Exercising is one of the most important things people can do to promote ongoing physical and mental health. Some of us exercise regularly, some erratically; some of us ‘go for the burn’ while others prefer gentle stretching. However you do it, exercising not only helps weight loss, controls food cravings, and reduces the risk of diabetes, and heart and circulatory disease, but it also prompts the body to release feel-good chemicals called endorphins, fostering a positive mental outlook on life that continues long after the exercise is finished.
Unfortunately, as more and more health-conscious people increase their levels of regular activity, so are sports-related injuries becoming increasingly more common. Around 11 per cent of all injury-related visits to emergency departments are sports-related (Ann Emerg Med, 2001; 37: 301-8). Injury can occur to anyone of any age and of any level of fitness, and the problem is becoming so extreme that some authorities believe that the cost - in terms of medical treatments as well as loss of mobility and productivity - may negate any benefits gained from the exercise (Inj Prev, 2003; 9: 99-100, 100-2). In the US, for example, sports-related injuries are now more common than automobile accidents (Inj Prev, 2003; 9: 117-23).
Most sports injuries involve cuts, abrasions, blisters or bruising. But strains - that is, injuries to muscles or to the places where muscles become tendons - and sprains - that is, injuries to ligaments, but sometimes to other connective tissues such as tendons and the capsules surrounding joints - are also very common, accounting for 31 per cent of all injuries.
Mild or minimal sprains, with no tearing of the ligament, usually produce a mild tenderness and some swelling. Moderate sprains, where the ligament has been partially ruptured, will produce obvious swelling, bruising, significant tenderness and functional difficulties, such as walking or lifting, depending on the location. Severe sprains, such as when the ligament is completely torn from the bone (known as ‘avulsion’), will make walking impossible and produce marked swelling, internal bleeding and joint instability.
In almost all cases, the treatment of minor sprains and strains will usually follow the tried-and-tested method known as RICE:
* Rest - reduce or stop using the injured area for 48 hours. If you have a leg injury, you may need to stay off it completely
* Ice - put an icepack on the injured area for 20 minutes at a time, and do this four to eight times per day. Use a coldpack, icebag or a plastic bag filled with crushed ice, wrapped in a towel
* Compression - of an injured ankle, knee or wrist can help to reduce the swelling. This can be done using bandages such as elastic wraps, special boots, air casts and splints
* Elevation - keep the injured area raised to above the level of the heart, using a pillow to help elevate an injured limb.
But what happens next, particularly your choice of pain-reliever, is key in terms of whether you will heal slowly or quickly.
Typically, a doctor might prescribe a non-steroidal anti-inflammatory drug (NSAID) - such as aspirin or ibuprofen - for sports- and exercise-related injuries, particularly when inflammation is present. NSAIDs can provide quick temporary relief from pain and inflammation, and they are generally safe to use for up to a few days at a time. However, when used chronically, these medications can bring on many complications. For example, NSAIDs are irritating to the stomach and, based on extensive clinical evidence, can cause microscopic gastrointestinal bleeding in virtually everyone after a relatively short period of use. These bleeds can progress and cause ulcerations and other gastro-intestinal problems when used over extended periods of time.