Sports Q&A

Q. How do you treat a corky (what is a corky)?

A corky is bleed into the muscle. As with a skin wound with ongoing bleeding, the treatment of choice is compression. With a muscle bleed, icing is achieved through compression with an elastic bandage – not a crepe bandage as they do not maintain pressure. Many practitioners recommend ice, but there is some controversy as to whether this actually reduces bleeding and in practical terms, constantly removing the bandage may neutralise the compression effect.

The main don’ts are heat and massage. Heat should not be applied particularly in the first 24 hours. This includes hot packs, spas, baths, and creams. Massage should also be avoided as it can cause further bleeding and can cause inflammation.

Your physio can tell you when to start running and when you will be ready to play again. Most corkys settle in a week but it is important not to go back too early as irritation can result in extended time off playing and in certain cases bone forming in the area of the bleed.

Q. I have back pain on my right side and my right heel hurts when I put weight on it, such as when I'm walking. Is this caused by a bulging disc and is there any cure for it?

Back pain has a variety of causes as does heel pain. However, walking is an extremely important activity to maintain fitness, to reduce obesity, manage depression, etc. Therefore if you are having trouble walking, you need to be assessed as soon as possible by your physio to ensure that it does not become limited. There is no simple answer as to the cause of these pains so get good advice. Long-term limitation of exercise to reduce injury results in far more general health problems than the simple pain coming from the back and heel.

Q. The trainer at my netball club says that I have strained the medial ligament of my knee. How long will it be before I can play again? Will I need surgery? Can physiotherapy help?

The first thing you need to do is be assessed by your physio. There are a variety of causes on knee pain and it is often misdiagnosed. Simple medial ligaments usually take 4 weeks to heel with the complete tears being about 10 weeks. Surgery is not usually performed on medial ligament strains but with more severe strains, you may need to be on crutches in certain cases or in a brace that limits part of your knee movement. Your physio can develop a plan with you to have a successful return to your netball.

Q. After spraining my ankle playing football two days ago I got some crutches from the chemist to help me get around. Do I need them? Should I get an x-ray? What can I do to get it better quickly?

The first thing you need to do is be assessed by your physio. There are a variety of causes on ankle pain including a large variety of bone fractures. Do not wait for the ankle to settle before attending. Elite physios have a variety of techniques that have people back at sport very quickly. However, many of these techniques are ineffective if there is too much delay after the injury. An example of this is crutches. Sometimes your physio can have you walking immediately without crutches. Without the advice, you may keep yourself on the crutches several weeks. In other cases, the physio will pick quickly that you have a fracture and need to stay on crutches and be referred to an appropriate specialist.

The main thing you can do and that your physio will want you to do as part of your treatment is keeping the ankle cool. Submersion in an ice bucket every two hours for 15 minutes is painful but will help you get going. Compression is also important. Unlike corkys, sprained ankles seem to respond well to compression with ice.

Q. I’m getting a sharp pain at the top of my shoulder when I serve at tennis; I also feel it when I lift the racquet to smash a ball. What could be wrong?

There are a variety of reasons for shoulder pain in tennis. Your physio can assist in the diagnosis but more importantly treat the reasons it is occurring. This could include technique and equipment issues. It might be due to muscle imbalance in the shoulder. Strange as it may seem, some people are weaker in certain muscles on their dominant hand than they are in the non-dominant hand. The arm and shoulder blades can move in an uncoordinated manner. There may also be an issue specific muscle tightness but general stretching is not recommended as usually certain muscles or ligaments are too flexible in the shoulder contributing to the injury. The very stretching that feels good can make the injury worse long-term.

Don’t let your injury drag on. Shoulders are notorious for being chronic if not treated. What’s more, simple rest does not result in healing as the injury recurs as soon as play recommences. Muscle imbalance and tightness does not change with rest.

See your physio soon and keep playing.

Q. A friend suggested that I take glucosamine for my osteoarthritic knees. Do you think it could be helpful?

There is good scientific evidence supporting the use of glucosamine for osteoarthritic knees. However, this is only part of a good management plan. There is also scientific evidence for weight loss and increased strength of the thigh muscles to assist in easing of the effects of knee osteoarthritis. Unfortunately with the exercises, it’s not a ‘one size fits all’ approach. Some exercises are not hard enough and have no effect on the muscle. Others will cause pain and in turn result in the muscle to actually become weaker. Your sports physio can make sure you do the right exercises. In certain cases, they can tape your knee or perform other techniques that allow you to do more exercise — which maximises muscles strength. The most important thing with the knee is to stay as active as possible not to just rest. Talk to your physio to assist you staying active with your osteoarthritic knee.

Q. Since retiring I have increased the amount of golf I play. I have decreased my handicap but the inside of my elbow is starting to get sore. Could I have ‘golfer elbow’? What is it and what can I do?

Golfer’s elbow is overuse of the muscles on the inside of the forearm that are involved in gripping and bending the wrist. These muscles come off a bone on the inside of your elbow. With gripping and wrist movement, the muscles pull on the bone which causes damage. Your physio will assist with exercises technique modification and treatment. But you might try a forearm brace that you can buy at your physio first as this can sometimes assist immediately with your condition However, as with all things, if the pain persists speak to your physio.

Q. Can I see a sports physiotherapist if my injury occurred at work or at home and not while I was playing sport?

A sports physiotherapist has completed a normal physiotherapy degree and additional training in the area of sports related injuries and problems. They are qualified to treat any type of injury – regardless of where the injury occurred. Injuries sustained at home or work can be quite similar to those sustained while playing sport, and a sports physiotherapist can assist in the management of these injuries whether you’re an elite sports person or don’t play any sport at all.

Q. My 13 year old daughter has been getting growing pains in her knees over the past few months. She complains of pain at the front of both knees when going down stairs, playing sport and even after sitting for a while at school?

The diagnosis of growing pains needs to be considered cautiously in any situation – it’s important that something more serious is not missed. In your daughter’s case, one of the most common causes of pain at the front of the knee (particularly in young females) is the position and movement of the kneecap. If the kneecap is sitting in the wrong position, and moves along the wrong tracks when the knee is bent and straightened - then this causes pain at the front of the knee. There are a number of possible reasons that this problem occurs and these should be examined by a physiotherapist. There is also very successful treatment that can be performed by a physiotherapist to help your daughter recover. Treatment often involves taping the kneecap to position is correctly and strengthening and stretching muscles to hold the kneecap in the correct position.

Last Updated - Wednesday, 27 August 2008 12:12