Sidelined with a sports-related injury? Sports physical therapy will help you get back in the game. Countless scientific studies have proven that sports physical therapy is the safest and most effective type of treatment for nearly all sports-related injuries.
Whether you're injury developed gradually or suddenly, is minor or severe, a sports physical therapist can get you back in the game stronger than ever.
Sports physical therapists are experts in sports-related pain and injuries. They can pinpoint the underlying cause of the pain (such as overused and unconditioned muscles) to provide athletes with the best treatment.
Strength and conditioning exercises that target the injured area are an important part of a sports physical therapy program. These exercises help prevent re-injury and other injuries from developing.
Sports physical therapists can treat almost any sport-related injury. This guide will cover everything you need to know about sports physical therapy, including:
What you can expect from a sports physical therapy program
How a sports physical therapist makes an accurate diagnosis
The most common injuries treated by sports physical therapists (& their symptoms)
Which techniques a sports physical therapist will use to treat you
What You Can Expect from Sports Physical Therapy
When you find a physical therapist who specializes in sports physical therapy, you can feel confident that you're working with a healthcare professional who has specific experience and training in treating sports-related injuries.
You can expect an accurate diagnosis of your injury, periodic functional testing, and a plan tailored to your injury and lifestyle. This will ensure that you’re getting the least invasive and most effective type of treatment for your injury.
A physical therapist who specializes in sports injuries is your go-to healthcare professional for just about any sports-related injury. Both professional and non-professional athletes are recommended sports physical therapy as a first-line treatment.
During your initial appointment, your physical therapist will ask questions about your injury, guide you through a physical exam, and take you through range-of-motion tests. Your physical therapist will use these questions and tests to diagnose your injury and determine what caused it.
Understanding Your Injury
Your injury can have more than one cause. For example, many runners who suddenly increase their weekly mileage and add more speed workouts may suffer an injury because of the rapid overload.
An abrupt increase in the intensity of training and changes in the type of movement you’re doing (such as adding jumps into your routine) are both common reasons why injuries appear in athletes.
The amount of time you’ll spend rehabilitating your injury will depend on the type of injury you have and the severity of the injury. It is important to follow a physical therapy program throughout since many athletes don’t end up hurting themselves again (sometimes worse than before).
Injuries can cause imbalances in different muscles. Some athletes who have an injury are subconsciously favoring the injured part of their body and putting more weight on the non-injured part. This act of favoring can lead to further imbalances and increase the risk of other types of injuries.
A sports physical therapist is trained to identify muscular imbalances. Even if you’re unaware that you’re favoring one side of the body (for example, bearing slightly more weight on the left leg due to a hamstring strain in the right leg), a sports physical therapist can catch this detail and prevent you from favoring your injury.
Once your physical therapist sees that you are well-conditioned, healed, and balanced, he or she will give you the “OK” to return to sport. It is important that you follow the physical therapist’s directions for your return process.
Your physical therapist will give you a specific plan to follow so that you are returning to your sport gradually. For example, a runner who normally runs 60 miles a week and has to stop running for two weeks due to an injury might only run 10-20 miles during the first week back to running. From there, the physical therapist will assess how the runner is doing with the low mileage and recommend gradually increasing the mileage.
If the runner carefully follows the physical therapist’s directions, the odds are that the runner will return to his or her goal mileage stronger than ever before. The muscular conditioning that the runner had performed in physical therapy will ensure that this runner’s body is more resilient to all types of injury (given that the runner does not make any sudden changes to their exercise routine).
No matter what sport you play, consistency is key. Inconsistency in training, such as only playing soccer for 30 minutes on the weekend and then deciding to play every day for an hour can lead to injury. This is because your body did not have time to adapt to the increased exertion.
Many injuries are caused by increasing the exertion level or duration of the sport too quickly for the body to adjust.
Your physical therapist will ask you questions related to your injury during your initial visit.
Below are the types of questions that your physical therapist will ask to help him or her make an accurate diagnosis and prediction of the underlying cause:
What Makes Your Injury Better or Worse?
