Know your knees

Your knee: it's the biggest joint in your body, made up of a lot of parts that can get injured in all kinds of sports. The knee connects the lower end of the thighbone (femur) to the upper end of the shinbone (tibia). Several large ligaments – strong, elastic bands of tissue that join bone to bone – make this connection, bracing and controlling the motion of the joint. The kneecap (patella) slides in a groove at the end of the thighbone; it protects the knee and gives leverage to various leg muscles. Cartilage at the ends of the leg bones helps to cushion the joint, like a shock absorber.

Sprains (stretched or torn ligaments) are an especially common knee injury, and the anterior cruciate ligament (ACL) is the one most often damaged. This can happen, for example, when you change direction quickly, twist a leg or fall, slow down when running, or land from a jump. Typically, a torn ACL will be immediately disabling: you'll feel or hear a "pop," and the knee seems to "give way." Even though it might not be painful, see a doctor right away. Surgery may be necessary.

Knee pain can also come on gradually from overuse of the joint. For example, "patello-femoral syndrome," or pain caused by the kneecap being pushed against the sides of its groove, can occur if you do a lot of running. The pain, either sharp or dull, is usually felt in the front of the knee. Squatting or walking down stairs often makes it worse, and you might feel a grinding or "clicking" in the joint. A sports medicine specialist can help you to rebalance the kneecap and prevent further pain through proper training, stretching, and strengthening exercises.

Shouldering the burden

When you play sports like swimming, tennis, baseball, or even golf, you're swinging your arms overhead a lot. That can lead to shoulder injuries. The key to preventing serious injuries is to spot problems early. Don't "play through" shoulder pain – you may end up making things worse.

If you're feeling pain in your shoulder, see a doctor if you answer "yes" to any of these questions:

  • Is the shoulder stiff? Is it difficult to rotate your arm in all the normal directions?
  • Does your shoulder feel like it could pop or slide out of its socket?
  • Is your shoulder too weak to carry out everyday activities?

You can prevent muscle pain and stiffness by warming up properly before your activity. If your exercise is particularly intense, don't stop immediately – slow down gradually before you stop and stretch afterwards. This will not only help with aches but prevent you from getting dizzy from an abrupt stop in activity.

The heat is on

Summer sun certainly makes exercising outdoors more fun. But if you don't take precautions, getting physical in the heat of day can be hazardous to your health. Sweating is the body's way of staying cool during exertion; you'll sweat off from 1 to 1.5 litres of water an hour in the process. But if you don't drink enough fluids to replace what you've lost, you may expose yourself to heat injury.

The mildest type of heat injury is heat cramps – when your muscles cramp up painfully from losing too much salt and not drinking enough fluids while exercising. As soon as you notice cramping, move to the shade or a cool area and have something to drink. Either salted water (¼ to ½ teaspoon of salt per litre of water) or a sports drink that contains electrolytes will do (make sure you get a sports drink and not an energy drink). Massage and stretch your cramped muscles and you should feel better soon.

Heat exhaustion is a more serious condition, brought on by sweating heavily, along with not getting enough fluids. The body can't deliver enough blood to the brain, skin, and muscles, leading to dizziness, weakness, and fainting.

If the body becomes dehydrated (runs out of fluids), you can end up with life-threatening heat stroke, which can show up suddenly. As the sweating mechanism shuts down, the skin becomes hot and dry, and the body temperature soars, leading to convulsions and permanent brain damage.

If you think someone is suffering from one of these heat injuries, get medical help right away. Meanwhile, move the victim to a shaded area, take off extra layers of clothes, wet and fan the body, and raise the person's legs and buttocks. Make sure to provide him or her with as much water to drink as possible.

Here are some tips to help you avoid heat injury in the first place:

  • Drink plenty of fluids while you're exercising – whether you're thirsty or not. Before, during, and after the activity, aim for roughly a cup every half-hour. You can also consider drinking salted water or a sports drink if you are sweating a lot.
  • To help your body cope with the heat and humidity, get into shape before the season.
  • Don't overexert yourself in hot weather – take a lot of breaks. This is especially true if you've only recently taken up a sport or a particular exercise; your body's more likely to feel the extra stress. 
  • Schedule your sports for the coolest parts of the day, either morning or late afternoon. The sun's rays are strongest between 10 a.m. and 4 p.m. Better yet, exercise indoors in an air-conditioned gym. 
  • Exercise at a slower pace. Working out for a shorter time, but more intensely, won't protect you from heat injury. 
  • Dress for the weather. Wear lightweight, breathable, light-coloured clothes. And don't forget to protect your head, eyes, and skin: wear a hat and sunglasses, and make liberal use of sunscreen.

Athlete, heal thyself

Mild sports injuries

Treating sports injuries early is important to prevent further damage to the injured site. For mild sprains, strains, bumps, or bruises, follow the RICE program for the first 48 hours:

  • Rest: Take a break for the first 24 hours to let the injured area rest and recover. Your body needs time to heal the injury. Once you can go about your usual daily routine without pain, you can ease yourself back into a full slate of activities.
  • Ice: Apply an icepack (or a bag of frozen vegetables, wrapped in a towel) to the injured area for 15 to 20 minutes every few hours. Ice helps to cut down on swelling and inflammation by slowing blood flow to the injury, as well as lessening the pain by numbing it a bit. Avoid leaving the ice on for too long, since it could cause frostbite.
  • Compression: Between ice treatments, wrap an elastic bandage around the affected part to apply pressure and reduce swelling for the first 24 hours. Compression can also help provide support to a weak joint. It should be fairly tight, but make sure it doesn't press on nerves or cut off blood circulation – if the end of the limb turns blue, that's too tight! It's also too tight if you feel throbbing in the bandaged area. For the same reason, don't wear the bandage at night.
  • Elevation: Let gravity do the work – try to keep the injured limb raised above the level of the heart to prevent fluids from pooling in the inflamed tissues. For an injured leg, prop it up above the hips when lying down. Injured arms can be held up in a sling.

In addition, you can lessen inflammation and relieve pain by taking ASA, ibuprofen, naproxen, or other anti-inflammatory medications. Check with your doctor or pharmacist first before taking any medications, and take care not to exceed the recommended doses. If, after following these steps, the injury doesn't seem to be getting any better within 48 hours, it's best to see your doctor.

Sports injuries requiring medical attention

It's vital to seek immediate medical attention if a sports-related injury involves more severe symptoms, which include:

  • blurred vision
  • confusion
  • dizziness
  • ear pain
  • headache
  • inability to move the limb or joint
  • loss of consciousness
  • loss of vision
  • nausea
  • nosebleed lasting longer than 20 minutes
  • numbness
  • ringing in the ears
  • severe pain and swelling
  • vomiting

So don't forget to warm up before you engage in physical activity, and wear proper protection while playing certain sports.Devices like insoles, ankle supports, or knee braces can prevent sprains to stress fractures. Helmets are common sense for protecting your head. Keep this in mind and keep yourself in the game.