Sports Injury Prevention

By their very nature, sports and other kinds of recreational activities are inherently risky ventures for your entire body, none the least being your neck, spine, joints and muscles. If you or your children are active participants, proper body conditioning is as essential as the equipment used in these kinds of activities.

High-risk sports

Though there is no such thing as a "safe" sport, highly competitive sports such as football, weightlifting, gymnastics, and wrestling pose particularly higher risks of injuries, especially among children. 

According to experts, as much as 20 percent of all sports-related injuries involve the lower back or neck. Running and weightlifting, and other sports that involve repetitive impact, expose children to a high risk for lumbar (lower back) injuries. Contact sports, such as soccer and football, expose the cervical spine, or neck to injury.

More than one-third of all high school football players sustain some type of injury. Soccer participants are easy candidates for mild to severe head traumas, neck injuries, cervical spine damage, headache, neck pain, dizziness, irritability, and insomnia. Heading the ball, the act of using the head to re-direct the soccer ball, has been linked with cervical injuries in children and adults. The trampoline and gymnastics also present significant risks for spinal cord injuries from unexpected and brute falls or contact with hard surfaces.

Proper conditioning

There is no substitute for proper conditioning, both long-term and just before play, and its role in preventing injury or minimizing the impact of injuries sustained during participation. 

Here are some warm-up tips:

  • Low-impact activities such as walking will help gradually increase the flow of warmed blood to the muscles and ligaments of the back. This helps to prepare those muscles for the work they'll be called on to do during the activity.
  • Simple lower and upper back stretches, as well as hamstring and quadriceps stretches, can help you stay flexible and limber.
  • To prepare for winter sports, such as skiing, skating, sledding, and tobogganing, do simple squats, lunges, and knee-to-chest stretches.
  • After you have finished playing, don't ever neglect the all-important cool-down, which allows your muscles to return to their normal, relaxed state. Without this important step, you run the risk of having your muscles tighten up or cramp.


Treating injuries

Even so-called minor sports-related injuries may require that you seek medical treatment. 

For minor injuries such as sprains or strains, follow the RICE (Rest, Ice, Compression, Elevation) protocol. Apply ice on the site of a minor sprain or bruise at least until any noticeable swelling has dissipated. Avoid keeping ice applied for more than 20 minutes because ice can actually begin wearing out your blood vessels, which in turns, increases the likelihood of additional swelling. After an hour has passed, re-apply an ice pack to the site if pain or swelling has not gone away. 

Make sure to contact your physician if pain or swelling persists.

Tips for your kids:

  • Always strive to maintain the recommended weight for your child's age and size-not the rigors of the sport.
  • Be wary of so-called energy or power bars.
  • Don't allow your child to load up on candy bars or carbonated rinks before or during a game. These foods will sap energy. Sports drinks are a better alternative.
  • Encourage proper conditioning, including a supervised weight training program.
  • Ensure your child is well-rested before an event. A tired body is much more prone to suffering an injury.
  • Insist on warm-up exercises before any sports activity.
  • Invest in and wear proper equipment, including safety equipment such as mouth guards, shatterproof goggles, and elbow and knee pads. If any equipment is excessively worn, replace it immediately.

Never forget the importance of proper nutrition (avoid high-fat foods, such as candy bars and fast food) and hydration (at least 8-10 glasses of water a day).



There are a variety of injuries that runners experience. In fact, it is estimated that up to 70% of runners experience an overuse injury within a one year period. Common running injuries include plantar fasciitis, ankle sprains, shin splints, knee pain, ITB syndrome, hip pain and back pain. Most these injuries fall into two categories: 1) Training Errors, and 2) Anatomical/Biomechanical Factors.

Training Errors - This is a result of the forces and loads placed on a muscle vs. its ability to deal with those forces and loads. When a muscle is overworked, the pressure and tension on it is increased, and this can lead to decreased circulation and swelling. This then contributes to decreased oxygen delivered to the muscle and results in adhesions or scar tissue formation.

