Pain in Sports: Injuries, Recovery, and Performance

  • Ayesha Ingham Folami Master of Science (MSc) – Biomedical Engineering, University of Southampton, England
  • Harry White Master of Science - MS, Biology/Biological Sciences, General, University of Bristol, UK

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Introduction

Pain is a fundamental part of sports, experienced by athletes and hobbyists across different levels and disciplines. Whether it's slight discomfort or a more severe pain associated with an injury, understanding and addressing pain in sports is essential. Pain can impact your performance, career, and general well-being.

It’s essential to address pain in sports. Athletes commonly push their bodies to the limit, and pain can be a sign of an underlying issue. Neglecting pain can cause more severe injuries, prolonged recovery periods, and possibly permanent damage. Untreated pain can cause career-ending situations for professional athletes. Pain can also have a psychological impact on athletes and people participating in sports. The fear of reinjury, performance anxiety, and mental stress can result from unaddressed pain.

The purpose of this article is to provide an overview of pain in sports, focusing on injuries, recovery, and performance. This article will delve into the various types of sports-related injuries, strategies for injury prevention, injury management and recovery techniques, and performance enhancement methods. Addressing these aspects aims to provide athletes, coaches, and sports enthusiasts with the knowledge and tools to navigate pain in sports.

Common sports-related injuries

Sports-related injuries vary widely in their type and severity, but there are some common ones among athletes. Understanding these injuries is crucial for athletes and sports personnel.

Sprains and strains

Sprains are ligament injuries, ligaments are tough bands of tissue that connect bones to one another. Strains are injuries to muscles or tendons. These injuries occur due to sudden twists, falls, or impacts and are common in running or jumping sports.1

Fractures

Fractures are bone injuries and commonly occur in high-impact sports (e.g., football or hockey) - they can vary in severity from hairline fractures to compound fractures that break through the skin. A quick diagnosis and correct treatment are important in ensuring effective healing and to minimise the possibility of long-term issues.

Concussions

Concussions are traumatic brain injuries resulting from head impacts – often occurring in contact sports (e.g., American football or rugby). Recognising the signs and symptoms of a concussion is very important. Repeat concussions can cause chronic neurological issues.

Overuse injuries

Overuse injuries occur from repetitive stress on specific body parts over time - they’re common in endurance sports such as running or cycling. Stress fractures and tendinitis are common overuse injuries.2

Impact of injuries on athletes

Injuries can have huge consequences for both professional and amateur athletes, aside from immediate pain and discomfort. They can go on to affect an athlete's physical performance, career, and mental health. The psychological and emotional aspects of injuries must be addressed and treated alongside physical treatment.3

Understanding pain

The role of pain in sports

Pain plays a large role in the world of sports – as it influences performance and well-being. It is a crucial physiological response, signalling potential harm and prompting protective actions. In sports, pain can serve several key functions:

Warning signal

Pain is a warning mechanism, to alert you of potential injuries sustained. This immediate feedback is important - enabling athletes to adjust their actions and prevent further damage.4

Performance regulator

Pain can limit an athlete's performance by signalling discomfort, requiring adjustments in movement patterns or reduced effort. 

Diagnostic tool 

Understanding the nature and location of pain can help diagnose an underlying issue. Athletes and healthcare professionals use pain descriptions and assessments to locate injuries and create treatment plans.

Differentiating between acute and chronic pain

Pain from sports is characterised as chronic or acute, each with its distinct characteristics and implications.

Acute pain: Acute pain is sudden and often caused by a specific injury or event. This pain serves as a warning signal to urge you to stop or seek immediate care. Prompt recognition and appropriate management are critical for preventing the progression of acute pain to chronic pain.

Chronic pain: Chronic pain persists over an extended period after the injury has healed. This can happen due to a failure to address acute pain adequately or from overuse injuries. Chronic pain can heavily impact an athlete's performance, mental health, and quality of life.

The importance of pain assessment

Accurate pain assessment is a fundamental component of managing injuries and optimizing performance in sports. It involves a combination of subjective self-reporting by the athlete and objective evaluation by healthcare professionals.

