Sports Injuries: Overview

Sports injuries include the musculoskeletal, neurological, and dermatological disorders or injuries that result from taking part in a sport.

The Chris Benoit Story

Odell and his friend Jason were huge fans of pro wrestling. They never missed a weekly broadcast, and the highlight of their year was when Odell's dad took the boys to a live match. But one day in 2007, Jason called with bad news. “Did you hear? The Rabid Wolverine! He's dead!”

Odell turned on the news. It was true: One of his favorite wrestlers, Chris Benoit, a.k.a. “The Rabid Wolverine,” had been found dead at his home. But the news got worse: Benoit's son and wife were dead, too. Police believed that Benoit had killed them and then himself.

As he watched the report, Odell thought, “How could this have happened? He was in great shape.”

Just because an athlete looks healthy, however, does not mean he or she is not suffering from a sports-related injury.

What Are Sports Injuries?

The general term sports injuries includes the musculoskeletal and dermatological (skin-related) injuries that result from taking part in a sport. The most common musculoskeletal sports injuries are ankle sprains; muscle strains of the hamstring and groin; knee injuries, including rupture or tear of the anterior cruciate ligament (ACL); and injuries to the elbows. Generally speaking, these injuries get better with home care, which includes icing and elevating the affected area; resting the injured area; and the use of analgesics, particularly nonsteroidal anti-inflammatory drugs (NSAIDs). Approximately four million emergency room visits in the United States each year involve injuries sustained while people engage in sports. Common skin-related injuries in sports include sunburn, fungal infections of the skin (particularly in wrestlers), and skin abrasions caused by contact with rough surfaces.

However, sports injuries go beyond road rash or sprains and strains, particularly among professional or elite athletes of both sexes.

Why Do Athletes Risk Injury?

Many athletes are willing to risk potentially severe injury because professional sports is a multibillion dollar industry. In the National Football League, the average football team is valued at two billion dollars, with some valued as high as three billion. In Major League Baseball, the average team is worth $1.2 billion as of 2016. Clearly, a great deal of money is riding on the performance of professional sports teams. These figures do not even take into consideration the value of endorsements, products, and other income sources; other professional sports and sports entertainment, such as bicycling, tennis, and pro wrestling; or amateur athletics, including college and high school sports.

1935: German scientists develop anabolic steroids.

1954: The doctor of the Soviet Olympic power-lifting team admits to injecting the Soviet lifters with testosterone.

1958: Ciba Pharmaceuticals releases the anabolic steroid methandrostenolone.

1960: A major article in Sports Illustrated discloses the use of tranquilizers, amphetamines, and other drugs among athletes.

1973: East German women win 10 of 14 gold medals at the world swimming championships.

1975: The International Olympic Committee bans anabolic steroids.

1983: Four weightlifters are stripped of their medals for using steroids at the Pan Am Games. A total of 23 medals, including 11 gold medals, are forfeited.

1988: Canadian sprinter Ben Johnson loses both his gold medal and his world record after testing positive for anabolic steroids.

1990: Federal law makes the possession of steroids without a prescription illegal.

1992: Former NFL player Lyle Alzado dies of brain cancer that he attributed to more than 20 years of using steroids and human growth hormone. He was 43.

1998: A team is ejected from the Tour de France bicycling competition after the director admits to giving his team performance-enhancing drugs, including erythropoietin.

2001: Retired baseball player Ken Caminiti admits to using steroids and estimates that half of the players in major league baseball also use them. Three years later, in October 2004, Caminiti died from an overdose of cocaine and heroin at the age of 41.

2004: A New York Times article estimates that between 500 and 2,000 of the East German athletes who were involved in using performance-enhancing drugs face serious health problems ranging from infertility to liver tumors to heart disease.

2006: Investigation into the use of anabolic steroids and human growth hormone in Major League Baseball by former U.S. Senator George J. Mitchell at the request of then-Commissioner of Baseball Bud Selig. The Mitchell Report was published in 2007.

2007: Professional wrestler Chris Benoit is found dead in his home, along with his wife and son. Police rule it a murder-suicide. Autopsy results suggest Benoit had brain damage from repeated concussions, which caused his erratic and violent behavior.

2007: Olympic runner Marion Jones is stripped of her five medals from the Sydney Olympics after admitting to using steroids.

2013: Lance Armstrong, seven-time winner of the Tour de France, admits to using performance-enhancing drugs. He was stripped of these titles and banned from professional cycling for life.

When so much money is at stake, ethics * and personal welfare can easily take a back seat to winning at all costs.

What Are Performance-Enhancing Drugs?

The human body has natural limits. Training and practice hone the athlete's skills to push the edge of those limits and produce astonishing performances. However, there is always the desire to be better, stronger, or faster, whether it comes from wanting personal glory or the cash rewards that follow winning. Once the natural limits are reached, some athletes turn to performance-enhancing drugs.

