Suddenly, it’s been months since you had to use your winter coat. The days are long and temperatures are on the rise. This can mean only one thing – at long last, summer has arrived! Summer is here again, and with it comes the fun of playing and exercising outside. Read the following information to ensure your summer sporting experience is safe and injury-free.

The American Academy of Orthopedic Surgeons (AAOS) once carried out a campaign entitled “Prevent Injuries America.” A linchpin of the effort was the AAOS ranking of specific summer sports or recreational activities and the estimated number of yearly injuries caused by each. AAOS created the ranking using data from the U.S. Consumer Product Safety Commission. The top two offenders were basketball and bicycling, each causing 1.5 million or more injuries yearly. The next three were baseball, soccer and softball, each responsible for almost half a million injuries yearly. They were followed, in descending order, by trampolines (246,875 injuries), inline skating (233,806), horseback riding (196,260), weight lifting (189,942), volleyball (187,391), swimming (149,482), wrestling (136,055), roller skating (115,763) and gymnastics (86,479). While not included on the list, golf causes perhaps as many as 132,000 injuries yearly.

A similar list from the AAOS ranked children’s summer sports and their associated injury rates. The specific sports and their yearly injury rates were basketball (1,066,004), bicycling (832,775), baseball/softball (211,646), swimming (117,889), volleyball (92,409), inline skating (82,903) and tennis (20,514).

Skateboarding is also a potential risk. A retrospective study over a five-year period in the United Kingdom uncovered a host of skateboarding injuries. Victims were mostly males under the age of 15 years, with the most common injury being a fracture of the upper limb. A California study of skatepark injuries estimated that the average time lost from school and work per injury was 1.1 and 5.5 days, respectively, with estimated medical costs and lost wages totaling $3,167.

With such a long laundry list of sports related injuries, it’s difficult to pinpoint which one is the most common. In fact, there are so many sports related injuries that an entire field of medicine – sports medicine – has been created to deal with them.

The most frequently occurring injuries are ankle and knee related injuries. Many people have twisted or sprained an ankle at one time or another, but beyond a simple sprain, Achilles tendon injuries can be very severe and require surgery and/or physical therapy. Knee related injuries follow closely behind ankle injuries. Being the largest joint in the body, and bearing the brunt of impact when running or jumping – along with the constant flexing and extending of walking or bicycling – the knee takes a lot of punishment all summer long. All of this activity wears on the joint and often inflammation will occur. This is usually minor and can be remedied with an ice pack and some NSAIDs, but the more severe injuries, again, may require evaluation by an orthopedist and result in surgery or rehabilitation.

Baseball and tennis often result in elbow injuries. Tennis elbow (Lateral epicondylitis) is an inflammation with soreness and pain on the outside of the upper arm near the elbow. Repetitive microscopic tears in the tendon located there cause the injury. Although it is called tennis elbow, you don’t have to play tennis to suffer this ailment. Repetitive motion of the arm may cause it. Painters, plumbers, carpenters, butchers and even an office worker on a keyboard all day may suffer from this.

Don’t overlook the impact injuries in sports like soccer and football; shin impact injuries are very common in soccer. Children’s leagues and school leagues often require players to wear shin guards to prevent shin injuries. Football players wear a lot of protective gear but even then there are impact injuries. Broken bones are not uncommon in football.

Skateboarding probably singlehandedly sends more kids to the emergency room than any other sport. Many skateboarders do not wear the proper protective gear that could prevent injury from a simple fall, and without the gear a simple fall can result in severe enough injury to require a visit to the Emergency Room or orthopedist.

Conditioning For Summer Sports

If your winter workouts consisted mainly of sprints to and from the refrigerator during commercials, don’t plan on returning to your favorite sport in the same condition you left in last year – or more importantly don’t try to. Too much activity too soon and you might be enjoying the season on the sidelines as a spectator. Instead, ease into your activity at a comfortable level and gradually increase the duration and intensity over several weeks. Try starting with 30 minutes of cardiovascular exercise 3 days a week, eventually working up to 40-45 minutes 4-5 days a week. Starting slowly helps you build endurance and allows your body to adjust to the new stresses put on it.

