5 Most Common Sport Injuries — What to Do Before Your First Visit

The five injuries we see most — and what actually helps

These are the injuries that fill our schedule at Medstar every week. What follows is the clinical reasoning that goes into our first assessment for each — the pattern recognition, the early management decisions, and the mistakes that slow recovery down. The full guide goes deeper, but the core reasoning is here.

1. Rotator cuff pain — the tear you may not have

Shoulder pain with overhead activity does not equal a rotator cuff tear. The most common presentation we see is subacromial pain syndrome — a movement and load-tolerance problem, not a structural failure. The distinction matters because the management is opposite: a load program for tendinopathy, careful progressive return for a confirmed partial tear, surgical referral for a complete rupture. We use specific orthopaedic testing and load-response to tell them apart before ordering imaging. MRI in asymptomatic adults over 60 shows rotator cuff pathology in roughly 50% of shoulders — imaging alone rarely answers the clinical question.

2. Runner's knee — rest is usually the wrong call

Patellofemoral pain (PFP) is the anterior knee ache that gets worse going downstairs, sitting for long periods, and on descents. Rest settles the pain but does nothing for the capacity problem that caused it. The evidence for PFP consistently points to hip and quadriceps strengthening — not taping, not orthoses, not rest. The first week of management is about reducing provocation enough to load. The following six weeks are about building the capacity the knee was missing.

3. Low back flare-ups — the 48-hour window

Acute low back pain is the second most common reason people miss work after the common cold. The evidence-based message that most patients don't get: early movement predicts faster recovery, and prolonged bed rest predicts worse outcomes. The clinical goal in the first 48 hours is to identify the small percentage of cases with red flags (saddle anaesthesia, bladder dysfunction, progressive neurological deficit) that need same-day imaging, while moving everyone else toward controlled, graded activity. For the majority of mechanical low back pain, a physio can assess, reassure, and set up an early-mobility plan in a single session.

4. Ankle sprains — the recovery shortcut

The Ottawa Ankle Rules exist so clinicians can rule out fracture without X-ray in the majority of ankle sprains. If you can bear weight immediately after and at the clinic, and there's no bony tenderness at the malleoli or base of the 5th metatarsal, a fracture is unlikely. Most lateral ankle sprains in fit adults can begin weight-bearing rehab within 24–48 hours. The part most people miss: proprioceptive training. Strength returns quickly; balance and joint position sense lag behind — and that lag is what sets up re-sprains. We build it back deliberately before return to sport.

5. Plantar fasciitis — why your morning steps hurt

The characteristic first-step pain after sleep or prolonged sitting is a load-tolerance problem, not an inflammatory condition in the traditional sense. The fascia has failed to adapt to cumulative load — typically a change in training volume, footwear, or surface. The fix is a graduated load program (heavy slow resistance calf work, specifically) rather than rest and passive treatment. High-power laser therapy, which we use at Medstar, has published evidence for plantar fasciitis specifically as an adjunct to loading, not a replacement for it. Complete rest typically produces short-term relief and long-term recurrence.

The full guide goes through each injury with specific timelines, what to avoid, warning signs that mean you need imaging, and first-session protocols. Download it above, or book an assessment at our North Vancouver clinic.