There are many factors that can make a sports-related injury better or worse, including:
Poor sleep habits
Improper athletic attire
Delaying treatment after symptoms first appear
A physical therapist will ask questions related to the above factors to make an accurate diagnosis and pinpoint the underlying cause.
Certain injuries that have similar symptoms can be distinguished from one another based on how the patient feels during certain movements and activities. Some specific questions your physical therapist may ask include:
“Do you feel pain while sitting or sleeping?”
“Do you feel pain during your athletic activity?”
“Do you feel pain after your athletic activity?”
“Are there poses that make your pain feel worse?”
Your answers to these questions will guide the therapist in making a precise diagnosis and determining what leads to the injury.
Your physical therapist must also know how long you’ve experienced the symptoms and/or pain. Typically, the longer you continue your athletic activity on an injury, the worse the injury becomes.
It’s understandable that athletes do not want to stop participating in their sport due to an injury that feels minor. However, these athletes are usually sidelined later with a much more serious injury due to delaying treatment for the injury. It is not until the injury is severe that these athletes finally seek treatment.
Ignoring an injury can convert a minor injury into a serious one. Your physical therapist will need to know if you’ve ignored your symptoms for a while so that he or she can assign the appropriate treatment plan.
Your physical therapist will ask if you’ve tried any treatments for your injury. If so, your therapist will want to know which treatments worked and which didn’t work.
Common treatments that patients try before seeing a physical therapist include heat/cold packs, medications, rest, or surgery. Some patients notice that the injury feels better with certain treatments (such as medications or rest) but return when the treatment ends.
An injury that returns right after stopping a treatment usually means that the treatment treated the symptoms and not the cause of the injury. Many doctors (who are not physical therapists) recommend treatments such as medications that fix the symptoms rather than heal the injury itself.
A sports physical therapist will ensure that your physical therapy program heals the injury so that you return to your sport rehabilitated and symptom-free.
After the initial questions, your physical therapist will guide you through a physical exam and a series of tests.
First, your physical therapist will look at the injured area to see if there are any visible signs of injury such as swelling or deformity.
Range of Motion Test
Next, your physical therapist will take you through a range of motion test. This test will reveal how far you can move your body. Physical therapists often notice a lack of joint mobility and poor flexibility around the injured area.
During the range of motion test, your physical therapist may lightly press a goniometer against your skin. A goniometer is a ruler-like device used to measure a joint’s range of motion.
A functional test reveals how well you can physically function with your injury. You will perform various types of physical activities during a functional test. Your physical therapist may also ask you to push inwards/outwards on his or her hands to assess your muscular strength.
You will perform a functional test in the initial visit and routinely throughout your physical therapy program to indicate healing progression.
Here is a simple hop-test that discerns if your athlete is at risk for an injury such as an ACL tear:
Determining the Cause of Injury
Your physical therapist will use the above tests to diagnose your injury. Sometimes, imaging tests such as MRIs are needed in cases where the injury is believed to impact the bone (such as a stress fracture).
Once your physical therapist diagnoses your injury, he or she will determine the cause from the series of questions that they asked you in the initial visit, as well as what they witnessed during the treatment program.
For example, during your treatment program, your physical therapist may ask you to perform your usual warm-up routine and find that you are warming up improperly or warming up with poor posture – both of which may have caused your injury.
A physical therapist may also look at your technique and posture during the most repetitive types of movements you do for your sport. If you’re a golfer, your physical therapist may ask you to perform a swing and assess your technique, for instance.
Many golfers who sustain golf-related hip injuries are weak in the core and glutes. If you’re a golfer with a hip injury, your physical therapist may see that you’re not activating your core and glutes during your swing. As a result, your physical therapist will work with you to strengthen and activate these muscles.
Often there is not one but several causes for your injury. For example, a lower back injury sustained by a cyclist may not only be caused by improper bike setup but also by how that cyclist sits and stands throughout the day.
Perhaps the cyclist is cycling with the handlebars too low and then sitting for hours at work in bad posture. Both the low handlebars and poor posture at work will add strain on the lower back. The joints in the back may have stiffened from poor posture. Additionally, the back muscles may be weak because the cyclist doesn’t practice a core strengthening routine.
