Sidelined: Injuries Can Take 'Weekend Warriors' Out of the Game

With Dr. Peter Looby, an orthopedic surgeon with Orthopedic Institute, located on the Avera McKennan campus in Sioux Falls.

What injuries are weekend athletes most prone to?
We most often see them coming in with meniscus tears, which are tears in the shock-absorbing cartilage (meniscus) of the knee; a torn labrum (torn cartilage) in the shoulder; ACL (anterior cruciate ligament) tears in the knee; and bone fractures.

With the different injuries, what's actually happening?
Meniscus tears are caused by twisting on a flexed joint. It typically happens when the athlete is bearing weight on the knee with the knee partially bent, and then there's a twist.

ACL tears can happen with or without contact. In men, it happens more commonly with contact, for example in a flag football game. There's a twist of the knee associated with a pop. Coming to a quick stop combined with a direction change, pivoting, landing from a jump, or overextending the knee joint can also cause injury to the ACL.

Labral tears in the shoulder occur in throwing athletes. Or, when softball or baseball players go out to catch a ball, land on the elbow and it pops their shoulder out.

Fractures happen in a fall - a softball player falling down in the outfield on a catch, or sliding into home and fracturing a wrist.

What sports do injuries most often happen in?
Touch and flag football, amateur hockey leagues, softball and baseball, and basketball.

Are weekend or seasonal athletes more prone to injury than professionals?
There are two things at play. One is conditioning. The "weekend warrior" is not as likely to be well conditioned, so that puts them at increased risk. But, they are engaged in athletics far fewer hours per week than pro athletes, overall decreasing their chances of being injured.

Do these types of injuries always require surgery?
Much of what we do is non-operative care: assessment, diagnosis, and then the appropriate treatment regimen which can include physical therapy, a home exercise program, oral medications or injections.

Meniscus tears and rotator cuff tears are probably the two we most often operate on. With ACL tears, younger, more active patients will often choose to have surgical reconstruction while older, more sedentary patients may pass on getting an operation.

How bad is the pain?
It depends on the injury. A lot of times, meniscal tears won't hurt until the next day, while acute ACL ruptures are associated with quite a bit of pain.

What typically brings people to the office is pain or loss of function. They realize their joint is not working the way it used to.

Should I go to the Emergency Room with a sports injury?
Only injuries like displaced fractures or a dislocated shoulder that doesn't go back in on its own need to be seen immediately. Pretty much everything else can wait until Monday morning.

What's the best way to get back into action after an injury?
A structured, focused rehab program has been shown to return athletes to their prior level of function more quickly than just allowing athletes to do it on their own. We use physical therapy services and athletic training services to help athletes return to activity.

How can I prevent an injury?
There's no question that maintaining your level of physical fitness with regular stretching and strengthening programs can reduce your risk. Proper equipment, training and technique are valuable as well. And, you should play on a field where there aren't hazards around like broken glass or rocks.

That being said, an injury usually happens so fast there's no way to stop it. If you're going to be active, you're at some risk for injury.

Is there some point when I should quit?
I always remind my patients that you're more likely to rust out than wear out.

You may need to change your type of activity. For example, someone with an arthritic knee should probably not let running be their Number 1 cardiovascular exercise. Instead, they should focus on more knee-friendly activities such as riding a stationary bike, walking on a treadmill, using elliptical machines or swimming.  But you won't hear me telling someone they're too old to play. Just stay active and keep moving.

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