Anatomical/Biomechanical Factors - These can be further divided into Kinetic and Kinematic Factors. Kinetic factors include the forces involved in the foot contacting the ground, the speed of this contact, and the forces of pushing off from the ground. Kinematic factors are mostly the rate and amount of foot pronation. Pronation is normal with running, but when it is too much or not enough the foot/shin/knee/thigh/hip complex does not function as designed. This predisposes one to injury.

In evaluating running injures both biomechanics and training must be evaluated. Gait analysis reveals underlying biomechanical and anatomic factors, and a review of training practices sheds light on potential training stresses. And of course where it is hurting highlights an area where dysfunction is occurring. All these factors are addressed when evaluating running injuries.



Low Back and Neck Pain in Cycling

Low back and neck pain is experienced all too often by cyclists, and it can have many different causes. The most common cause of any type of cycling pain is due to an improper bike fit. After having your bike professionally fit which can be done at our office, use the following guidelines to make any necessary adjustments:  

1. Moving your seat back may help to reduce lower back and knee pain but may increase neck and shoulder tension. 
2. Lowering the handlebars decreases lower back and hamstring muscle stress but may cause increased neck and shoulder tension, and hand numbness.  
3. When the seat is set too high, you become unstable and your hips may rock slightly from side to side, putting a strain on the muscles which stabilize your low back. A leg length difference may cause a similar type of problem, which can be detected in a chiropractic exam.  

Another cause of low back pain is the stress placed on your spinal discs, joints, and muscles due to the prolonged forward POSTURE of cycling. To counteract these postural stressors, proper stretching before, during, and after riding is critical. Standing up while riding, as well as alternately bending forward and arching backwards, will help to relieve lower back tension. Tilting your head from side to side will help to stretch out your neck while riding, but watch the road!  

The third main cause of neck and back pain in cycling is due to the "Multiple Micro Whiplash" syndrome caused by the ROAD SHOCK of the continuous jarring forces experienced while riding. The following tips will help to decrease these potentially harmful forces:  

• Increase your training gradually to properly condition your body.  
• Use a wider tire with less inflation to reduce road shock. 
• Change your hand positions frequently and unlock your elbows.  
• Use padded gloves and a light helmet. 
Call us to schedule an appointment. With advanced notice we'll be happy to provide bike fits at our office.


Knee Pain In Cycling

Of all the overuse injuries in cyclists, KNEE PAIN is the number one problem, and the most common cause is an improper bike fit. Effective prevention and treatment relies upon an understanding of four key factors: bicycle fit, anatomic variants, mileage/intensity, and training practices.  

Bike Fit 
Once you've gone for your professional bike fit, you may need to make some minor modifications. A seat that is too far forward leads to increased stress at the knee. A seat that is too high may cause pain at the back of your knee, while a seat that is too low may lead to pain at the front of your knee. If you are using a floating cleat system and are experiencing knee pain, a good rule of thumb is to restrict the degrees of rotation to 5 degrees. 

Anatomic Variants 
These may include increased pronation, shortened or "tight" muscles, and leg length differences which can cause rather complicated biomechanical problems. Although proper stretching may help in some cases, an examination in our office is recommended. 

When experiencing knee pain, several days of total rest and ice is advised, with a gradual return to activity. It is important to reduce both mileage and intensity to ensure that the injured and inflamed tissues receive adequate rest and heal properly. While making a gradual return to cycling, stick to flat terrain, avoiding hill work, and ride with a high cadence (90–110 R. P.M.) in a low gear, with easy resistance. 

An inadequate "training base" is a common cause for injury. To prevent future problems, start building an adequate training base through progressive, gradual increases in training. If your pain persists despite these recommendations call our office to schedule an appointment.