Anabolic steroids

More worrisome is the psychological condition commonly called roid rage. High levels of steroids have been linked to increased aggression, which can range from a mild person's simply becoming more assertive to someone else's overreacting violently. The drugs have been known to uncover an underlying psychological disorder.

It is estimated that between 500,000 and one million young athletes and 5 percent of high school students have tried anabolic steroids. Some studies indicate that as many as 13 percent of high school football players abuse steroids.




Illustration of the head and brain, depicting the areas of the brain most vulnerable in a concussion. The frontal lobe regulates reasoning, planning, parts of speech and movement, emotions, and problem-solving.





Illustration of the head and brain, depicting the areas of the brain most vulnerable in a concussion. The frontal lobe regulates reasoning, planning, parts of speech and movement, emotions, and problem-solving. The temporal lobe is concerned with perception and recognition of auditory stimuli (hearing) and memory. Broca's area is important in the production of written and spoken language.
Illustration by Electronic Illustrators Group. © 2016 Cengage Learning®.
Human growth hormone

The ready availability of human growth hormone (HGH) and the fact that it is undetectable in standard urine tests have led some athletes to inject themselves with it. (Newer blood tests, however, can detect the difference between natural HGH and the synthetic form, and are used to test Olympic athletes.) However, a study conducted by the University of Vienna with serious athletes, as well as a study on nonathletes that appeared in the American Journal of Physiology, found that a course of HGH injections had no effect on body weight, body fat, or the strength of the biceps or quadriceps. The researchers concluded that while HGH may help people who lack the hormone, it apparently does not change the strength or body composition of those who do not lack the hormone.

Stimulants

Athletes may also turn to stimulants or diuretics to enhance their performance. Stimulants are drugs that act on the nervous system to increase heart rate and metabolism and reduce fatigue. They also sharpen focus and aggressiveness.

This group of drugs includes caffeine, amphetamines, ephedrine, cocaine, and methamphetamine. It is easy to become addicted to stimulants, which can cause heart problems, hypertension * , weight loss, convulsions * , and brain hemorrhages * .

Diuretics

Diuretics (DYE-yoor-EH-tiks) remove water from the body, and athletes use them to lose weight quickly. As a diuretic removes fluids, however, it also washes out the electrolytes they carry. Electrolyte imbalances can cause muscle cramps and irregular heartbeat, and overuse of diuretics can lead to dehydration * .

What Are Other Types of Sports Injuries?

Head and brain injuries

Head injuries can occur in any field in sports. For example, according to the Centers for Disease Control and Prevention, as of 2016, there were about 900 bicycle-related deaths in the United States each year (approximately one death every eight hours), and 494,000 injuries that required treatment in the emergency room. Almost half of all biking accidents occur in children under age 16 with head injuries making up 75 percent of the injuries. Other sports in which head injuries are common include football, soccer, baseball/softball, and basketball.

Between 15 and 40 percent of former boxers show symptoms of chronic brain injuries, which range from having speech problems to needing institutional care. One study showed that most professional boxers have some brain damage, the result of being hit with the equivalent of a 13-pound bowling ball traveling at 20 miles an hour every time a punch is landed.

Former professional football players also have been found to suffer brain injuries. In 2007 doctors studied the brain of Justin Strzelczyk, a former Pittsburgh Steelers lineman, who had died in a car accident. They found that Stezelczyk, who was 36 when he died, had a condition more often found in people in their 80s: chronic traumatic encephalopathy (en-SEP-ah-LOP-path-ee), or CTE, which is a progressive, degenerative brain disease assocated with repetitive brain trauma. The NFL estimates that 160 concussions occur among pro players each year. Regarding the double murder-suicide of Chris Benoit, the conclusion suggested by an autopsy * on Benoit's brain was that Benoit had suffered brain damage from years of blows to the head and that this damage had caused dementia * . This finding seemed to explain his erratic behavior and may have contributed to his violent acts.

Although soccer players receive less attention in the United States than football players, the rising rate of CTE cases among soccer players worldwide has led to calls for inquiries into the way the sport is played. As of 2016, modern soccer balls weigh between 14.5 ounces and a full pound, and can travel at speeds up to 50 miles per hour. A soccer player who heads an airborne ball (strikes it with his or her head) is at serious risk of a concussion. In January 2016, U.S. Soccer banned heading for boys and girls 10 years or younger, and limited heading for those between 11 and 13 years of age.

Amenorrhea

Male and female athletes, especially runners and gymnasts, have very little body fat. Female athletes can experience a decrease in or a halt to their menstrual cycle * , a condition called amenorrhea (ahmen-or-REE-ah). Because female athletes experience considerable stress during competition, often try to keep their body weight as low as possible, and expend a great deal of energy, their bodies may cease to menstruate.

