When Should I Start Physical Therapy After a Sports Injury?

When Should I Start Physical Therapy After a Sports Injury?

Most people will experience some kind of physical injury in their lifetime, and sports injuries are particularly common amongst children. More than 3.5 million children and teens are injured each year as part of organized sports or physical activity. In fact, one-third of all injuries in children are sports-related.

The most common sports injuries include patellofemoral injuries, or trauma to the kneecap like a dislocation or fracture, shoulder injuries, tennis or golf elbow, hamstring strains and sciatica. The general recommendation for those who have been injured is to start rehab with range-of-motion exercises around 72 hours after injury, and it can continue for a period of several weeks or months. However, the time that you should begin physical therapy will depend on the type of injury and the severity of it, and your physical therapist at ProFysio will be able to create a personalized treatment plan. Some injuries require rest during the first 72 hours and some call for 10 days or more of rest.

Let’s walk through the five most common sports injuries and when you will typically begin physical therapy for each.

Patellofemoral Pain

Patellofemoral pain, or PFP, occurs at the front of the knee or under and around the kneecap, otherwise known as the patella. Because it is commonly caused by overuse, it is often called “runner’s knee.” It is one of the most common types of knee pain in the US and accounts for 20 to 25% of all reported knee pain.

Symptoms tend to increase with walking, kneeling, squatting, going up or down stairs or running, so some patients may need to refrain from these activities as much as possible for a period of time. When symptoms are severe, a period of four to six weeks of rest is usually recommended.

When a patient is diagnosed with PFP, running or any similar strenuous activity that places pressure on the knees will immediately be replaced with physical therapy. The focus of the physical therapy will be on building strength around the injured knee. These exercises should be performed three times a week for about six weeks in order to decrease pain and improve physical activity.

Your physical therapist at ProFysio will work to develop a treatment plan for your specific knee pain. Your plan might include strengthening exercises, taping, shoe inserts, coordination training and cross-training guidance. The key muscle groups that the patient will work to build during physical therapy include quadriceps, glutes, hamstrings and adductors.

Shoulder Injuries

Because the structures that hold your shoulder together are greatly intertwined, there are a multitude of ways to injure your shoulder. These injuries tend to require a slightly longer period of rest before physical therapy exercises begin. For a shoulder sprain, physical therapy should begin after a rest period of two to three weeks. For rotator cuff tendinitis or even a small tear, the period of rest is about two to four weeks, but severe cases can take a few months.

In its early stages, the goal of physical therapy for shoulder injuries is to reduce swelling and inflammation of the tendons and relieve compression. Once that is achieved, the goal of the exercises then becomes strengthening the muscles and improving range of motion. Your physical therapy plan will be personalized to your condition, but methods can include ice, heat, hands-on therapy that encourages the tissues to loosen up, stretching, strengthening, joint mobilization and stabilization, ultrasounds, electric stimulation, athletic taping, activity modification and workplace position adjustments.

Tennis or Golf Elbow

Tennis or golf elbow occurs when one damages the tendons that connect the muscles of the forearm to the elbow. It is caused by repeating the same motion that places stress on the elbow joint, which is common with activities like tennis and golf. The primary symptom is typically pain that radiates from the outside of the elbow into the forearm and wrist. Tennis or golf elbow interferes with basic activities like shaking hands and gripping objects.

The condition affects the tendons and ligaments, which tend to take longer to heal than muscles. Because there are fewer blood vessels in these tissues, they don’t receive as much oxygen as other tissues. If you become affected by tennis or golf elbow, the best first step is to rest the area as much as possible, use ice treatments, compression treatments and elevate the area. If you do not begin to see improvement in one to three weeks, our physical therapists will create an exercise plan designed to strengthen and improve flexibility of the muscles surrounding the elbow.

Physical therapy can also help improve blood flow to the tendons. If your pain is still severe during your appointment, your physical therapist may perform an ultrasound, use muscle stimulation and provide tapes for support. Types of exercises you might be asked to do include wrist extensions, wrist flexions and towel twists. Most cases of tennis or golf elbow improve within six to eight weeks, but some cases may take months.

Hamstring Strains

The hamstrings are located in the back of the upper leg and are one of the most important muscle groups for athletes. They protect the Anterior Cruciate Ligament (ACL), which is the most essential stabilizer of the knee. Symptoms of hamstring strains include pain in the back of the thigh when bending or straightening the leg, tenderness, swelling and bruising in the area and prolonged weakness in the leg.

Hamstring injuries are divided into three “grades.” Each of the grades requires a different rest period before beginning physical therapy. Grade one is a mild pull that does not interfere with walking but prevents the injured person from running at full speed. The severity of grade one hamstring injuries can vary, but a person might need between one and three weeks of rest from sporting activities if affected.

A grade two hamstring strain includes partial muscle tears, and it is more likely that the injured person will need to refrain from sporting activities for about four to eight weeks.

A grade three hamstring strain is a complete rupture or muscle tear. It usually requires several months of rehabilitation to completely heal and may require surgery. For any hamstring strain, resting, icing and compression should take place immediately after injury and continue for 48-72 hours, after which point physical therapy exercises can generally begin.

Sciatica

Sciatica is pain that radiates along the path of the sciatic nerves, which reach from the lower back through the hips and buttocks down each leg. It is caused by irritation or compression of the sciatic nerve. Symptoms include pain in the buttocks or leg, burning or tingling down the leg, difficulty moving the leg or foot, constant pain in one side of the buttocks and shooting pains that make standing up difficult.

Most people who get sciatica are between 30 and 50 years old. Lots of heavy lifting or prolonged sitting can damage herniated disks and cause sciatica. The first recommended steps when experiencing sciatica can primarily be taken at home. These include applying ice and warmth to the areas in pain, stretching the hips, legs and hamstrings, avoiding prolonged sitting and taking anti-inflammatory agents as recommended by a doctor.

If home treatments are not helping and symptoms persist for more than a week without improvement, physical therapy should begin. The goal of physical therapy at ProFysio will be to strengthen and mobilize the tissues in the lower back, pelvis, abdomen, buttocks and thighs. Your physical therapist will provide a personalized treatment plan that may include extension and flexion back exercises, strengthening exercises, functional retraining, nerve glides, joint mobilization, joint manipulation and active assisted range of motion. Sciatica is typically a temporary issue and most recover from the pain within four to eight weeks.

If you are suffering from any of the injuries above or a different condition, call ProFysio today at (732) 812-5200 or contact us online for more guidance about when to begin physical therapy, and for a personalized treatment plan!

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