Sports injury clinic in Crows Nest: assessment, rehab and return to sport.

At a glance

• Most sprains, strains and overuse injuries do better with a short period of protection and early, graded loading than with long rest.²
• Strength training has the strongest evidence for lowering the risk of sports injuries in the first place.¹
• Some injuries need a doctor or imaging first. The red flags are listed below.

What does a sports injury clinic do?

It assesses an injury that came from sport or training, decides what is safe to do in the meantime, and plans the road back. The words "sports injury clinic" are not a qualification, so it is worth asking any clinic who you will see and what their training is.

At Chiro Central I am a chiropractor working inside PT Central at 455 Pacific Hwy, Crows Nest. That means assessment and hands-on care sit next to a gym floor where rehab can happen on the same day. Where an injury is better managed by a GP, a sports doctor or a physiotherapist, I will say so.

What sports injuries do I see?

Most of what comes through is common and unglamorous. Typical examples, with what I look at for each:

• Ankle sprains and ankles that keep giving way: ligament stress tests, balance, calf and hip strength.
• Hamstring, calf, quad and adductor strains: pain location, strength, sprint and stretch demands.
• Achilles, patellar and gluteal tendon pain: training load changes, tendon loading tolerance.
• Shoulder pain with pressing, overhead work or throwing: movement, strength, neck and upper back contribution.
• Knee pain in runners, lifters and field-sport players: load history, hip and thigh strength.
• Low back and hip pain from lifting and rotation sports: movement, load, nerve involvement.

What should I do in the first few days after a sports injury?

Protect the area briefly, keep gently moving what you can, and get assessed if you are unsure how serious it is. Healthdirect's current advice for sprains and strains is rest, ice, compression and elevation for a few days, then strengthening once healing begins.⁴

Some sports medicine authors now argue for a different emphasis, summarised as PEACE and LOVE. They suggest limiting rest to about one to three days, adding load early as symptoms allow, and questioning the routine use of ice and anti-inflammatory medication.² That paper is expert opinion, not a trial, so treat it as a direction the field is moving in, not settled fact. Ask your GP or pharmacist what is right for you if you are considering anti-inflammatory medication.

Both sources agree on one thing: prolonged rest is not the plan.

When should I see a GP or go to hospital?

See a doctor if you are unsure whether the injury is a fracture or dislocation, if the pain is severe, or if it is not improving within about a week.⁴ Call triple zero if you need urgent medical help.⁴

Also get medical advice before a clinic visit if there is an obvious deformity, you cannot put weight on the limb, or you have numbness, pins and needles or loss of strength that is new since the injury. Fever, a hot swollen joint or unexplained calf swelling and pain after an injury also need a doctor.

How do you assess a sports injury?

Assessment starts with how the injury happened and what your training has looked like for the last month or two, then moves to examination. I grade how severe the injury looks, test movement and strength, and decide whether imaging or a medical review would change the plan. The first visit runs for 45 minutes; fees and rebates are on the pricing page, and the first visit page walks through it.

Scans are not automatic. I refer for imaging when the examination suggests it would change what we do, not to find something to point at.

What might a chiropractor do for a sports injury?

A chiropractor might use hands-on care, exercise and advice together, with the exercise doing most of the long-term work. Options include:

• Hands-on techniques such as joint mobilisation, manipulation and soft tissue work, mainly to settle pain and make movement easier early on. The research on hands-on care for specific sports injuries is limited, so it is a way into the plan, not the plan.
• Dry needling in selected cases, alongside exercise. Trials in physiotherapy settings found it may reduce pain in the short term, with no long-term benefit shown.⁵ I go through the detail in the dry needling article.
• Taping and load advice so you can keep training what you can.
• Graded rehab: strength, tendon loading, then speed and change of direction.
• Referral to a GP, sports doctor, physiotherapist or surgeon when that is the better fit.

How do you decide when I can go back to sport?

Return to sport is a staged process with testing, not a date on the calendar. The 2016 consensus statement describes it as a continuum: return to participation, then return to sport, then return to performance, and says the decision should be shared, not made in isolation at the end of rehab.³

In practice I look at things like these, which are examples from clinic practice, not trial-derived cut-offs:

• Pain settled enough with everyday movement and the sport's basic movements.
• Strength on the injured side compared with the other side.
• Hop, sprint or change-of-direction testing where the sport needs it.
• Gradual exposure to training volume and speed before match play.

Can strength training stop sports injuries?

It is the best-supported prevention tool we have. A 2018 review pooled six trials with 7,738 participants aged 12 to 40 and found strength training programs were associated with about one third of the injury risk of comparison groups (relative risk 0.34, 95% confidence interval 0.24 to 0.48), with more strength work linked to fewer injuries.¹ That describes groups of people in studies, not a promise for any one person.

What you can do at home

• Keep moving within what is comfortable. Walking, bike or pool work usually suit when the injured area is painful to load.
• Avoid pushing through sharp or worsening pain.
• Keep training the parts that are not injured.
• Pick one change at a time when you return, such as volume or speed, not both.

Summary

A good sports injury clinic names the injury, protects it briefly, loads it early and tests before you go back. If you would like an assessment, book online or call +61 451 226 451. HICAPS is available on the spot.

This page is general information, not individual medical advice. Miles Prosser is a chiropractor, not a medical practitioner. If you are unsure about an injury, speak to your GP.

References

• Lauersen JB, Andersen TE, Andersen LB. Strength training as superior, dose-dependent and safe prevention of acute and overuse sports injuries: a systematic review, qualitative analysis and meta-analysis. Br J Sports Med. 2018;52(24):1557-1563.
• Dubois B, Esculier J-F. Soft-tissue injuries simply need PEACE and LOVE. Br J Sports Med. 2020;54(2):72-73.
• Ardern CL, Glasgow P, et al. 2016 Consensus statement on return to sport from the First World Congress in Sports Physical Therapy, Bern. Br J Sports Med. 2016;50(14):853-864.
• healthdirect. Sprains and strains (last reviewed June 2024).
• Gattie E, Cleland JA, Snodgrass S. The effectiveness of trigger point dry needling for musculoskeletal conditions by physical therapists: a systematic review and meta-analysis. J Orthop Sports Phys Ther. 2017;47(3):133-149.