Sports medicine Gilbert answers for a joint that still aches

Extra use and old injuries cause many aches

Your knee may ache after extra walking, stairs or pickleball, while a shoulder may hurt after lifting or reaching. A hip can feel stiff after sitting and hurt as you rise. Slow soreness often doesn't begin with one clear accident.

Your old injury may become sore again during harder activity. Arthritis can cause stiffness, swelling and a deep ache without another injury. A strained muscle may hurt during one certain movement. Where it hurts and how it began both help explain it.

Less strain and easy movement may help

You won't always need complete rest for a mild ache. Use the movement that hurts less often for several days. Easy bending can keep the joint from getting too stiff. A cold pack may soothe it after a busy day.

Notice the soreness that evening and again the next morning. If it's worse, the activity was still too hard or too long. If it settles, add a little time before adding speed. Don't raise distance, pace and playing days together.

Repeated or strong soreness needs an exam

How long can you watch a mild ache? Several easier days may be enough for it to settle. Arrange an exam if it keeps returning or blocks normal daily tasks. The clinician can compare the sore joint with your other side.

Tell the clinician when it began and which movement hurts. Include swelling, weakness, night pain and any earlier injury. Ask whether a doctor, nurse or another trained clinician will examine you. You'll also learn which activities are sensible for now.

Seek quick care when a joint is hot and red or weakness begins suddenly. A joint that has changed shape also needs care soon. Chest pain, fainting or numbness isn't normal exercise soreness. You can't safely wait with those signs.

Sources

1. In 25 randomised trials covering 26,610 participants and 3,464 injuries, STRENGTH TRAINING reduced sports injuries to less than a third (RR 0.315, 95% CI 0.207-0.480) and proprioception training roughly halved them (RR 0.550, 0.347-0.869), while STRETCHING showed no protective effect at all (RR 0.963, 0.846-1.095). Overuse injuries specifically were nearly halved by exercise programmes (RR 0.527, 0.373-0.746).

   Lauersen JB, et al. — The effectiveness of exercise interventions to prevent sports injuries: a systematic review and meta-analysis of randomised controlled trials.. Br J Sports Med, 2014. DOI: 10.1136/bjsports-2013-092538.

2. Across 15 studies and 8,459 athletes in different sports, ages and sexes, injury-prevention programmes that INCLUDED the Nordic hamstring exercise reduced hamstring injuries with a risk ratio of 0.49 (95% CI 0.32-0.74) - essentially halving them. Restricting the analysis to the eight randomised studies (RR 0.52) or removing the eight high-risk-of-bias studies (RR 0.55) barely moved the estimate.

   van Dyk N, et al. — Including the Nordic hamstring exercise in injury prevention programmes halves the rate of hamstring injuries: a systematic review and meta-analysis of 8459 athletes.. Br J Sports Med, 2019. DOI: 10.1136/bjsports-2018-100045.

3. An overview of 46 systematic reviews on ankle sprain found STRONG evidence for bracing and MODERATE evidence for neuromuscular training in preventing recurrence, and for the acute injury strong evidence for NSAIDs and early mobilisation with moderate evidence for exercise and manual therapy on pain, swelling and function. Evidence for surgery and acupuncture in acute sprain was conflicting, and there was insufficient evidence for therapeutic ultrasound.

   Doherty C, et al. — Treatment and prevention of acute and recurrent ankle sprain: an overview of systematic reviews with meta-analysis.. Br J Sports Med, 2017. DOI: 10.1136/bjsports-2016-096178.

4. A systematic review of long-distance runners found the incidence of lower-extremity running injury ranged from 19.4% to 79.3% depending on the population and definition, with the knee the predominant site. There was STRONG evidence that a long weekly training distance in men and a history of previous injury were risk factors - and, counterintuitively, that an increase in weekly training distance was protective against knee injuries specifically.

   van Gent RN, et al. — Incidence and determinants of lower extremity running injuries in long distance runners: a systematic review.. Br J Sports Med, 2007. DOI: 10.1136/bjsm.2006.033548.