Proper Bike Fit

Without a doubt, the single most common cycling injury is the overuse injury, and the most common cause is an improper bike fit. Overuse injuries occur gradually over time, so the most important thing you can do for injury prevention is to get your bike properly fit by a well-trained professional as soon as possible. Don't wait for the pain of a long ride to discover that your bike was improperly fit. Keep in mind that as you train, you will probably need to use trial and error in making minor adjustments to achieve your optimal fit. In doing so, you may find the following guidelines helpful:

Choosing the Type of Bike and Helmet

Generally, for long distances, a sport/touring or racing road bike is ideal. However, many people have comfortably completed long rides on mountain or hybrid bikes by switching to a thinner, smoother road-type tire. A lighter helmet may help to reduce neck pain.  

Proper Frame Size 
Allow 1 to 2 inches between crotch and top of frame tube on a road bike. If using a mountain bike, the clearance between the crotch and top tube should be 3 to 6 inches.  

Seat Height  
Several methods have been developed to determine proper seat height. The two most generally accepted are as follows: 

1. While on a bike trainer, place your heels on top of the pedals and pedal backwards. The proper saddle height is the point where the heels maintain contact with the pedals, but the hips do not rock side to side. Also, when sitting with the pedals at six and twelve o'clock position with your heels on the pedals, the seat should be adjusted until the leg is nearly straight.  
2. When placing the pedals at six and twelve o'clock, with the balls of your feet on the pedals, there should be a 25 to 30 degree bend of the straighter leg. Note that a mountain bike used off-road should have the seat lowered slightly. A seat that is too high may lead to pain behind the knee. If too low, pain may develop at the front of the knee. 

Fore and Aft Saddle Position 
A straightedge should be 90 degrees to the ground extending from the front end of the knee cap to the end of the crankarm when the pedals are in the three and nine o'clock position. A seat too far forward may result in back and knee pain but may help to decrease neck and shoulder tension, and vice versa. 

Saddle Tilt 
Your seat should be level. A seat tipped forward may cause neck and shoulder pain and/or hand pain and numbness. A seat tipped up can cause unique problems for men: saddle sores, numbness of the groin region, and even erectile dysfunction. Consult your chiropractor or doctor of chiropractic if these problems develop. They usually resolve on their own, but an exam and/or treatment may be indicated. 

Handlebar Position 
This should be performed after seat adjustment. A line drawn down from the nose should fall one inch behind the stem. The back should be lower than 45 degrees and should have no sharp bends. An overly upright position places more stress on the low back and hamstrings. However, elevating the handlebars may reduce neck and shoulder tension as well as hand numbness. A cramped forward position may inhibit normal breathing and cause increased neck stress. Keep in mind that your upper body position is the least exact part of the bike fit and may require the most experimentation on your part to find the right fit. 

Foot Position  
The widest part of your foot should be directly over the pedal axle. Cleats should be adjusted so that the angle of the foot on the pedal is neutral. The best way to get an accurate measurement of foot placement for cleats is to use a special instrument at a quality bike shop called a RAD (Rotational Adjustment Device). If using a floating cleat system and having knee pain, restrict the rotation to 5 degrees.


Miscellaneous Riding Tips

1. To prevent knee pain, keep your cadence high–about 80-100 RPM. 
2. Change gears when appropriate–lower for uphill to maintain proper cadence. 
3. As a beginner, you may find that you'll want your handlebars higher; but as you grow accustomed to riding, you will be able to tolerate a lower handlebar position. 
4. To avoid neck, shoulder, wrist, and hand pain and numbness, use padded gloves, change your hand positions often, and keep your elbows unlocked and loose. One helpful accessory for a mountain bike is vertical extensions at the end of the handlebars, which give you another option for hand placement. 
5. Stretch before, during, and after riding: another topic itself. 
6. If increasing your mileage to complete, for example, a century ride, do so gradually over a period of several months. 
7. Educate yourself about proper nutrition and especially be sure to drink enough water and sports drinks when riding for more than two hours. For more information go to Sports Nutrition
If your symptoms have not resolved in several days, be sure to call us to schedule an appointment. 

Injury Prevention Articles

The following articles are adapted from and address preventative tips for specific sports:



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