A Mass General physical therapist offers advice on how best to avoid and treat sports injuries most likely to occur during the fall season.

With fall sports in full swing, Lenore Herget, PT, DPT, senior physical therapist in the Massachusetts General Hospital Sports Medicine Center, provides key information about how to avoid sports injuries during the season. She also says yoga isn’t for everyone.

What are the most common fall sports injuries? With what sports are they associated? 

Overall, the most common injury we see initially see is muscle strain from overtraining, typically from the preseason.

Overall, the most common injury we see initially see is muscle strain from overtraining, typically from the preseason. Injuries can vary based on the specific sport:

  • Soccer: ACL (anterior cruciate ligament) and meniscal injuries; patella femoral joint dysfunction
  • Football: Concussions, AC joint separations
  • Cross Country: stress injuries (stress fractures and stress reactions); patella femoral joint dysfunction
  • Field Hockey: Contusions
Lenore Hergot, PT, DPT
Lenore Hergot, PT, DPT

What are some ways to prevent these sports injuries?

It’s important to adequately train in the off-season leading up to preseason so that the shock of preseason demands doesn’t overtake what the musculoskeletal system is prepared to handle. Also, glute strengthening is important as many lower extremity injuries can be prevented or lessened by appropriately training the gluteal muscles. Particularly with sports that involve a lot of one-plane motion, like running. These sports use muscles on the front and back of the legs – quadriceps, hamstrings and calf muscles – and leave the hip rotators and extensors, like the glutes, out of the picture. This muscle imbalance can lead to a lot of hip, knee and even foot problems from biomechanical breakdown during many weight bearing activities.

For sports that involve a lot of jumping, landing, twisting and cutting, it is important to train these motions as well. There are many good preseason and during season “preventative ACL” programs available. Many sports teams have adopted them as part of their pre, during and offseason workouts. For the upper extremity, strengthening the muscles that stabilize and move the shoulder blades can have a big effect on preventing shoulder injuries caused by throwing.

What are the most common therapies and treatments for such sports injuries? 

Pain is typically a good indicator that something is wrong, and pushing through the pain can lead to more injuries . . .

In some cases, surgery may be warranted. In non-operative cases, we look to normalize the mechanical load through the joint or body part. This is done through a combination of physical therapy approaches: soft tissue techniques – which may include various types of tissue specific massage, joint mobilizations or stretching; strength training of areas around the affected region; core strengthening and stability exercises – which can include the “upper core” (mid-back) and “lower core” (pelvic, abdominal and glutes); motor control and motor retraining – which involves teaching proper biomechanics with certain activities; and unlearning bad habits gained from previous muscle imbalances.

If an athlete thinks he or she has been injured, what is the best course of action?

The RICE method is generally a safe and effective method: Rest, Ice, Compression, Elevation. If after two to three days there is no improvement, seek a consult. Of course, if there are any red flags, the athlete should see a physician or report to the Emergency Department immediately.

What are some common injury myths, such as girls tear their ACLs more?

Girls do tear their ACLs more, actually! Here are some myths:

Sometimes overstretching before exercise can predispose an athlete to more injuries.

  • No pain, no gain. Pain is typically a good indicator that something is wrong, and pushing through the pain can lead to more injuries or increase the severity of the existing injury.
  • Running is a good strengthening workout. Not a lot of strength training and muscle building occurs with running; more muscular endurance and cardiovascular endurance training.
  • Yoga is good for everyone. Not always the case, particularly with someone who is exceptionally stiff. They may try to emulate the person in front of them who is very flexible and incur an injury in the process.
  • If you don’t stretch before you run or workout, you’re going to pull something. Sometimes overstretching before exercise can predispose an athlete to more injuries.
  • Taking anti-inflammatories before running/playing can help minimize the pain. It will mask the pain, but again, pain exists for a reason. Don’t ignore it.
  • Minimalist shoes are good for everyone. Everyone has a different foot type, bone anatomy and mechanical stresses through the foot; what might be good for one can be detrimental to another.

For more information about making a donation to support the Sports Medicine program at Mass General, please contact us.

This story was first published by MGH Hotline.