Inflammation and Injuries: What Could be Causing Recurring Issues

That nagging case of tendinitis has flared up again, throwing you off your game and keeping you away from the sport you love. These recurrent injuries (injuries that repeatedly affect a specific area of the body) can particularly affect people who compete in a single sport, such as elite-level athletes. Although there aren’t any definitive studies on the topic, a recent Sports Med Open analysis determined the rate of recurring injuries among world-class athletes ranged from 5% to 21%.

Sports injuries have a myriad of different causes. Inflammation issues are common triggers for all kinds of injuries, including recurring ones. Inflammation is the body’s typical response to injury or trauma, and it isn’t a bad thing in and of itself, says Shervin H. Shaffiy, MD, MSc., of St. George’s University School of Medicine. Shaffiy is also the CEO of S&S Wellness & Aesthetics and president and founder of Eco-Medical Solutions.

“Inflammation helps fight off infection and it also promotes healing using white blood cells along with other immune cells,” Dr. Shaffiy says. “Inflammation starts once a foreign invader is detected. White blood cells release chemicals to protect the body, leading to increased blood flow (i.e. swelling).” 

Dr. Shaffiy adds that the swelling can be acute, lasting only a few days, or it can be chronic, or long-lived. The latter type of inflammation can weaken muscle strength and range of motion over time. The affected muscle can’t function properly, which increases the risk of recurrent injury. Recognizing common inflammatory sports injuries and sources of inflammation is critical for preventing multiple injuries.

Typical Sports Injuries Involving Inflammation

Some of the most common sports injuries involve sprains, broken bones, or dislocations. Many others involve inflammation. These include:

  • Tendinitis (inflamed tendons)
  • Fascitis (inflamed tissues supporting tendons and muscles)
  • Arthritis (inflamed joints)
  • Synovitis (inflamed joint membrane)
  • Bursitis (inflamed bursa sacs between joints and bones, muscles and tendons)

Because these injuries have inflammation in common, they share many of the same symptoms. You may feel an ache or pain in the affected area, and swelling appears as the body’s immune response kicks in. The skin at the injury site may also turn red, while the muscle or tendon underneath may feel stiff, limiting your movement there. Dr. Shaffiy adds that in some cases you may experience flu-like symptoms such as fever, chills, fatigue, loss of appetite, and headaches.

Typical treatment for these types of injuries aims to reduce the symptoms of inflammation. Usually, that involves the RICE treatment:

  • Rest by keeping weight off the area and limit movement as much as possible.
  • Ice the affected area with a gel ice pack or something similar. It’s often recommended to ice the injury for 20 minutes every three to five hours in the three days after an injury.
  • Compress the injured body part by wrapping it in a bandage. Numbness, pain, or tingling are tell-tale signs you’ve wrapped the bandage too tightly. 
  • Elevate the injury as you rest it, keeping it above heart level if possible. 

Physical Therapy and Sports Performance Services at the MidAmerican Energy RecPlex


However, there is some concern that RICE, specifically icing, prolongs injury because it inhibits the inflammatory immune response. This school of thought proposes that inflammation “is not an undesired outcome that needs to be reduced or delayed, but rather an instantaneous defense mechanism with the primary objective of controlling the extent of cell injury and preparing the tissue for the process of repair,” according to The Sport Journal.

Another traditional treatment method incorporates nonsteroidal anti-inflammatory drugs (NSAIDs). A recently published meta-analysis in the journal Sports Medicine-Open stated that NSAIDs are the most common medication used by athletes. However, this review of the scientific literature on the subject found there wasn’t enough evidence available on how NSAIDs affect athletic performance and that more research needs to be done on the topic. 

In the case of recurrent injuries, it may be more important to address the cause of the injury, rather than the symptoms.

Methods for Preventing Multiple Injuries

Single-sport athletes are prone to overuse injuries, which often trigger inflammation. Stretching pre- and post-workout can help guard against injury, as can cross-training that mixes in low-impact moves and strength-based workouts.

Improper form can also lead to repetitive motions that cause injury. A personal coach or trainer can review your technique and pinpoint areas for improvement. Equipment and gear should also be properly fitted so they don’t negatively affect your form. 

An innovative method for guarding against recurring injuries is cortisol testing. The body produces the stress hormone cortisol in the adrenal cortex as a normal part of the fight-or-flight response; when the perceived threat goes away, so does the increase in cortisol.

The problem occurs when you have too much stress in your life. This puts the body in constant fight-or-flight mode, which means your cortisol is perpetually elevated. At normal levels, cortisol has positive anti-inflammatory benefits. But when cortisol is always high, this dysfunction can lead to pain and inflammation, as well as immune system suppression, muscle mass breakdown, and other factors that can make injury recovery more difficult. What’s worse is that an injury can add even more stress to an athlete’s life, which in turn prolongs the recovery period.

Relaxation techniques such as deep breathing and mindfulness meditation can help eliminate chronic stress and lower cortisol to desirable levels. It’s also helpful to monitor your cortisol levels to determine if that’s the source of your recurring injuries. An at-home stress test is a simple tool you can use to track cortisol anytime you want. These tests typically involve a simple blood sample and the results can tell you if it’s time to adopt lifestyle changes that reduce your daily stress level.

Don’t let the same injury keep bringing you down. When you address the reason behind your sports injury — and not just the symptoms — you have a better chance of making a full recovery. 


Medically Reviewed by Shervin H. Shaffiy, MD, MSc, CEO of S&S Wellness & Aesthetics, President & Founder of Eco-Medical Solutions and Board Member at True Marker.