When you've been hit with an injury, it's natural to want to get back to your regular activities as soon as possible. In fact, it's not uncommon for athletes to sidestep doctors' orders and return to the field or the court before an injury has healed.
"It doesn’t matter how much you train, or how much you prepare, injuries are going to happen, especially if you're an athlete," says Jamie Schwab, an athletic trainer at Henry Ford Health System. "But the real trouble arises when athletes try to play through their pain without allowing sufficient time for recovery."
Risks Of Returning Too Soon After Injury
If you sprain your ankle during a cross country run, it can be tempting to finish the race. Unfortunately, hiding your pain and powering through the activity can actually make matters worse.
"If you continue to work out after suffering from an injury, you run the risk of furthering that injury," Schwab says. So what began as a minor ankle sprain can evolve into a major sprain that sidelines you for weeks.
Returning to play after surgery demands extra precautions. "Athletes are a lot more susceptible to re-injury after returning from surgery, especially if they don't complete the entire 9-month or year-long rehabilitation protocol," Schwab says. In some cases, you can exacerbate an injury to such a degree that you'll never be able to participate in the same capacity.
A Safe Return To Play
The road back to play after an injury is a long and winding one. Before you can even consider returning to exercise, you need to reduce swelling, get pain under control and get your range of motion back to almost normal.
"The recovery process takes time," Schwab says. "But if you stick with it, and you take it seriously, it's going to be a whole lot easier for you to return to the playing field in a timely manner."
Once you get pain and swelling under control, you can focus on agility and weight exercises that will help you regain strength and slowly return to baseline. The key tenets for a safer return to play:
► Be honest about your abilities: "So many athletes are afraid to tell the truth," Schwab says. "But if you're hurting and you're not competing at your full potential, you're letting your team down and yourself down, too." Even worse, you could increase your risk of further injury.
► Focus on building strength: Strength training is critical. It can help you become faster, stronger and more agile on the field. It can also help you recover more quickly after an injury.
► Listen to your body: If something doesn't feel right, pay attention to it. Talk to your athletic trainer or a physical therapist to get to the bottom of what's bugging you and put a plan in place to address it.
Boosting Performance Over The Long Haul
Unfortunately, not every coach and athletic trainer stresses the importance of a maintenance program. In fact, focused training and maintenance exercises are key to preventing injuries in the first place.
"The rehabilitation exercises you begin doing on day one after injury need to be maintained at least three to four times each week, indefinitely," Schwab says. "If you follow that regimen, all of your muscular nagging strains will no longer be a problem because your body is constantly adapting to the stresses. It's conditioned, it's strong, it can withstand the constant changes in direction."
Most important, don't be afraid to try complementary strategies. Practice using a foam roller, try cupping to release tension in the muscles and enhance blood flow and consider getting a monthly massage.
Jamie Schwab, AT, ATC, SCAT, CSCS, is an athletic trainer with Henry Ford Sports Medicine and works with student athletes at Edsel Ford High School. She is a National Strength and Conditioning Association certified strength and conditioning specialist.
Macomb Lutheran North freshman Emiliana Manzo has already achieved a long list of accomplishments, including a 3.8 grade-point average while juggling two sports she loves.
As a point guard, she led her basketball team to an undefeated season in its division. She is also a center attacking midfielder, sometimes playing forward, on the 2009 Nationals Girls Academy Blue soccer team, ranked No. 1 in Michigan and 14th in the country.
In June of 2022, Emiliana hit a detour on her sports journey when she was participating in a club soccer national championship in Oceanside, Calif. With a few seconds left in the game and her team up 2-1, she ran 20 yards full speed to get to the ball. Hyperextending her left knee, she felt two pops. It was the first time she experienced an injury.
“I was screaming and crying and got taken off the field on a golf cart,” explains Emiliana. The trainer felt she was OK. Fortunately, she had the next day off and her knee was feeling better. The following day she played again, and 20 minutes into the game she knew there was an issue.
“Someone hit me from behind and I heard the pop again. I knew there was a problem.”
Emiliana’s father Vince Manzo said she experienced swelling, and the athletic trainer thought she may have a meniscus injury; however, she was able to continue to walk around during the championship in California before heading home.
Finding the Right Provider
Back in Michigan, Emiliana saw a few surgeons during her evaluation to seek treatment. When she met with Vasilios Bill Moutzouros, MD, chief of Sports Medicine at Henry Ford Health, she felt she met the right match.
“He treated me like an athlete and made me feel really comfortable,” she says.
Vince adds that both he and Emiliana were also appreciative of something Dr. Moutzouros said during her evaluation: “He emphasized to Emiliana that she was an athlete before this injury, and she would be an athlete after the injury.”
A detailed evaluation by Dr. Moutzouros revealed Emiliana had a complete anterior cruciate ligament (ACL) tear and medial and lateral meniscal tears. The meniscus, a C-shaped piece of tough, rubbery cartilage, acts as a shock absorber between the shinbone and the thighbone. It is one of the most common knee injuries. The ACL, one of the strong bands of tissue that help connect the thigh bone (femur) to the shinbone (tibia), is also prone to injury during sports when there are sudden stops or changes in direction.
Emiliana required physical therapy to get the swelling down and increase mobility before surgical repair.
Dr. Moutzouros reconstructed her ACL with her own patellar tendon graft and repaired her medial meniscus.
“She handled the surgery well and has been working very hard in her rehabilitation,” he says. “Her high-level soccer experience likely helped in her recovery as her range of motion and strengthening advanced so quickly.”
Understandably, Emiliana was nervous and scared when she went into surgery but expressed appreciation for the little things from Henry Ford like hearing “great music” as she was entering surgery, which gave her a sense of calm.
“That’s when I knew I picked the right doctor,” she said.
The Road to Recovery
As part of her recovery, after surgery which took place in July of 2022, Emiliana has undergone six months of physical therapy to increase mobility and strength training to get her leg strong again.
She also participated in the Return to Sport Program at the Henry Ford Center for Athletic Medicine to optimize recovery.
“We loved it,” says Vince. “It gave us peace of mind.”
Dr. Moutzouros explains that ACL prevention and rehabilitation programs are critical, especially for women because they have a four times greater risk of ACL tear than men. He says performance training post-surgery, along with an injury prevention program for those playing cutting sports, can markedly reduce the likelihood of future ACL injury.
“At Henry Ford, we work with physical therapists across the Midwest as well as our own. They do a great job in following our Henry Ford specific post-ACL reconstruction protocol,” he says. “After therapy runs its course, we strongly encourage our athletes to undergo performance training to allow a smooth transition back to sport.”
Nick Parkinson, supervisor of Athletic Training and Sports Performance at Henry Ford Health, emphasizes that the return to sport program is designed to bridge the gap between rehabilitation and returning to full activity in your chosen sport.
“Many times, insurance limits rehabilitation to regaining activities of daily living and not necessarily rebuilding the skills needed to play a sport or return to activity,” Nick says. “This program provides an affordable option to fill this need and return athletes to competition at the highest level.”
As for Emiliana, who hopes to play soccer in college and pursue a career in the medical field, she says this experience has taught her to not be afraid of injuries and treatment. She has also used the experience to volunteer for a program through the Girls Academy which serves as an advisory board to come up with ideas to help with mental and physical issues girls her age may be facing.
“For other kids who experience injuries, I’ve learned that this does not define you,” she said. “You can push through it, recover from it and be way better than you even were before.”
To find a sports medicine doctor or athletic trainer at Henry Ford, visit henryford.com/athletes.