Safety Equipment

Real athletes don’t wear protective equipment, right? Wrong! Everyone needs protective gear – no exceptions. Helmets are important insurance against head and neck injuries when your summer sports include bike riding, inline skating, baseball, horseback riding and skateboarding. Bottom line, if your head is in danger of being struck or if there is a chance you might fall at a high rate of speed, you should wear a helmet. Remember though, helmets prevent cuts and fractures, not concussions. If you suspect a concussion, seek medical attention immediately whether you were wearing a helmet or not. Safety experts also recommend practicing how to fall. Avoid the tendency to tense up and stretch your arms out to break a fall. Instead, relax as much as possible and roll with the fall. Don’t forget wrist guards, elbow protectors, kneepads, lifejackets and mouthpieces when appropriate. As for sunscreen, aim for a SPF of 15 or higher and reapply it as needed. Remember, there really is no such thing as sweat-proof.

Beat The Heat

It doesn’t matter if you’re a weekend warrior or a seasoned pro, when the thermometer starts to creep above 90 degrees you’re putting yourself at risk for heat related illnesses. Fluid replenishment before, during and after your activity is essential. Always consume more water than you think you need, and don’t wait until you are thirsty to drink. When possible, don’t plan sporting events between 10 a.m. and 3 p.m. (the hottest times of the day) and wear light colored, well-ventilated, loose fitting clothing. Never underestimate the importance of shade. Before you start playing outside, do some research to make sure shade is close, and if not bring your own umbrella or tarp to rest under.

Your body can generate 15-20 times the amount of heat it normally produces with hard physical work. Not only should you be aware of the signals your body sends as it begins to heat up, you need to act accordingly. Stop all activity and call a doctor if you develop a headache, lose coordination, feel dizzy, develop muscle cramps, stop sweating or begin to feel nauseous – all could be signs of heat-related illnesses. Know when to quit playing. Common sense goes a long way in preventing heat related illnesses.

Seven Tips For The Summer

Any of the above issues can cause summer athletes to be sidelined for the whole summer. Some injuries may even require physical therapy and even surgery in order for patients to fully recover. Prevention is the key to staying healthy and happy this season. Here are some tips to avoid those summer-fun-ending injuries:

1. Year-round maintenance. Ideally, athletes of all levels won’t only stay active in the warmer months. As we’ve told you before, during the winter, hit the gym or walk an indoor mall to keep up their fitness levels. Any regular efforts will make a big difference when activity levels dramatically increase for the summer since your bodies won’t be starting “cold.”

2. Warm-up and stretch. Stretching before a workout or sport is a good idea for anyone but particularly those who haven’t been active for a while. For those planning to be involved in an especially rigorous event, begin warming up a week in advance by including some cardio with the stretches.

3. Know one’s limits. As people get older, their bodies simply aren’t capable of what they once were. This is particularly true if they’ve taken off the winter months from physical fitness. Don’t jump right into running that 10K. Start out slow and build up endurance. Take a few power walks, move into jogging and slowly increase the pace and distance.

4. Treat old injuries. Putting off a sports injury issue because it just didn’t seem too bad? Well it could be getting worse. Getting back into sports may exasperate the problem. Don’t delay – see a sports medicine doctor to get the body in perfect working condition again before attempting any strenuous activity.

5. Hydrate. Although the elderly and young are most susceptible to extreme heat, everyone should stay hydrated in the summer months. Drink lots of water beforehand and compensate for lost levels of electrolytes during the longer exercise sessions by drinking a sports drink. Avoid alcohol and caffeinated beverages before the activity as they increase the rate of dehydration.

6. Wear a helmet. Brain injuries cannot only be season ending, they can be life-altering. If a person is skateboarding, bicycling or rollerblading, strap on a helmet to prevent head injuries. Helmets should be a comfortable fit, low on the head as possible and stable enough to support hard impacts.

7. Check the weather before exercising outdoors. If the heat or humidity is too high then stay indoors. Dawn and dusk are the best times of the day to exercise outdoors. Most websites and weather reports include information about the heat index and pollen counts. Pay attention!

Whenever you have experienced a sports-related injury, it is a wise idea to make a physician appointment before medicating yourself. Doing so allows a trained professional to rule out such serious problems as a fracture or dislocation. It also assures you that, in many cases, the problem is a simple sprain, strain or other self-treatable condition. Until you get to the doctor, you may use over the counter medications, cold therapy (for the first 48-72 hours), heat therapy (only after 72 hours have passed) and other nonprescription products. 

Enjoy the warm weather and all the opportunities it provides for outdoor activities. Just be sure to keep safety in mind and take the necessary precautions needed for a safe and healthy summer. After all, fun in the summer sun only applies if you’re injury-free.

By Michael L. Gross MD

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