“An ounce of prevention is worth a pound of cure.”
Ben Franklin said these famous words in 1736 in reference to fire prevention. The same philosophy, however, can apply to sports injuries. For several reasons--beyond the obvious--we want to avoid initial injuries which often lead to further pain and musculoskeletal issues.
Reason One: Injury and surgery can cause recurring problems.
My husband, Ken, is living proof of this statement. He has had two ACL surgeries and two cartilage repairs for a total of four surgeries on the same knee. I, too, have had three knee surgeries on the same knee. Knee surgeries became so frequent in our household that Ken and I joked about it, wondering who would go under the knife each year.
The truth is that surgery alters the natural state of the body: reconstructing ligaments, removing cartilage, inserting metal plates, pins and rods, replacing joints or performing other invasive procedures all limit hope for a full recovery. As a posture alignment therapist, I have worked with many clients who have pain or limitation from a previous operation.
Reason Two: Osteoarthritis (OA) develops after injury, surgery and overuse.
OA is breakdown of the cartilage within joints. Cartilage, found on the ends of bones, is a protective tissue that absorbs shock and facilitates smooth joint motions. According to the Arthritis Foundation, athletes might have more cartilage issues: “Athletes . . . have a higher risk of developing osteoarthritis due to injury and increased stress on certain joints. Soft tissue injuries, such as ACL tears, can lead to OA; it can also appear in joints affected by previous bone fractures and surgeries.” The Arthritis Foundation goes on to state, “Osteoarthritis can also damage ligaments, menisci and muscles” (2011 Arthritis Foundation).
OA can begin after injury, and OA itself can cause more injury. This condition can be very painful and incapacitating, causing stiffness, swelling and movement restrictions. As the cartilage is worn down, the bone becomes exposed. Consequently, OA is a leading cause of joint replacements. In 2009, the American Academy of Orthopaedic Surgeons (AAOS) reported that 700,000 primary total hip and knee replacements are performed annually. This figure is expected to double over the next 10 years. Since cartilage is very slow to heal, it would obviously be better to prevent OA and protect the cartilage than it would be to try to manage the disease. I was diagnosed with bone-on-bone OA in my left hip after my arthroscopic surgery. When my doctor and I parted, his last words were, “I'll see you in 15 years for your hip replacement.” I don’t think so!
Reason Three: Asymmetrical movements become ingrained and are perpetuated by our bodies.
When we are hurt, our movements compensate, and we favor the affected side. For example, if the joint or muscles cannot move or bear weight the way that nature intended, the unaffected joints and muscles step up to take on more of the load. If you have ever hurt your ankle, you know that it does not take long for the unaffected ankle to become painful because of the extra weight the joint is bearing. Just limp around for a while, and you will get the idea.
My dad experienced this issue. Before his knee replacement, it was painful for him to bear his full weight on his affected knee. Therefore, he altered his walking pattern so that the opposite side of his body had to assume more physical work. Consequently, his other knee began to hurt, and he also developed pain in his hips and lower back. These joints had to exert more effort to alleviate the strain on his knee and became painful from the additional stress. These altered movement patterns can become ingrained at an unconscious level still occurring even after the pain has subsided, which can lead to muscle imbalances between the right and left sides of the body. Simultaneously or alternatively, the muscles on either side of the joint lose symmetry. For example, the hamstrings and quadriceps muscles become out of balance in strength or function.
When we are out of balance and compensating in our movements, the body lets us know. Learn the signs to look for in my blog: Are you moving in balance? Three ways to tell.
Reason Four: We ignore the underlying cause of the injury.
Why did your injury occur? Often we are so concerned with getting back to our sport that we do not take time to evaluate why the injury happened in the first place, setting ourselves up for repeating the mistake. This situation is particularly important for slowly-developing, chronic injuries. It was not until after my hip surgery, eight years following my first knee surgery, that I realized my preceding knee injuries were because of two factors: poor postural position and a lack of muscle function. Failing to recognize and correct the underlying causes of my injuries furthered the problem, leading to recurrent joint deterioration and numerous surgeries.
The Good News!
Injuries happen and surgery is sometimes required. If, however, you address the reasons that are within your control, reasons two through four above, you can reduce your chances for further problems. It has been nearly a decade since my last surgery. Despite being diagnosed with severe OA in my hip, I have no pain in the joint. The posture therapy I have done has reduced the strain on my cartlidge, giving it the opportunity to regenerate. I feel stronger and more at ease in my body as a result of correcting my compensated movement patterns that developed to alleviate my hip and back pain. Addressing the underlying cause of my injures though the combination of improved joint position and proper muscle mechanics has excelled my athletic performance and given me confidence for long-term, pain free activity.
Heed our experiences, and listen to Ben Franklin: Avoid injury in the first place, and you will be a life-long athlete!