Subjective assessment: An athlete's descriptions of pain (quality, intensity, location) and factors that exacerbate or alleviate it are very useful. These descriptors enable healthcare providers to gauge the athlete's experience and tailor treatments.5

Objective assessment: Healthcare professionals utilise various tools and techniques in pain assessments (e.g., range of motion assessments, strength testing, and imaging studies such as MRI or X-rays). These assessments aid in identifying the source and extent of the pain.

Holistic approach: A holistic approach to pain assessment considers physical, psychological, and emotional components. Understanding an athlete's mental state and pain responses is crucial for complete care.

Injury prevention

Preparation

Effective preparation before sport or physical activity is essential to reduce the risk of sports-related injuries. There are several key components:

Warm-up and stretching

Warm-up and stretching routines are important – as they gradually increase the heart rate, blood circulation, and muscle temperature. Dynamic stretching, involving active movements, can help improve flexibility and range of motion immediately prior to physical activity. Static stretching can follow the dynamic warm-up and be used to target specific muscle groups.

Proper equipment and footwear

Wearing appropriate sports equipment and footwear is crucial for injury prevention. Poorly fitting or worn-out gear increases the risk of sprains, strains, and other injuries. Athletes should check that their equipment and footwear are in good condition before participating in sports.

Conditioning and strength training

Physical conditioning and strength training are the foundation of injury prevention. Strong and well-conditioned muscles and connective tissues are less likely to be injured. Regular strength training also improves balance and stability – to reduce the risk of falls or collisions.

Sports-specific injury prevention strategies

Different sports carry different injury risks, and therefore tailored injury prevention strategies are important. This may involve technique refinement, sport-specific drills, and education on common injury patterns.6

Rest and recovery

Rest and recovery are sometimes overlooked components of injury prevention. Overtraining and minimal recovery time can cause fatigue and increase the risk of overuse injuries. Athletes should prioritise sleep, nutrition, and active recovery (e.g., stretching and foam rolling).

Injury management and recovery

Immediate response to injuries

When injuries happen, a swift response is important to minimise damage and improve recovery. 

RICE (rest, ice, compression, elevation)

The RICE protocol is a method to manage acute injuries. The process involves resting the injured area, applying ice for inflammation reduction, utilising compression (to control swelling), and elevating the injured limb to reduce fluid build-up. This protocol helps reduce pain and minimise tissue damage in the early stages of injury.[7]

When to seek medical attention

Quickly recognising the severity of an injury is important in ensuring timely and appropriate care is received. Typically, mild injuries can be managed with self-treatment, whereas more severe injuries may need immediate medical attention. Severe pain, deformity, inability to bear weight, or signs of infection indicate medical attention is required.8

Rehabilitation and physical therapy

Rehabilitation and physical therapy are important components of the recovery process and are essential in more severe cases.

Physical therapy aids in restoring function, strength, and flexibility post-injury. This often involves personalising an exercise program and manual therapy to aid recovery. Rehabilitation programs are designed to facilitate a safe return to sports and prevent re-injury.

Psychological aspects of recovery

The psychological impact of injury shouldn’t be underestimated. Athletes commonly experience frustration, anxiety, and depression during the recovery process. It is important to address the psychological components of recovery with counselling.

Returning to sports after an injury

Deciding when an athlete can return to sports post-injury is complex. Clearance should be based on absence of pain, strength, range of motion, and functional ability. Athletes should work with medical professionals and coaches to form a structured plan that minimises re-injury risk.

Pain management techniques

Effective pain management techniques are important in athletic performance optimisation while combating injuries.

Medications

Medications (e.g., non-steroidal anti-inflammatory drugs (NSAIDs)) can be utilised in pain management and inflammation reduction. These medications are administered with guidance from a healthcare professional to ensure safety and minimise side effects.9

Physical modalities (e.g., heat and cold therapy)

Physical modalities like heat and cold therapy can be useful in pain management and promoting recovery. Heat therapy helps blood circulation and relax muscles, whereas cold therapy can reduce inflammation and numb pain. The choice of modality depends on the specific injury and the athlete's needs.

Rehabilitation exercises

Targeted rehabilitation exercises from a physical therapist or healthcare professional can strengthen injured muscles, improve range of motion, and increase joint stability.

