Sever’s disease is caused by irritation of the bony growth plate at the back of the heel bone, and is directly related to overuse of the bone and tendons in the heel. It occurs in children ages 7-15, though it is most common in 10-14 year olds. Overuse can come from playing sports (e.g., soccer, basketball, or football) or any other activity that involves a lot of lots of heel movement. This is sometimes associated with starting a new sport, or the start of a new season.

Treatment: Sever’s disease is “self-recovering,” meaning that it will go away on its own when activity subsides or when the heel bone is through growing. It generally subsides within 2-8 weeks, though it can recur, for example, at the start of the next sports season. Possible treatments include elevation of the heel, regular stretching of the hamstring and calf muscles, following the R.I.C.E. regimen, and foot orthotics. In severe cases, a cast or medication might be necessary. Seek the advice of a trained medical professional.

Concussions are classified into five grades, as follows.

Grade I: Involves only confusion.

Grade II: Involves anterograde amnesia of less than five minutes as well as confusion.

Grade III: Involves the Grade I and II symptoms as well as retrograde amnesia and unconciousness lasting up to 5 minutes.

Grade IV: Involves the Grade I, II, and III symptoms as well as unconciousness lasting 5-10 minutes.

Grade V: Same as Grade IV, except unconciousness lasts longer than 10 minutes.

Treatment: The best recovery technique is rest. The best course of action varies with the severity of the concussion, and a trained medical professional should be consulted for guidance.

Treatment: Dislocated shoulders are treated by placing the ball of the humerus back into the socket of the scapula (also know as the glenoid fossa). This process, which is known as ‘manipulation and reduction’ (M&R) is usually accompanied by an x-ray to ensure that the reduction didn’t result in a fracture. The arm is then immobilized in a sling for several days, during which time most doctors recommend icing the should 3-4 times/day. Rehabilitaion involves exercises to restore strength and range of motion. Because ligaments may have been stretched or torn, a previously dislocated shoulder is often susceptible to re-injury. Severe or repeated dislocations might require surgical repair to tighten or re-attach stretched or torn ligaments.

Treatment: Rest and avoiding the sports/activities that caused the problem in the first place followed by a gradual return to activity is the first line of defense against runner’s knee. Lower impact cross-training activities such as swimming can be used to maintain fitness while resting the knee(s). Unlike damage from arthritis, the body is thought to be able to repair damage due to chondromalacia. In cases where runner’s knee doesn’t respond to conservative treatment, surgery may be indicated. In some cases, the problems are caused by anatomical mis-alignments that can be corrected.

Shoulder separations are classified into one of six types, as follows.

Type I: Injury to the capsule that surrounds the AC joint. The bones do not move out of position, and the primary symptom is pain.

Type II: Injury to the AC joint capsule as well as a partial tear of the coracoclavicular ligament. Patients with a Type II separation may have a small bump over the injury.

Type III: Same as Type II, but more severe. Patients with a Type III separation usually have a large bump over the injured AC joint.

Type IV: An unusual type of separation where the clavicle is pushed behind the AC joint.

Type V: An exaggerated Type III injury, wherein the muscle above the AC joint is punctured by the end of the clavicle, resulting in a significant bump.

Type VI: an exceedingly rare injury wherein the clavicle pushes downward and become lodged below part of the scapula (the corocoid).

Treatment: The recommended course of treatment depends on the severity of the injury. Conservative treatment, involving rest and wearing a sling until the ligament heal, is the simplest option. Ice may help reduce the pain and swelling, and physical therapy can be used to increase range of motion and strength. Most shoulder separations heal within 2-3 months without complications, but in the case of severe injuries, surgical repair may be indicated. Seek the advice of a trained medical professional.

Treatment: A torn rotator cuff needs to be evaluated by a trained medical professional to determine if surgery is needed; if left untreated, large tears can lead to arthritis due to inflammation of the joint. A torn rotator cuff surgery can often be repaired via arthroscopic surgery. Recovery then involves medication to reduce inflammation and physical therapy to improve strength and range of motion.

Most ruptures occur during a forceful stretch of the Achilles tendon while the calf muscles contract. A rupture is especially likely to occur if the foot is ‘dorsiflexed’ (i.e., the toes are drawn away from the ground, up toward the shin) while the lower leg moves forward and the calf contracts.

Treatment: Partial tears are sometimes treated by surgery followed by time in a cast. A completely ruptured Achilles tendon requries surgery followed by up to 12 weeks in a cast. Since the tendon shortens as it heals, a heel lift is typically used for six or more months starting when the cast comes off. Physical therapy is also initiated at that point to help restore flexibility and strength.

Treatment: Treat the injury following the R.I.C.E. regimen. Anti-inflammatories can be used to reduce pain and inflammation. Once swelling and pain subsides, a stretching program can be initiated. The injured muscle should ultimately be rehabilitated through a strengthening program to prevent re-injury.

Pulled hamstrings can best be avoided via proper stretching/warm ups, as well as post-workout stretching. In the case of a severe injury, seek the opinion of a trained medical professional.

Treatment: Groin pulls should be treated following the R.I.C.E. regimen. Avoid potentially aggravating activity for 1-2 weeks following the injury, and once you resume activity, ice the affected region following exercise to reduce swelling. Anti-inflammatory medications can be used to reduce pain and inflammation for up to a week following the injury. Once inflammation subsides, begin a stretching program followed by a low-intensity strengthening program.

Pulled groins can best be avoided via proper stretching/warm ups, as well as post-workout stretching. In the case of a severe injury, seek the opinion of a trained medical professional.