For the cyclist who cycles and works in poor posture, a combination of strengthening, stretching, joint mobility exercises, and manual therapy can help the cyclist return to sport pain-free, stronger, and more flexible.
Pay attention to what makes your injury feel better or worse. Also, take note of which strengthening exercises you do or don’t do at home.
Sometimes, home treatments can worsen injuries if they are performed incorrectly. A physical therapist will monitor your form and technique to ensure you’re doing the physical therapy exercises correctly.
The best part of a physical therapy program is that it treats the cause, which prevents the injury from returning.
Other types of treatments (such as medication) only treat the symptoms, meaning that your injury will likely return since it was never fully healed.
The Most Common Injuries Treated by Sports Physical Therapists (& their symptoms)
Your physical therapist will recommend a specific treatment plan based on the type of injury that you have.
Listed below are the most common types of injuries treated by sports physical therapists. If you identify with the symptoms, it’s time to seek treatment:
An ACL Tear is one of the most common sports-related injuries. The ACL is a band of tissue that supports the knee bones. The ACL can be torn if it is stretched past its limit (usually during a quick movement, such as a sudden turn while running or jumping).
Athletes who play high-speed sports with sudden stops and/or changes in direction are most at risk for developing an ACL tear.
Examples of sports that put athletes at a higher risk of ACL tears include soccer, football, volleyball, basketball, and skiing.
Many sports fans have witnessed an ACL tear at some point. The telltale sign of an ACL tear is an athlete who falls while grabbing his or her knee immediately after changing directions during a sprint or jump. This injury can sideline our favorite professional athletes for the rest of their season and sometimes even the next season.
An ACL tear can take a while to heal but is usually healed best through physical therapy. A primary focus in the treatment of this injury is to mobilize the knee, reduce swelling, repair the ACL, and strengthen the surrounding muscles so that the risk of a future ACL tear or knee strain is greatly reduced.
Signs & Symptoms of an ACL Tear
A loud “popping” sensation in the knee coupled with pain and instability
Severe pain and inability to continue the activity
Rapid swelling around the knee
Loss of range of motion in the knee area
A lack of stability when bearing weight on the affected leg
It is often difficult to walk, let alone participate in a sport, with an ankle sprain. These types of sprains are usually painful and limit the ankle’s range of motion, strength, and stability.
Most ankle sprains occur suddenly, causing immediate pain followed by persistent pain and lack of mobility. You might sprain your ankle if you twist your ankle too far when performing a movement. Poor shoe wear, mobility, and strength are often to blame for ankle sprains.
Signs and Symptoms of Ankle Sprains
Sudden pain after twisting the ankle
Swelling and/or bruising around the ankle
Tenderness in the ankle
Pain that varies from mild to severe
Inability to place your weight on the affected ankle
Back pain can range from mild to severe. This condition often puts athletes on the sidelines. Lower back pain can be particularly debilitating and can radiate from the tailbone area to the thighs/hamstrings
Unless you’ve experienced sudden back pain from an accident or fall, it might be difficult to determine the exact cause or causes of the pain. Usually, physical therapists find that back pain stems from various causes that are both sports and non-sport-related.
Many athletes who do not do enough core work and slouch a lot while sitting or standing are prone to back pain. This pain might be further aggravated by participating in certain sports.
Signs & Symptoms of Back Pain
Muscle aching in the back
Shooting or stabbing pain in the back and/or surrounding muscles
Pain that radiates to the leg
Pain that worsens with certain movements such as bending, twisting, lifting, standing, or walking
Pain that improves with reclining/lying back in a position that supports the back
Golfer’s & Tennis Elbow
This golfers elbow and tennis elbow is appropriately named due to golfers and tennis players being the most afflicted athletes with this injury. Repetitive use of the forearm muscles can lead to repeated strains which cause pain and inflammation in the tendons that connect the forearm and elbow.
