The answer depends on several factors such as the specific sport, position played, and acute versus chronic injuries.

In terms of acute injuries, sprains (stretching/tearing of a ligament) are extremely common in sports. Sprains of the ankle are common and can be managed conservatively in most cases.  A common mistake we see is overlooking an appropriate rehabilitation program.  We often see recurrent sprains and ankle laxity in those athletes not undergoing rehabilitation.

In terms of chronic/overuse injuries we often see patellofemoral pain syndrome.  This condition can often be secondary to training errors and/or muscular imbalances around the lower extremity.

This is not true and in fact can be detrimental to the athlete and their recovery. We advise an appropriate level of activity during recovery from concussion.  We have also found that the level  of activity prior to the concussion can help dictate when to start exercise.

Stress fractures of the lower extremity are common.  Although not an absolute, the typical pattern is a low-grade pain which increases with activity and over time evolves into increased pain that can be present throughout the day even without exercise.  Pain at night or the first thing in the morning when getting out of bed is worrisome for stress fracture.

Ideally there is a balance between workload and recovery.  Workload includes training and competition.  In overtraining there is not enough recovery for the workload sustained.  Most athletes will see a decline in athletic performance which results in an increased effort (workload) to improve performance.  Unfortunately, this leads to worsening performance as there is even less ability to recover.  We refer to this situation as “athlete quicksand” where increasing the training effort results in a worsening performance. Treatment involves identifying the causes for poor recovery and making the appropriate modifications to training.

Sports that emphasize extension of the back (bending backwards) include gymnastics as well as figure skating.  Other extension activities include back squats in weightlifting and offensive linemen in American football.  When the back is repeatedly extended stress fractures can occur. Although not all low back pain results from stress fractures, we believe these athletes should be evaluated, especially in the pediatric age group where these injuries are commonly seen.

No, there is no magic number of concussions that necessitate retirement. Each concussion is as unique as the individual that suffers the injury.  For this reason, we customize the treatment of the athlete.  The same is true in the uncommon situation where retirement is considered.  Retirement is not taken lightly, and a detailed discussion is necessary. Fortunately, with appropriate management of concussions discussions of retirement are rare.