The Most Common Injury I See

By Jake Francis

This is a question I get asked a lot, "what is the most common injury you see?". Well, working in multiple different settings, this can be a tricky one to answer. The most common injury in all sports, provided the lower limb is involved, is a lateral ankle sprain. This is where you may land funny and roll your foot inwards, this damages the ligaments on the outside of your ankle. We know it is the most common from epidemiology papers and consensus statements. We also know this from past experiences: how often have you 'rolled' your ankle? How many people have you come across that have 'rolled' theirs? I bet the combined total answer to these questions will be higher than any other injury you can think of.

I haven't actually seen a huge amount of ankle sprains this year. I have definitely seen more over my lifetime than any other injury, but this year I haven't had to deal with many. Now this could be for many reasons, but I believe it comes down to just two: players aren't reporting them to me, or they have become so common and regular for individuals that they no longer notice it. I edge towards this second one more, because I'd like to think the players I see would trust me enough to tell me. Plus, I have seen this happen before: I was first aiding a women's football match, and I watched as a member of the opposition turned and lost all stability in her ankle (she did not have the ball and was not running fast). Her foot rolled in at near enough a 90 degree angle to her leg. Ordinarily, this would be agony, difficult to weight bear and there would probably be a fair amount of swelling. This player, didn't fall to the ground, and carried on running as if nothing had happened... How? I suspect she has sprained her ankle so many times and carried on regardless, that it no longer reacts in the same way. This is where an acute injury becomes chronic. This particular condition is called chronic ankle instability (CAI). This is not a good thing to have because it reduce range of movement and makes you very unstable on one foot. This means running won't feel great, your balance won't be great, and you are more susceptible to ankle injuries. To be honest, this is one of the most common conditions I see in people across clinic and sports. However, it is definitely not the most common one that people see me for, because it doesn't feel injured, you just feel like you've got bad balance.

What I have seen in sports this season is a few traumatic injuries: a dislocated patella (which I did a bit of a case study on Instagram), a Lisfranc's injury (a very rare injury that dislocate the metatarsals in your foot), and a double fracture to the lower leg with the foot rotated out by 90 degrees. These injuries were dealt with appropriately, and are either back playing or in rehabilitation. I have also seen a number of concussions in rugby. However, the most regular injury I have seen across the teams I cover is cramps. This is pretty simple to deal with - whatever helps the cramps to ease is fine. I'm not a big fan of stretching the cramped muscle, I prefer to massage/rub it to get some heat back into the muscle to help it relax. My advice after this is always to work on endurance of that particular muscle, usually the calves. This will build up the muscles capability to deal with exercise over a longer period.

In clinic, I see less people who play sport. So, it is much more reasonable to assume the vast majority of injuries I see here are chronic. This assumption would be correct, although I do on occasion see some more acute injuries. These acute injuries have included ankle sprains and CAI (surprise, surprise!), sprained knees and knee meniscal injuries... and that is about it, to be honest with you. Of those, I have probably seen knee meniscal injuries most. I have often heard this structure referred to as knee cartilage, so you can imagine its function - it keeps the knee moving smoothly and provides some shock absorption. When it get injured, little tears are created and it can flap and cause your knee to lock when bending the knee at certain angles. It is probably most debilitating when walking up or down the stairs.

However, I see many more chronic conditions: a lot of shoulder conditions (frozen shoulder, rotator cuff imbalance, shoulder instability, impingement, etc.), upper back and neck pain/stiffness, headaches. But, perhaps the most common complaint, is lower back pain. This can be manifested in many ways. However, it tends to be quite diffuse pain, and can include sciatica symptoms (tingling, pins & needles, numbness down one leg). I like to talk to my clients with these types of chronic condition to get a good sense of what is going on, and then my first aim is to reduce the pain/discomfort. My ultimate goal is to find the root-cause of the problem and provide exercises to ensure your pain doesn't return.

You may notice that I have dealt with many injuries, both acute and chronic. The most common one I see hasn't always lined up with the research, and that might change going forward. However, below are the top 5 most common injuries I have seen this year:

  1. Low back pain

  2. Chronic Ankle Instability

  3. Shoulder Impingement

  4. Frozen Shoulder

  5. Cramps


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