Signs & Symptoms of Golfer’s & Tennis Elbow
Pain that centers at the bony bump on the inside of the elbow and radiates to the entire forearm
Tenderness on the outside of the elbow
Weakness in the forearm that can lead to a weaker grip
Pain when gripping or twisting objects
Pain with backhand strokes if you are a tennis player
Hip impingement is a condition where the femoral head (ball of the hip) is misaligned with the acetabulum (cup of the hip). The misalignment results from a misshapen femoral head or a misshapen acetabulum and prevents the ball of the hip from gliding smoothly within the socket.
Most people who have this condition are born with a misshapen femoral head or acetabulum. Others, particularly young athletes who frequently squat and twist at the hip, develop hip impingement as their bodies mature.
Hip impingement usually worsens with repetitive movements of the hip required by certain sports such as soccer, golf, or tennis.
If left untreated, hip impingement can cause cartilage/labral damage.
Signs & Symptoms of Hip Impingement
Stiffness in the thigh, hip, or groin
Pain in your groin area, particularly after your hip has been flexed (such as by running, jumping, or sitting for a long period of time)
Pain in the hip, groin, or lower back that occurs with both rest and activity
The inability to stretch your leg out in front of you beyond 90 degrees when lying down. Bringing your leg in front of you and therefore decreasing the gap between your hips is called hip flexion. To test for hip flexion, your physical therapist will have you lie down and lift one leg up straight while the other rests flat. The physical therapist may push on the leg that is lifted until you feel you can no longer comfortably stretch the leg out.
IT Band Syndrome
The IT band is a long piece of connective tissue on the outer portion of each leg that runs from the hip to the shin. IT Band Syndrome occurs when the IT Band is too tight and therefore rubs against the thighbone, prompting pain, irritation, and swelling.
Athletes who practice sports that require repetitive bending at the knee (such as long-distance running, hiking, cycling, and long-distance walking) are at the highest risk of developing IT Band Syndrome. This condition usually develops when athletes increase the duration and/or intensity of their sport too quickly.
A 2013 study revealed that about 22% of long-distance runners develop IT Band Syndrome at some point in their running careers (Beals & Flanigan, 2013).
IT Band Syndrome is often confused with a condition called Runner’s Knee because the symptoms are similar. The treatment for these two conditions is different, so it is important to distinguish between the two.
The main way to distinguish between IT Band Syndrome and Runner’s Knee is to determine which part of your knee feels painful.
The pain felt with IT Band Syndrome occurs on the outer portion of the knee and partially along the thigh, whereas the pain felt in Runner’s Knee occurs directly in the kneecap area (such as at the front of the kneecap, right around the kneecap, or right behind the kneecap).
Your sports physical therapist can help you to determine whether you have IT Band Syndrome or Runner’s Knee and give you the appropriate treatment.
Signs & Symptoms of IT Band Syndrome
Pain and/or swelling along the outside of the knee that may radiate to a portion of the thigh
Pain when pressing on the outer portion of the knee but no pain when pressing on the kneecap or directly around the kneecap
Pain that worsens when going downhill or downstairs (which is the opposite of Runner’s Knee, where the pain will be felt when going uphill or upstairs)
Pain when bending at the knee or repetitively moving the knee
A gradual increase in symptoms (which can have major impacts on sports performance if persisting for more than four weeks)
Plantar fasciitis is a pesky injury that provokes heel pain. This condition causes inflammation of the fascia (the thick band of tissue that runs from the heel to the toes). Plantar Fasciitis is notorious for returning again and again for athletes who don’t seek the appropriate treatment.
Athletes who perform sports that require repetitive landing (such as long-distance running, dancing, or jumping) are most at risk for developing this condition.
The pain is typically described as “stabbing” and worse in the morning.
Signs & Symptoms of Plantar Fasciitis
Pain in the heel & tenderness in the sole of the foot
Difficulty walking due to pain & stiffness. This is worst after waking and feels gradually better throughout the day.
Sharp/Stabbing pain that may feel severe
Swelling at the bottom of the foot
Pain that worsens with activity, especially activity that requires repetitive pounding on the feet (e.g. long-distance running or walking, dancing, or jumping)
Shoulder injuries are most common in athletes who participate in contact sports or sports that require repetitive movements of the arms overhead.
