Pain Management for Athletes

Few people would disagree with the statement that pain
management for athletes can be a major concern in the 21st century. Pain is
common problem for athletes across the board and is frequently associated with
sport injury.

Understanding the best approach to pain management for
athletes requires a better understanding of the source and scope of those
injuries.

There are currently no evidence-based or consensus-based
guidelines for the management of pain in elite athletes. This has resulted in
what may be an over-reliance on opiate medications, and ineffective topical
analgesics, without considering the benefits of newer approaches and
complementary therapies.

Pain management for athletes should take into consideration
all of the contributing factors to pain, including underlying pathophysiology,
biomechanical abnormalities and psychosocial issues, and should employ
therapies providing optimal benefit and minimal harm. 

Generally speaking, it is the role of the physician or
physical therapist to determine which strategies among the possible treatment
options will best facilitate the management of pain in the individual athlete
suffering from a sport-specific injury.

Studies suggest that the identification of the gaps in
knowledge in the management of pain among athletes will provide better access
to the latest information, and further medical research, that could provide
reassurance, speed return to active sport, and benefit performance.

In one study, entitled, “Management of Pain in Elite Athletes: Identified Gaps in Knowledge and Future Research Directions” scientists noted:

“For elite athletes to train and compete at peak
performance levels, it is necessary to manage their pain efficiently and
effectively. A recent consensus meeting on the management of pain in elite
athletes concluded that there are many gaps in the current knowledge and that
further information and research is required.”

[Source: https://www.ncbi.nlm.nih.gov/pubmed/29952840]

Also of important note is that a federal advisory committee
recommended that the government lower the daily recommended dosage of
acetaminophen, based on the idea that it is relatively easy to overdose on the
drug, and that it’s been linked to liver damage. Acetaminophen is in Tylenol,
of course, but it’s also in plenty of other multipurpose medications. [Source:
http://www.nytimes.com/2009/07/07/health/07well.html]

PREVENTATIVE APPROACHES

Stretching and strengthening may provide some of the best
protection for athletes prone to injury.

The best way to avoid needing pain management for athletes
is to avoid the injuries that occur in the first place. This would include
proper conditioning, including adequate stretching and strengthening, as well
as connecting with pain management specialists when injuries do occur.

Some research indicates that as many as 1 in 5 Americans
struggle with knee pain, and it can be frustrating when the usual RICE (rest,
ice, compression, and elevation) treatment doesn’t cut it.

Principle dancer at the American Ballet Theatre, James Whiteside, recently told an interviewer that after a decade of trying to find a solution to chronic pain in both knees, what ultimately worked for him was settling into a professionally developed, targeted exercise and movement therapy.

“I love ballet, but it sure does hurt. I’ve found that strengthening my VMO, quads, and glutes has given me more power in my lower body, lessening the tension on my patellar tendons,” he says. “The pain isn’t gone, but it’s much less severe.”

James Whiteside – American Ballet Theatre
Source: https://www.prevention.com/health/a20482109/7-athletes-reveal-how-they-manage-chronic-knee-pain/

An article in the American Physical Therapy Association‘s blog recommends three primary types of exercise to prevent injury to all parts of the body, including the knees:

  • Range-of-motion exercises to help maintain
    normal joint movement and relieve stiffness.
  • Strengthening exercises to keep or increase
    muscle strength.
  • Aerobic or endurance exercises (such as walking
    or swimming) to improve function of the heart and circulation and to help
    control weight. Weight control can be important to people who have arthritis
    because extra weight puts pressure on many joints, including the knee.

“To keep knee pain and other musculoskeletal pain at bay, it’s important to maintain an overall healthy lifestyle, exercise, get adequate rest, and eat healthy foods. It’s also important for runners and other athletes to perform physical therapist-approved stretching and warm-up exercises on a daily basis—especially before beginning physical activity.”

Source: Choose PT article – Physical Therapy Guide to Knee Pain

If you’re interested in exploring the options that exist for pain management, whether or not you consider yourself to be a professional athlete or simply a casual athlete, we can help to connect you with professionals ready to help.

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