Michigan High School Athletic Association - Promoting Educational Athletics
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Health & Safety Resources Sprains, Strains & Contusions The most common sports related injuries include sprains, strains and contusions. Contusions are injuries to bones or soft tissue that result from direct impact to the injured site whether it be contact from an opponent, the playing surface or sporting equipment such as a stick or ball. The impact results in a painful bruise or hemorrhage (bleeding). The bleeding will often accumulate into a blood tumor which presents as a hard lump at the site of impact. Healing time increases with a greater area of impact and/or higher force. Time to return to play is affected by the location and amount of loss of function associated with the injury. A general rule of thumb is that an athlete should have full joint range of motion and full strength of the surrounding musculature before re-entering a practice or game. Any contusions involving tingling or numbness should be closely monitored and medical evaluation is recommended. Contusions to the back or abdomen should be carefully evaluated by a qualified medical professional to ensure that an injury to underlying organs has not occurred as this can result in internal bleeding, a medical emergency requiring immediate attention. Contusions typically take 1-2 weeks to heal, however the lump often associated with the injury may take a prolonged period of time to resolve. Re-injury to the same site increases healing time and can lead to complications. Sprains are injuries to joint connective tissue (ligaments) that result from overstretch or tearing of these stabilizing structures. This type of injury occurs when a joint is forced beyond its normal range of motion causing ligaments, capsule and/or joint membranes to tear to varying degrees. The extent of injury is graded on a 1-3 scale. Grade 1 injuries are the mildest of sprains and are characterized by overstretching of connective tissue with the possibility of microscopic tearing of tissue. These injuries are associated with minor pain, minimal tenderness to touch, minimal loss of joint function, and little to no swelling. These injuries usually heal quickly but may require support from either taping or bracing for a few days to a few weeks. Typically healing time for a grade 1 sprain is 2-10 days. Grade 2 sprains involve some partial tearing of the ligaments and are accompanied by moderate levels of pain, slight to moderate loss of range of motion, function, and stability, a moderate amount of swelling. These injuries can take 10 days to 6 weeks to heal. Grade 3 sprains are severe and can result in complete rupture of ligaments involved. These sprains cause extreme pain, loss of function and instability. These injuries will swell significantly and should be x-rayed to rule out bone injury. With or without fracture grade 3 sprains may require temporary casting or splinting. Athletes will often be non-weight bearing for one to several weeks and require extensive healing time before return to sports. Formal rehabilitation during the recovery period with a Certified Athletic Trainer or Physical Therapist is recommended with this degree of injury to ensure safe return to sport. Athletes may need to refrain from athletic participation for 6-10 weeks when a grade 3 sprain has been sustained. Strains are injuries to muscle or tendon tissue. Strains can be caused by overstretch or tear of muscle tissue. These tiny tears accumulate over time and eventually result in a strain or pain. A ballistic over-stretch of a muscle during a sprint or powerful kick can also lead to muscle strains. Strains can also be caused by an abnormal muscle contraction that can occur as a result of dehydration, poor muscle flexibility and/or muscle weakness. Strains are graded on a scale similar to the sprain grading scale. Grade 1 strains involve a minute tearing of muscle fibers. Minor strains are mildly painful to the touch and when stretched and are associated with minimal loss of strength. Mild swelling and bruising may be present. Protective wrapping may be indicated with return to athletics possible in 2-6 weeks. Grade 3 strains are most significant with severe pain, loss of function and loss of strength. The greater extent of muscle tearing that occurs with grade 3 strains can often be detected as a divot or gap in the muscle fibers when touched. This degree of strain is very painful to the touch and often accompanied by extensive swelling and bruising. Healing time adequate for return to athletic participation can take as long as 12-16 weeks. Consult your physician if you have significant loss of function, if your symptoms are not resolving quickly or if you have any concerns or questions about the symptoms you are experiencing Henry Ford Health System’s Center for Athletic Medicine offers a comprehensive approach to sports medicine, including surgical and non-surgical care, sports rehabilitation, injury prevention, and performance enhancement programs. The HFHS treatment team includes sports medicine fellowship trained orthopedic surgeons, sports medicine fellowship trained primary care physicians, as well as certified athletic trainers and physical therapists. These health care professionals are supported by the HFHS nationally recognized bone and joint research facility, including the prestigious Herrick Davis Motion Analysis Lab. HFHS is proud to be health care providers to the Detroit area’s premier sports programs including professional, collegiate, and high school athletes. |