The main shoulder joint is a ball-and-socket joint containing a very small socket. This joint is held together and controlled by a bunch of tendons that form a capsule around the joint to facilitate movement.
Shoulder injuries are frequently caused by inflammation, tendon damage, muscle tension, tendon tension, and inflammation in the bursa.
Signs & Symptoms of Shoulder Injuries
Pain while resting on or applying pressure to the shoulder
Pain with certain arm movements such as lifting and lowering the arm
Weakness when lifting or rotating the arm
A popping/crackling sensation (crepitus) when moving the shoulder in certain positions
Common Sports Physical Therapy Treatments
Your sports physical therapist will combine multiple treatments to maximize your healing. These common sports physical therapy treatments are proven to help athletes get back into the game:
Functional exercise helps athletes suffering from sports injuries complete everyday tasks more easily.
These types of exercises are designed to improve the athlete’s technique while performing daily tasks (such as lifting with good posture). These exercises also strengthen the core (including lower back muscles).
Since the muscles and techniques used in daily tasks take up most of an athlete’s day, functional exercise will help heal the injury and lessen the injury’s impact on daily activities.
Manual therapy restores function, motion, and mobility back into the injured area. A skilled physical therapist will use his or her hands to press down and massage the injured area in order to loosen stiff joints.
Myofascial Release & Active Release Technique
Myofascial Release is often used to treat a condition called “myofascial pain syndrome,” in which the myofascial tissue (a type of tissue that extends throughout your body) tightens and causes chronic pain.
An expert physical therapist trained in this type of treatment will use his or her hands to place pressure on trigger points and loosen the myofascial tissue. The goal of this treatment is to alleviate tension and pain caused by tight myofascial tissue.
As experts in sports-related injuries and movement, sports physical therapists will teach you how your injury occurred, how to heal your injury, and how to prevent future injuries.
Athletes who “jump the gun” against their physical therapist’s advice are risking reinjury and greater severity of the injury. Athletes who follow their physical therapist’s advice closely often return to sports injury-free and resilient.
This type of treatment (also known as spinal manipulative therapy) is a type of manual therapy in which a practitioner uses his or her hands (or a specialized tool) to stretch, massage, activate, and move the joints.
This treatment helps to alleviate pressure on the joints, improve nerve function, and reduce inflammation.
Only the most advanced sports physical therapists are trained in spinal manipulation. This treatment can speed up recovery time.
Spinal traction is used primarily for athletes suffering from back and/or neck pain. A physical therapist will decompress your spine either manually or via a mechanical decompression device.
Patients often feel decreased pain when their spine is decompressed. Pain reduction can improve a patient’s overall functioning and ability to perform stretching and strengthening exercises for the injury.
Spinal traction is proven effective in curing many back conditions, including:
Degenerative Disc Disease
Strengthening & Stretching Exercises
Your sports physical therapist will assign you strengthening and stretching exercises tailored to your diagnosis and lifestyle. These exercises are considered the foundation of a physical therapy program and usually provide the greatest benefits to the athlete.
In most cases, sports-related injuries are due to muscular imbalances, lack of flexibility, and weak or unconditioned muscles. Many sports-related injuries occur when an athlete increases training load or intensity without proper muscular conditioning.
Strengthening and stretching exercises will repair muscle tissues and increase the athlete’s flexibility. These exercises promote healing, prevent reinjury, and ward off other types of injuries.
For the athlete whose injury results from poor flexibility, posture, or muscular strength, these exercises are a critical part of the rehabilitation program.
Taping done at a physical therapist’s clinic is not to be confused with the athletic taping that many athletes find at sporting goods stores or even grocery stores.
Unlike athletic tape, which limits motion and decreases circulation, the taping done in a physical therapy clinic will improve the range of motion and increase circulation. This is because physical therapists apply kinesiology tape rather than athletic tape, and they apply the tape strategically to maximize the athlete’s recovery.
When a physical therapist skillfully applies tape to the injured area, the athlete will experience a host of benefits, including: