A sprain, strain or overuse injury doesn't have to mean weeks on the couch. Here's how sports injuries are treated at our Palo Alto clinic, what to do in the first few days, and how to lower the odds of getting hurt again.
What the Research Says
The old playbook for sports injuries was simple: rest, ice, compress, elevate, and wait. A randomized trial in the BMJ put that to the test with 101 people who had sprained an ankle. Half followed standard rest and ice; the other half added structured therapeutic exercise in the very first week. That early sports injury rehab group had better function at both one and two weeks, and they were noticeably more active during that first week, walking more and spending more time on their feet.
Hands-on treatment adds to that. A multicenter randomized trial compared a home exercise program with manual therapy plus exercise, the core of chiropractic care for ankle sprains, and the researchers concluded the hands-on approach was superior. Restoring normal joint motion early seems to let the rehab exercises do their job better.
The research is just as strong on preventing sports injuries in the first place. A meta-analysis in the British Journal of Sports Medicine pooled 25 trials covering more than 26,000 athletes. Strength training cut sports injuries to less than a third, and overuse injuries were nearly halved by exercise programs. Stretching, by contrast, showed no protective effect at all, which is useful to know if you've been relying on a pre-run stretch to stay healthy.
Why Athletes Get Hurt
Most sports injuries aren't bad luck. They happen when load outpaces capacity. When training volume jumps faster than tissues can adapt, something gives. Runners who add mileage too quickly develop shin, knee, or foot pain. Tennis players who ramp up their match schedule start feeling it in the elbow or shoulder. Lifters who push intensity without enough recovery end up with irritated tendons or a tweaked back.
Movement patterns play a huge role too. A stiff ankle forces the knee to compensate. Weak hips let the knee collapse inward on every landing. A thoracic spine that doesn't rotate pushes extra strain into the lower back and shoulder during a golf swing or tennis serve. Treating the painful spot without fixing the pattern behind it is why so many injuries come back.
Who We See in Palo Alto
- The runner — Training for a half marathon, logging miles on the Dish and the Baylands. Knee pain, IT band irritation, shin splints, or plantar fasciitis show up just as the mileage peaks.
- The cyclist — Long climbs up Old La Honda and Page Mill. Neck, lower back, knee, and hip pain from hours locked in one position, often worsened by a bike fit that's slightly off.
- The racquet player — Tennis or pickleball several times a week. Shoulder, elbow, and wrist overuse from repetitive swings.
- The gym regular — CrossFit, Olympic lifting, or a heavy strength program. Back strains, shoulder impingement, and irritated tendons from high-intensity training.
Why Early Care Matters
The ankle sprain research reflects something we see with almost every sports injury: the early weeks set the trajectory. Start guided, progressive loading early and you tend to recover function faster and stay more active through the process. Wait it out on the couch and the injured area weakens, neighboring muscles tighten, and you lose the fitness you'd built.
Early care also helps you avoid the classic mistake of returning too soon. Feeling better isn't the same as being ready. A structured plan rebuilds strength and control before you return to full training, and given what the prevention research shows about strength work, that's the step that most lowers the odds of getting hurt again.
What You Can Do Today
Protect, don't immobilize. In the first day or two after an acute injury, ease off the activity that caused it and avoid anything that sharply increases pain. After that, gentle movement within a comfortable range is usually better than total rest.
Modify, don't stop. If running hurts, try cycling or swimming. If overhead work bothers your shoulder, focus on lower-body sessions. Keeping your fitness up while the injured area recovers makes the return much easier.
Look at your training log. Check whether your volume or intensity jumped in the weeks before the pain started. Spotting the spike helps you avoid repeating it.
Seek urgent care if you heard a pop with immediate swelling, can't bear weight, see an obvious deformity, or have numbness or weakness after an injury.
Your First Visit: What to Expect
Your initial appointment is a comprehensive 3-step process designed to move you from pain to performance. It is a paid visit, separate from the free consultation.
Medical history review, orthopedic and neurological testing, and biomechanical analysis to understand not just where it hurts, but why it hurts.
We sit down with you to explain what is causing your pain, our recommended recovery plan, and how long we expect your recovery to take.
When it is possible and safe to do so, we begin your first phase of therapy during your first visit: gentle spinal adjustments, manual soft-tissue therapy, or initial corrective exercises.