This condition is not permanent, and it can be corrected. A physician may prescribe birth control pills to an amenorrheic female athlete in order to restore a normal menstrual cycle.

MRSA infections

An unexpected side effect of the collegial atmosphere surrounding team sports is the spread of bacteria, including MRSA. MRSA, or methicillin-resistant Staphylococcus aureus, is a form of bacterial infection that can be spread by sharing equipment, uniforms, and even towels, or by the cuts and scrapes associated with team play.

The antibiotics used to treat regular staph infections cannot kill this type of bacterial infection, so it is important for athletes to have an infected wound tested before antibiotics are used.

To guard against MRSA infections, athletes should not share equipment, towels, or razors with teammates; and they should be sure to shower with soap and water after practice or a game.

How Do Doctors Treat Sports Injuries?

The choice of treatment depends on the severity of the injury. When an injury occurs, athletes should stop playing or exercising and not try to “play through the pain.”

Professional care

A doctor should be called in the following circumstances:

Self-care

If the injury does not have the above criteria, the athlete can treat the injury at home using the RICE method (rest, ice, compression, and elevation) for 48 hours after the injury occurs to reduce pain and swelling and promote healing.

Can Sports Injuries Be Prevented?

There are a number of actions a person can take to prevent injury while exercising or engaging in athletic activity. These include the following:

See also Bacterial Infections • Brain Injuries • Broken Bones (Fractures) • Bruises • Concussion • Foot Disorders: Overview • Heat-Related Injuries • Knee Injuries: Overview • Osgood-Schlatter Disease • Repetitive Stress Syndrome • Staphylococcal Infections • Strains and Sprains • Substance Abuse • Tendinitis • Tennis Elbow (Epicondylitis) • Trauma

Resources

Books and Articles

Andrews, James R. Any Given Monday: Sports Injuries and How to Prevent Them for Athletes, Parents, and Coaches. New York: Simon & Schuster, 2014.

Doral, Mahmut Nedim and Jon Karlsson. Sports Injuries: Prevention, Diagnosis, Treatment and Rehabilitation. 2nd ed. New York: Springer Publishing Company, 2015.

Knight, Sam. “The Cost of the Header.” The New Yorker, October 2, 2014. http://www.newyorker.com/news/sporting-scene/cost-header (accessed July 11, 2016).

Mottram, David R. and Neil Chester. Drugs in Sport. 6th ed. New York: Routledge Publishing, 2015.

Websites

National Institute of Arthritis and Musculoskeletal and Skin Diseases. “Handout on Health: Sports Injuries.” http://www.niams.nih.gov/Health_Info/Sports_Injuries/ (accessed July 11, 2016).

MedlinePlus. “Anabolic Steroids.” U.S. National Library of Medicine, National Institutes of Health. https://www.nlm.nih.gov/medlineplus/anabolicsteroids.html (accessed July 11, 2016).

MedlinePlus. “Sports Injuries.” U.S. National Library of Medicine, National Institutes of Health. https://www.nlm.nih.gov/medlineplus/sportsinjuries.html (accessed July 11, 2016).

Organizations

American Association of Neurological Surgeons. 5550 Meadow-brook Dr., Rolling Meadows, IL 60008-3852. Telephone: 847-378-0500. Website: http://www.aans.org (accessed July 11, 2016).

American Medical Society for Sports Medicine. 4000 W. 114th St., Suite 100, Leawood, KS 66211. Telephone: 913-327-1415. Website: http://www.amssm.org (accessed July 11, 2016).

National Institute of Arthritis and Musculoskeletal and Skin Diseases. 1 AMS Cir., Bethesda, MD 20892-3675. Telephone: 301-495-4484. Website: http://www.niams.nih.gov (accessed July 11, 2016).

* ethics is a guiding set of principles for conduct; a system of moral values.

* hypertension (HI-per-ten-chen) is abnormally high arterial blood pressure

* convulsions (kon-VUL-shuns), also called seizures, are involuntary muscle contractions caused by electrical discharges within the brain and are usually accompanied by changes in consciousness.

* hemorrhage (HEH-muh-rij) is uncontrolled or abnormal bleeding

* dehydration (dee-hi-DRAY-shun) is a condition in which the body is depleted of water, usually caused by excessive and unreplaced loss of body fluids through sweating, vomiting, or diarrhea.

* autopsy (AW-top-see) is an examination of a body after death to look for the cause of death or the effects of a disease.

* dementia (dih-MEN-sha) is a loss of mental abilities, including memory, understanding, and judgment.

* menstrual cycle (MEN-strooal) culminates in menstruation (men-stroo-AY-shun), the discharging through the vagina of blood, secretions, and tissue debris from the uterus that recurs at approximately monthly intervals in females of reproductive age.

  This information is not a tool for self-diagnosis or a substitute for professional care.