Treating Sports Injuries in an Urgent Care Setting

May is National Physical Fitness and Sports Month—a time set aside to promote the benefits of regular physical exercise. But as individuals head out to gyms, tracks and fields, this month is also a good time to raise awareness about the prevention and treatment of sports injuries.

“Spring, summer and fall are typically the busiest times of year for sports injuries because people are getting outside and doing more things. More of the sports are starting up now—baseball, softball, spring soccer,” says Paulo Gazoni, M.D., a Medical Director for BetterMed who has over 10 years of emergency room experience.Gazoni, who is also a lifelong athlete and extreme sports competitor, says most sports injuries can be handled in an urgent care setting like BetterMed. “I’d say about 5-15% of our cases are sports-related injuries. The most common ones we see are extremity injuries, including sprains and strains to the ankle, foot and knee. Upper extremity sprains are usually caused by a fall, which results in a sprained wrist or elbow.”
A sprain can result when ligaments—the tissues found in joints that connect the bones together—are stretched or torn. A twisted ankle is one common sprain.

A strain, also known as a pulled muscle, occurs when a muscle or tendon is stretched or torn. Hamstring muscles, for instance, are vulnerable to this injury.

Such injuries can be quite painful, and proper diagnosis and treatment are essential to stem further injury.

In one typical scenario, “we may have someone who comes in after playing basketball or soccer, and they have ankle discomfort. We’ll examine them, see where they’re most tender, make sure they have good blood flow and a good neurovascular exam,” says Gazoni.

All BetterMed facilities offer x-rays, which can help the physicians determine, “one, what we do immediately, and two, the type of follow-up that we provide the patient,” he says.

“If the x-rays show no fractures, and the exam is consistent with a sprain or strain, we would typically immobilize the joint and if it’s a lower extremity if we can immobilize it plus provide some crutches.” The doctor might also prescribe physical therapy.

“If the x-rays show a fracture—again, immobilize, crutches for a lower extremity—then we would typically prescribe an orthopedic follow-up for 5 to 7 days after the onset of injury.”

Treatments might include rest, ice, compression and elevation (RICE); anti-inflammatories or pain medication; and physical therapy or even surgery, depending upon the severity of the injury.

Other sports-related injuries seen at BetterMed include concussions, problems related to dehydration, and injuries that result from overuse of joints. The latter include tennis and golfer’s elbow—forms of tendonitis, which involve inflammation of the tendons.

To prevent injuries, Gazoni recommends stretching before and after exercise, wearing correct gear, and hydrating before, during and after exercise. Proper hydration is especially important during the warmer months.

Additionally, listen to your body. “If you start having some level of discomfort in an area, back off on the activity because that could be a sign of an underlying injury or weakness that could potentially become injured further.”

If despite caution, an injury occurs, be sure to seek proper care. Emergency care is required for “breaks that are significantly angulated, in which it looks like the bone is severely deformed—the skin is tenting or popping, or there’s a skin break over the site of the injury,” he says. “That would need an emergency orthopedic intervention, whether it be reduction, splinting and/or surgery. But everything else that people have for sports injuries, we can typically see and take care of in an urgent care setting.”

Dr. Paulo Gazoni has over 10 years of experience working in the emergency department of VCU Medical Center. An athlete as well, he competed last October in the Obstacle Course Racing World Championships.