Nutrition and hydration

Proper nutrition and hydration are fundamental for an athlete's performance and recovery. Good nutrition gives the body essential nutrients, vitamins, and minerals needed for energy production, tissue repair, and overall health. Proper hydration is important in maintaining performance and preventing cramping and heat-related illnesses.

Mental preparation and sports psychology

Mental preparation and sports psychology can enhance athletic performance. Athletes who manage stress and anxiety, and maintain a positive mindset are more likely to perform at their best.

Monitoring and tracking performance

Monitoring and tracking an athlete's performance is important in optimising their training and recovery. Physiological data and training results can help coaches and athletes make informed decisions and alter training programs.

Summary

In this article on pain in sports, common sports-related injuries and risk factors have been covered, as well as, the importance of pain assessment, injury prevention, injury management, recovery, and performance improvement strategies (e.g., pain management techniques, nutrition, mental preparation, and performance monitoring).

Addressing pain in sports requires a holistic approach. Pain is not only a physical sensation; it includes psychological and emotional elements that can greatly impact an athlete's well-being and performance. By recognising and addressing pain, we can properly support ourselves in our journey towards success, recovery, and well-being.

Injury prevention, proper injury management, and performance enhancement in sports are all important. Taking proactive and preventative measures against injuries will enable athletes to promptly and effectively manage them as they occur, contribute to high levels of performance and allow athletes to achieve their full potential whilst minimising the risks associated with pain and injury. These concepts should be integrated into a training regimen and medical care plan, to ensure longevity, success, and overall health in sports.

References

  • Petrella, R. J., & Cogliano, A. (2016). Overuse injuries in sport: a comprehensive overview. Sports Medicine - Open, 2(1), 16.
  • Kerr, Z. Y., Collins, C. L., & Fields, S. (2018). Epidemiology of overuse and acute injuries among competitive collegiate athletes. J Athl Train, 53(1), 7-15.
  • Ardern, C. L., Taylor, N. F., Feller, J. A., & Webster, K. E. (2016). A systematic review of the psychological factors associated with returning to sport following injury. British Journal of Sports Medicine, 50(7), 481-487.
  • Meeusen, R., Turner, L., Baillieul, S., & Hettinga, F. (2018). Endurance exercise in the heat: Hydration, pacing, and neuromuscular function. In Progress in Brain Research (Vol. 240, pp. 175-190). Elsevier.
  • Hjermstad, M. J., Fayers, P. M., Haugen, D. F., Caraceni, A., Hanks, G. W., Loge, J. H., ... & Kaasa, S. (2011). Studies comparing Numerical Rating Scales, Verbal Rating Scales, and Visual Analogue Scales for assessment of pain intensity in adults: a systematic literature review. Journal of Pain and Symptom Management, 41(6), 1073-1093.
  • Soligard, T., Schwellnus, M., Alonso, J. M., Bahr, R., Clarsen, B., Dijkstra, H. P., ... & Engebretsen, L. (2016). How much is too much? (Part 1) International Olympic Committee consensus statement on load in sport and risk of injury. British Journal of Sports Medicine, 50(17), 1030-1041.
  • Bleakley, C., McDonough, S., & MacAuley, D. (2004). The use of ice in the treatment of acute soft-tissue injury: a systematic review of randomized controlled trials. The American Journal of Sports Medicine, 32(1), 251-261.
  • McDonald, J. T., Wilken, J. M., & Brenner, J. S. (2016). Concussion and musculoskeletal injury-related emergency department visits in high school athletes. Journal of Athletic Training, 51(8), 662-668.
  • Warden, S. J., & Gosselin, L. E. (2016). Conditioning and injury in athletes. In Encyclopedia of exercise medicine in health and disease (Vol. 11, pp. 199-210). Springer.

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Ayesha Ingham Folami

Master of Science (MSc) – Biomedical Engineering, University of Southampton, England

Ayesha is a Biomedical Engineer with a Master of Science (MSc), with a passion for improving the lives of others with cutting-edge medical solutions. Having earned her MSc from The University of Southampton, Ayesha honed her skills in medical device design, bioinformatics and biomechanics. Ayesha brings a distinctive blend of scientific acumen and passion for writing, making her work enlightening, engaging and accessible.

With an unwavering commitment to bridging the gap between engineering and healthcare, Ayesha continues to utilise her knowledge and dedication to improving healthcare.

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