It might start as a creaky knee, or stiff joints, or perhaps you feel a twinge in your back with a simple movement. Old age? Maybe. But chances are, if you injured yourself playing a youth sport, you could be experiencing the painful consequences of an injury that didn’t heal properly.
In the U.S., about 30 million children and teens participate in some form of organized sports, and more than 3.5 million of them sustain injuries. The most common of these are sprains and strains, but broken bones, stress fractures, dislocations, meniscus tears and other injuries can be troublesome decades later.
The classic scenario is the 40-year-old male who comes into our office with a swollen knee after playing pick-up basketball. He played football back in high school and had an old injury where he felt a pop in his knee, but he “toughed” it out. Now, years later, he re-aggravated it playing basketball. It is his old youth injury coming back to haunt him. He likely had an anterior cruciate ligament (ACL) tear or meniscus tear which was left untreated and eventually developed arthritis.
Most of the youth knee injuries that I typically see with older patients are untreated ACL injuries, meniscus tears that were surgically cleaned-up at the time of injury through meniscectomy that now has worsening arthritis or cartilage damage that was left untreated or has been cleaned up through a surgical procedure called chondroplasty, and now has become osteoarthritis.
Typical youth shoulder injuries that can cause problems later in life are dislocations that can cause cartilage damage and lead to arthritis. Labral tears can occur from overthrowing in baseball, which can require surgery in the future. Ulnar collateral ligament (UCL) injuries in the elbow are becoming more common as more youth play year-round baseball. In the hip, we are identifying more adolescents and young adults with femoral acetabular impingement and labral tears, which left untreated can lead to hip arthritis.
It’s important to distinguish between acute and chronic injuries. An acute injuryhappens suddenly and could result in broken or fractured bones, torn muscles or ligaments and bruising. Acute injuries that are treated inappropriately or neglected are more likely to cause problems years later.
Chronic or overuse injuries are common among young athletes. In fact, overuse injuries are responsible for nearly half of all sports injuries to middle and high school students. These injuries are caused by prolonged repetitive motion, improper technique or training, lack of correct equipment support, or structural abnormalities. Overuse injuries typically involve tendon issues which can lead to tendinitis. A classic case of this is tennis elbow, which is a common problem seen in patients who enjoy racquet sports.
If an old sports injury is flaring up, abide by the acronym RICE (rest, ice, compression, elevation). A short course of anti-inflammatories can be used to decrease pain. Also, avoid going back to the sport if you are still having pain or weakness from the injury. If the pain doesn’t improve within 24 to 48 hours, consult with your physician. Other signs to see a physician include hearing a pop, joint swelling, if a deformity appears on the extremity, if the joint or extremity feels unstable, and if you are unable to weight bear on the injured extremity.
Also remember that certain injuries such as fractures and tendon injuries have a time window in which to have treatment. For example, rotator cuff tears can become scarred down and more difficult to repair if treatment is delayed. Fractures can start healing in the wrong position leading to more difficult treatment options.
“No pain, no gain” is no longer the accepted motto for working out in the modern fitness world. Listen to your body and adjust workout routines so they won’t cause overuse injuries. If an old injury continues to bother you, see an orthopedist who can properly diagnose the injury and create a safe, customized treatment plan.
Written by: Tim Bert, M.D., Abrazo
Tim Bert, MD, is a board-certified sports medicine orthopedic surgeon specializing in hip arthroscopy, fellowship-trained in arthroscopic surgery of the shoulder, hip and knee at the Kerlan Jobe Orthopaedic Clinic in Los Angeles. Dr. Bert has served as an assistant team physician for Phoenix Suns and Mercury, the Los Angeles Lakers, Sparks, Kings, Dodgers and Anaheim Ducks, and provided coverage for the Summer X Games. His community involvement has included being team physician for the Sereno Soccer Club of Arizona, Arizona Scorpions Football Team, Arizona Interscholastic Cycling League, ASU Wakedevils wakeboarding team and the Grand Canyon Professional Rodeo Association. He is a member of the medical staff at Abrazo Scottsdale Campus