Physiotherapy and Injuries
Sports Physiotherapy: Understanding Injuries and Getting Back to the Activities You Love
Whether you run, cycle, play tennis, go to the gym or simply enjoy being active, injuries can be frustrating. Pain can affect your training, your confidence and sometimes even everyday activities.
Sports physiotherapy is not just about treating the painful area. It is about understanding why the problem has developed, managing symptoms and gradually rebuilding the strength and capacity needed to return to your activity.
At Perform Health Co in Edinburgh, physiotherapy and rehabilitation are built around this approach.
Why do sports injuries happen?
Sports injuries can happen suddenly, such as an ankle sprain or muscle strain, but many develop gradually.
One of the most common factors is a change in training load.
You might suddenly increase your running distance, add more cycling, start playing tennis more frequently or increase the weight and volume of your gym training.
Your fitness might feel ready for the change, but your muscles, tendons and joints may need more time to adapt.
Other factors can include:
Previous injuries
Changes in training frequency or intensity
Repetitive movements
Reduced strength or conditioning
Changes in terrain or equipment
Insufficient recovery
Returning to sport after a break
An injury does not necessarily mean that something is damaged or that you are moving incorrectly. Often, it is a sign that the demands being placed on the body currently exceed its capacity.
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Running is a repetitive activity, with every stride placing load through the lower limbs.
Common running problems include knee pain, Achilles pain, shin pain, calf strains, hamstring injuries and plantar heel pain.
These problems can develop after increasing mileage, introducing hill or speed sessions, changing running frequency or returning to running after time away.
Rehabilitation usually involves finding an appropriate level of running that your body can currently tolerate, before gradually increasing the load again.
Strength work can also help build the capacity required for running, particularly through the calves, quadriceps, hamstrings and hips.
The aim is not necessarily to stop running completely. In many cases, training can be modified while rehabilitation takes place.
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Cycling is relatively low impact, but the repetitive nature of the activity can still cause problems.
Cyclists commonly experience pain around the knees, hips, lower back, neck and shoulders. Wrist and hand discomfort can also develop during longer rides.
Training volume is often an important consideration. Increasing distance or spending more time on the bike can increase the overall load on the body.
Strength and conditioning can help cyclists develop the capacity to tolerate this load, while rehabilitation can address specific areas that are causing problems.
For some cyclists, bike setup and position may also be relevant, particularly when symptoms consistently appear during longer rides.
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Tennis combines acceleration, deceleration, changes of direction, lunging, jumping and repeated upper-body movements.
Common problems include tennis elbow, shoulder pain, calf and hamstring strains, knee pain, ankle injuries and Achilles problems.
Injuries can occur during a single movement, but they can also develop gradually when training volume increases.
Returning to tennis after an injury therefore needs to involve more than simply waiting for pain to disappear.
Rehabilitation can progressively introduce the movements and loads required for tennis, including running, changes of direction, lunging and faster movements.
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Strength training can be an important part of injury prevention and rehabilitation, but problems can occur when training load increases too quickly.
For example, you may increase the weight, number of sets or training frequency, or introduce an exercise your body is not accustomed to.
Pain during exercises such as squats, deadlifts, presses or pulling movements does not always mean the exercise needs to be removed completely.
Depending on the problem, it may be possible to adjust the weight, range of movement, repetitions or technique while continuing to train.
Progressive strength training is also commonly used during rehabilitation because muscles and other tissues need to become strong enough to cope with the activities you want to return to.
What does sports rehabilitation involve?
Rehabilitation varies depending on the injury and the individual, but there are some common principles.
Understanding the problem
The first step is working out what is likely contributing to your symptoms.
This includes looking at your injury history, current training, symptoms, movement and strength.
Managing load
You may not need to stop all activity.
Instead, your training can often be modified to keep you moving while reducing the amount of load currently aggravating the problem.
Building strength
Progressive strengthening helps increase the capacity of muscles and other tissues.
The exercises and amount of resistance will change as your rehabilitation progresses.
Returning to your sport
As your capacity improves, rehabilitation becomes increasingly specific to your activity.
A runner may progress towards longer distances and faster running. A tennis player may work on changes of direction and repeated efforts. A cyclist may gradually increase time and resistance on the bike.
This helps bridge the gap between being pain-free in everyday life and being ready to return to sport.
Physiotherapy is not just about pain
Pain is an important part of an injury, but it is not the only thing that matters.
Two people can have similar symptoms but need completely different rehabilitation programmes.
Your training history, previous injuries, strength, fitness, recovery and goals all influence how rehabilitation should be approached.
This is why a good rehabilitation programme should be individual rather than simply a list of exercises for a particular body part.
At Perform Health Co, physiotherapy can be combined with strength and conditioning, clinical sports massage and personal training, depending on what is appropriate for the individual.
When is it worth getting an injury assessed?
Some aches and soreness after exercise are normal, particularly when you have increased your training.
However, it is worth considering an assessment if:
Pain keeps returning
Symptoms are gradually getting worse
Pain is affecting your training or everyday activities
You are changing how you move because of pain
You are unable to perform your usual activity
You have had repeated injuries in the same area
You are unsure how to return to training
Getting an injury assessed can help you understand what is happening and, importantly, what you can continue doing while you recover.
Steven Cockburn
HCPC registered Physiotherapist
