Summer sports: How to prevent limb injuries

Falls and accidents can result from sports and non-sport activities, which usually increase during the summer holidays, resulting in upper extremity injuries.

“In the summer and especially during the holidays, most people want to make up for the time they spent inside, spend their leave doing summer sports, near or in the sea. The sudden increase in the intensity of the exercise, however, becomes the cause of many injuries of the upper limb, as well as insufficient warm-up, the existence of previous injuries that have not been sufficiently restored and the wrong technique”, explains Orthopedic Surgeon Dr. Panagiotis Pantos, Director of Orthopedics of the Upper Extremity Clinic at the Athens Medical Center and head of the Upper Extremity and Sports Injuries departments of the Osteon Orthopedic & Spine Clinic.

“Falls, as well as accidents that may arise from sporting and non-sporting activities (e.g. driving a motorcycle) are, of course, the most common reasons. Slippery surfaces near pools, beaches or water parks can lead to sprains, dislocations or fractures.

Engaging in high-risk activities or sports that require repetitive motion, such as swimming, volleyball and racquetball, puts stress on the shoulder and elbow joints and can cause muscle and tendon damage – as can weight lifting (e.g. luggage) with incorrect technique,” he adds.

More specifically, the most frequent injuries include dislocations and fractures. Tendonitis, shoulder impingement syndrome and rotator cuff tears are common in the shoulder, while in the elbow medial or external epicondylitis and ligament damage. These injuries can occur both from engaging in sports that do not require contact with another person (e.g. swimming and rackets) and those that require contact (e.g. basketball).

As for the shoulder, fractures of the clavicle, scapula and humerus can be the result of a violent impact or fall. A fall from a bicycle, for example, can result in an injury to the acromioclavicular joint at the top of the shoulder.

Repetitive overhead arm movements, such as throwing a ball or swimming, can cause compression and irritation of the tendons and shoulder socket and lead to shoulder impingement syndrome. However, the most likely injury due to swimming and rackets (but also sports that involve collisions and falls) is a tear of the rotator cuff of the shoulder, that is, the muscles and tendons that surround this particular joint and keep the head of the humerus stable inside in the socket of the shoulder (homoglenius).

Activities that involve repetitive overhead movements or require heavy pulling movements (eg wakeboarding and skiing) can cause a labral tear [ρήξη SLAP (Superior Labrum Anterior to Posterior)]a ring of fibrocartilage that surrounds the shoulder socket and provides greater stability.

Injuries from a fall (eg from a bicycle or skateboard) can have the same effect. Tearing of the labrum can cause recurrent shoulder dislocations, and people who play racquetball or volleyball are more at risk.

A fall or impact can also result in a fracture or dislocation of the elbow. Apart from these, the most common sports-related injuries are ligament injuries. Sports and games that involve throwing a ball with the arm raised can cause damage to the ulnar collateral ligament and pain on the inside of the elbow.

Overuse, extremely intense loading at the level of the wrist and fingers, incorrect technique of lifting objects, throwing or hitting with the hand can cause tendinitis in the elbow, with internal and external epicondylitis being the best known conditions (golf and tennis elbow).

In order to avoid all the above pathological conditions, it is important to prepare for physical exercise with a gradual increase in physical activity, to perform muscle strengthening exercises that support the joints of the upper limb and stretching (especially before performing repetitive movements), as well as the maintenance of good body posture”, points out Dr. Pantos and adds:

“Performing exercises that improve balance and increase the strength of all the muscles of the body is also of decisive importance, as this prevents falls. But even if they do occur, the effects are milder. To prevent overuse injuries, breaks should not be skipped, which give the muscles time to repair damage and recover,” he says, continuing:

“Pain is the first sign that something is wrong, so the best advice is to listen to your body. When it is severe and acute or milder but persists for more than 15 days while rest and ice recommendations have been followed, a medical diagnosis should be sought.

Treatment depends on the type of injury and its severity. Most of the time it is conservative, but when the symptoms do not subside with it (pain, swelling, loss of functionality, structural damage, etc.) then surgery is likely to be required, which must be performed by specialized orthopedists, given the complexity of the specific joints.

Under no circumstances should the possibility of an injury prevent you from enjoying nature in the summer. All that is needed is the observance of the rules to avoid them”, concludes Dr. Pantos.

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