to adapt to what you’re asking from it.

    Once again, if a significant recurring pain isn’t improving with treatment and rest, then it’s time to be evaluated by an orthopaedic expert.

    Cuts, Scrapes and More

    Lacerations—cuts, gashes, etc.—when do you come in vs. taking care of it at home?

    If the injury is a scrape—even a large one—cleanse it thoroughly with soap and water, and if appropriate, apply an OTC antibacterial ointment for the first day. Keep it bandaged, clean and dry. The bandage should be replaced and the wound inspected daily.  (Also replace the bandage any time it’s soiled or wet.) If the wound starts to ooze anything but clear fluid, see your primary care doctor or an urgent care.

    If there is an actual opening of the skin--a wide/deep cut--it should be seen to determine if it needs closure. A visit to an Urgent Care is appropriate. However, if the cut is deep enough that you can see muscle, bone, etc. a visit to the Emergency Department is best.

    Also, overall, if there are multiple injuries such as several cuts that probably need closure, joint pain, swelling, etc. a trip to the Emergency Department is needed. They’re most equipped to deal with many issues at once.

    Concussions are serious—they’re not just a headache or “getting your bell rung.” We now know there can be lifelong effects from concussions, and they need to be assessed and treated as soon as possible after they happen.

    Our colleagues at the Deaconess Concussion Clinic are the experts on concussion, and their webpage is full of information regarding signs and symptoms, what to do, etc.

    Prevention Is Key
    James: As a certified athletic trainer, I’d like to wrap up this discussion today by addressing the most important factor in injuries:  preventing them.

    I’ll briefly touch on some of the most significant prevention techniques and mindsets to have.

    • Proper conditioning is key to preventing injury. This means training that gradually builds, proper warm-up and cool-down, hydration, adequate nutrition (protein, calcium, etc.)
    • Being well-rested is important. Overall wellness helps prevent injury.
    • Don’t return to play too quickly after an injury. A more serious second/re-injury can happen if you do.
    • Monitor your environment. Temperature, safe surfaces, adequate lighting, etc. are all factors in preventing injury.

    Using proper and well-fitting equipment and gear is critical. Taking shortcuts here can lead to many injuries. For more information about the services and departments mentioned in this article, visit the links below:

    • Deaconess Urgent Care
    • Orthopaedic Associates Walk-In/Urgent Care
    • Deaconess Concussion Clinic

    Wishing you a fun and safe sports season. 

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