Spring can be a Real Pain in the Neck, Back, and Knees

For so many of us, we spent the winter months sitting more and exercising less than is recommended. The American Heart Association says only one in five is getting the heart-pumping exercise our bodies need for optimal health each week. But seasons change, and those early beautiful spring days beckon us to be outdoors. Whether we are weekend warriors on the tennis court, the soccer field, or in the garden, early spring sore muscles and achy backs can be the result. Jumping into activities without ramping up, stretching, and conditioning can be a real pain.

Stretch it out
Primary Care and Sports Medicine physician Dr. Steven Cetel of Shore Physician Group in Somers Point said everyone needs to make sure they are prepared when they head out in the spring for sports or heavy chores. “In the spring, we see an uptick in sprains, strains, knee injuries, shoulder injuries, and concussions with people involved in sports. We will see more knee and back pain with people working in their garden,” said Dr. Cetel. “Stretching is so important, both before and after an activity, to cut down on injuries. I remind patients to start with bending whatever the joint is they might be pushing. They also need a strong core. A weak core leaves you susceptible to back pain and knee pain.”

Getting to the core
For athletes, whether on the varsity squad or with the over 40 men’s baseball league, injuries are a part of the game. “To avoid injuries, it is important to have strong mechanics and a strong core. There is a reason for spring training, to get athletes ready for their sport and to ramp up to whatever activity they plan,” said Dr. Cetel. “For those who may be older, start low and slow. You cannot go from sitting on the couch to playing tennis or pulling weeds in the garden for four hours. That is how people wind up with problems.”

Core exercises train the muscles in your pelvis, lower back, hips and abdomen to work in harmony. This leads to better balance and stability, whether on the playing field or in daily activities. In fact, most sports and other physical activities depend on stable core muscles.

“For my older patients planning to do work in their garden, I remind them to work up to it by bending over for a few minutes and remaining active,” said Dr. Cetel. “To avoid injury, sometimes people need a reminder to bend from the hips and not from their back. Once again, a strong core helps keep pain at bay.”

Kneeling is another cause of discomfort and injury. Dr. Cetel explained that knee pain is often due to arthritis. He reminds patients that kneeling for an extended period will result in pain. Kneel for shorter periods and use some type of knee pad or protection to cut down on knee pain or injury.

RICE is always nice for sprains
The classic advice Dr. Cetel offers patients is the acronym RICE, which stands for “rest, ice, compress, elevate”. RICE still holds true for strains and sprains, but according to Dr. Cetel, the amount of time someone should follow RICE has changed over time. “That guideline is for right after the injury. It used to be that if you sprained your ankle, you stayed off of it and followed RICE protocol for a longer period. Now we want to make sure you are getting your range of motion back earlier. When the swelling goes down, start moving around as much as you are able. But on the flip side, if it is too tender for you to walk on that ankle, you need to come in for an evaluation.”

A sprained ankle is an injury that occurs when you roll, twist or awkwardly turn your ankle. These injuries can stretch or tear the tough bands of tissue or ligaments that help hold your ankle bones in place. The ligaments stabilize joints and prevent excessive movement. A sprain happens when the ligament is forced beyond its normal range of motion.

A high-ankle sprain is different and, according to Dr. Cetel, will take longer to resolve or heal. A high ankle sprain is when you tear or damage the high ankle ligaments that connect the tibia to the fibula. The ankles connect the leg bones to the foot bones. Dr. Cetel said, a patient with a high ankle sprain might need crutches or wear a boot to keep weight off the area until it heals. Sometimes, the high ankle sprain may require surgery, depending upon the severity of the strain. Football players may get a high ankle sprain and be out for weeks until it heals. Baseball players sliding into a base can experience a similar injury.

Shouldering the season
“The best way to avoid shoulder injuries is to maintain proper mechanics,” said Dr. Cetel. “You need a strong shoulder, upper body, and scapular muscles to avoid pain. We often sit stooped in our chair, or worse, stooped with a phone in our hand, texting. That is just setting you up for pain,” said Dr. Cetel.

Shoulder injuries are common in the garden as well. Dr. Cetel explained that people may use improper form to lift heavy landscaping rocks or do repetitive work too often. “They should be lifting with their legs and glutes, not with their back,” said Dr. Cetel. “People in pain should move as quickly as possible to avoid getting stiff.”

Help for those knees
For an acute knee injury that results from a direct blow, unusual twisting, bending, or falling on the knee, Dr. Cetel suggests stopping the activity and RICE. For pain caused by arthritis, Dr. Cetel said strengthening activities, possibly physical therapy, can help the affected area get stronger. He also suggested glucosamine chondroitin may help. “In some cases, a brace on the knee might be helpful. The patient and their doctor could also look at the possibility of steroids or gel injections to help alleviate pain and promote healing.”

For shoulders, knees, and even hamstring pulls, Dr. Cetel said it is important to strengthen the area surrounding the injured joint to make it stronger. “It is our goal to make sure they heal safely. Included in that equation is also good nutrition, proper sleep, and staying hydrated. All of those factors will help everyone get back to the baseball field, the tennis courts or out in the backyard, pulling weeds and planting flowers.

Dr. Cetel recently served as the team physician for the Metro Atlantic Athletic Conference at Boardwalk Hall in Atlantic City. He also served as the NBA League Delaware Blue Coats Asst. team physician as well as team physician for the University of Delaware men’s and women’s basketball and lacrosse teams.
To make an appointment with Dr. Steven Cetel call 609-365-5600 for the Primary Care in Northfield office or 609-365-6280 for the Orthopedic office in Somers Point.