5 common sporting injuries of the upper body and how to prevent them
Australians are known for their love of sport, with approximately 41% of us participating in sport related activities at least once per week (Australian Sports Commission, 2022). Regular sporting involvement can help both physical and mental health, improve sleep quality, help to develop discipline and routine and help to form important social connections. However, playing sports is not without its downsides, and getting injured is one of them. In this post, we will talk through 5 common upper body injuries.
Concussions are a type of head injury that occur with a direct knock or blow to the head, and are considered mild traumatic brain injuries that result in compromised brain function. Common symptoms include headaches, confusion, dizziness, memory loss, loss of consciousness, nausea and vomiting, mood swings and fatigue. Early identification and appropriate management of these injuries are critical to the long term health outcomes of the injured player.
While not all concussions can be avoided, there are a number of suggested ways to reduce the frequency and severity (Waltzman & Sarmiento, 2019). Firstly, educating all players, staff and parents as to the signs and symptoms of a concussion allows for the early identification, which will lead to better outcomes for the injured athlete. Secondly, using protective equipment that is in good condition and that meets Australian safety standards can reduce the impact forces associated with the collision. Lastly, strengthening of the neck muscles has been shown to help absorb some of the forces associated with concussions.
Dislocated joints are another common injury presenting to physiotherapy clinics, often sustained while playing ball or contact sports. Dislocated shoulders, fingers and patellas (knee caps) are often seen across a range of sports.
Joints, or the meeting of two bones, allow for smooth pain free motion between the segments which allow us to move. Joints are supported by ligaments, capsules that surround the joint and even tendons or muscles passing along the joint. Under normal pressures and loads, these structures are able to stabilize the joint and keep it together. Dislocations occur when the bones are forced apart by high external forces, such as a collison or tackle during sport, a fall, or a sudden change of direction. If the joint moves only a little and is not completely separated, it is called a subluxation. If however the joint surfaces are completely disengaged, this is known as a dislocation. In both cases, there may be damage to the ligaments and other structures that support the joint.
Dislocated shoulders and fingers seem to be the prevailing dislocations seen by physiotherapists in our clinic. Whilst some joint injuries are accidental and unavoidable, there are known risk factors that we should be mindful of, including weakness in the surrounding muscles, stretched ligaments from previous dislocations, joint hypermobility, connective tissue disorders such as Ehlers-Danlos syndrome or Marfan syndrome. In all of these examples, a thorough strength program targeting specific stabilizing muscles has been proven to be effective at reducing the risk of dislocations. Furthermore, the use of tape whilst playing sport can help to support the joint and reduce the chance of a dislocation (Turgut et al., 2021).
Shoulder Impingement or Pinching Shoulder Syndrome
The shoulder joint is one of the most mobile joints in the body, allowing for very large ranges of motion in multiple directions. Not surprisingly, this means that the shoulder is susceptible to being injured, often affecting overhead and throwing athletes. Shoulder impingement refers to the compression, irritation and inflammation of the structures that sit in the subacromial space of the shoulder. These structures become progressively more irritated and begin to cause pain, which also leads to a loss of shoulder movement overhead and sometimes pain at night when lying on that shoulder.
Common causes of shoulder impingement include poor strength of the shoulder rotator cuff muscles, particular shapes of the tip of the acromion bone and thickened or degenerative rotator cuff tendons; all leading to a narrowing of the subacromial space. Furthermore, poor mobility of the scapular itself can orient the shoulder downwardly, contributing to an apparent loss of subacromial space. . Short term relief may be possible with anti-inflammatory medication, however successful management depends on the accurate identification of the contributing factor and targeted exercise and strengthening to correct this (Consigliere et al., 2018).
Lateral epicondylitis, or tennis elbow, is an injury that presents with pain on the outside of the elbow. It is most commonly an overuse injury of the muscles in the forearm that extend the wrist, but sometimes can be caused by an acute traumatic injury to the elbow. Whilst it is not an injury exclusive to the sport of tennis, a large number of cases are those that play tennis.
Like most overuse injuries, ensuring the correct load or amount of exercise is a key preventative strategy. Working closely with a coach to hone your stroke, getting the right grip size and string tension and not over training are easy ways to avoid becoming injured. Strengthening the entire upper limb, from grip strength all the way to shoulder stabilizers is must in order to stay on the court (Nabil et al., 2019).
Like Tennis Elbow, Golfer’s Elbow is an overuse injury of the elbow where pain is typically seen on the inside of the elbow and forearm. Again, the condition is not only seen in those playing golf. Sports involving repeated throwing or gripping, and physical jobs like trades are common causes of Golfer’s Elbow.
Taking a period of time to rest from the activities that hurt, while ice and anti-inflammatory medications are of limited benefit. The most effective way to manage Golfer’s elbow is through physiotherapy, which may include things like dry needling, shock wave therapy, and strengthening of the upper limb and counterforce braces (Hoogvliet et al., 2013). Rarely do these elbow overuse injuries require surgery, so it is best to make an appointment with your Physiotherapist to assess and begin your rehabilitation.
Stay tuned for the second part to this post where we will look at common lower body injuries.
Hoogvliet P, Randsdorp MS, Dingemanse R, Koes BW, Huisstede BM. Does effectiveness of exercise therapy and mobilisation techniques offer guidance for the treatment of lateral and medial epicondylitis? A systematic review. Br J Sports Med. 2013 Nov;47(17):1112-9
Consigliere P, Haddo O, Levy O, Sforza G. Subacromial impingement syndrome: management challenges. Orthop Res Rev. 2018;10:83-91.