Sports Injuries & Return to Sport: who to see and what helps

Sports Injuries & Return to Sport · Kitchener, Waterloo & Cambridge

A sports injury can be sudden, like a sprain, a strain or a blow to the head, or it can build up from overuse. Most sprains and strains feel better within about two weeks, but getting back to your sport takes longer, and a 2016 international consensus statement gives functional testing an important role in deciding when. Check the urgent signs below first. Otherwise start with a physiotherapist or a chiropractor, who assess and treat at the first visit.

What counts as a sports injury

Among the sudden injuries, a sprain is a torn or twisted ligament, most often at the wrist, ankle, thumb or knee, and a strain is an overstretched or torn muscle.

The consensus statement describes return to sport as a continuum with three stages: return to participation (rehabilitation or training, perhaps modified, at a level below your goal), return to sport (back in your sport but not yet performing as you want to) and return to performance (at or above your pre-injury level).

Signs of a sprain or strain

• Pain, tenderness or weakness, usually around the ankle, foot, wrist, thumb, knee, leg or back
• Swelling or bruising
• Not being able to put weight on the injury or use it normally
• Muscle spasms or cramping

Common sports injuries, with a page on each

• Ligaments (sprains). Ankle Sprains, High Ankle Sprain, Knee Sprains (MCL & LCL), ACL & PCL Injuries, Thumb Sprains & Skier’s Thumb, Wrist Sprains, UCL Injuries & Tommy John Rehab and AC Joint Separation.
• Muscles (strains and soreness). Muscle Strains & Bruises, Hamstring Strain & Tendinopathy, Quad Strain, Calf Strain, Groin Strain, Hip Flexor Strain and Sports Hernia, and Muscle Soreness (DOMS).
• Overuse. Tendonitis & Tendinopathy links to each tendon page, including Achilles Tendon Rupture. See also Runner’s Knee (Patellofemoral Pain), IT Band Syndrome, Shin Splints and Stress Fractures.
• Joints. Meniscus Tears, Shoulder Dislocation & Instability, Shoulder Labral & SLAP Tears, Hip Labral Tear and Kneecap Instability & Subluxation.
• Head. Concussion.

When a sports injury needs urgent care

Call 911 or go to an emergency department, and do not drive yourself, if you heard a crack when the injury happened; the injured part has changed shape or points at an odd angle; it is numb, tingling or has pins and needles; or the skin around it has turned blue or grey or feels cold to the touch. You may have broken a bone and need an X-ray.

Hip, groin and shoulder injuries follow a stricter rule. If the pain is in the hip or groin, call 911 or go to an emergency department when it is severe after a fall or injury, when you cannot walk or put weight on the leg, or when you have any tingling or loss of feeling in the hip or leg after an injury. If you have injured a shoulder, go to an emergency department when you cannot move the arm, when the shoulder looks out of place or has changed shape, or when it is painful, bruised or swollen. Do not try to push it back in, do not drive yourself, and call 911 if you have no safe way to get there. Hip Pain and Shoulder Pain have the full lists.

Call 911 or go to an emergency department, too, for sudden, severe pain in a muscle. It may be worse when the muscle is stretched and may come with swelling, tightness, numbness, weakness, pins and needles or difficulty moving the area. Do the same after exercise for muscle cramps, aches or pains that are more severe than you would expect, dark urine the colour of tea or cola, or feeling too weak or tired to finish a workout you could manage before. Muscle Soreness (DOMS) explains both emergencies and has the full list of signs.

The emergency departments in Waterloo Region are:

• WRHN @ Midtown (formerly Grand River Hospital), 835 King St. W., Kitchener
• WRHN @ Queen’s Blvd. (formerly St. Mary’s General Hospital), 911 Queen’s Blvd., Kitchener
• Cambridge Memorial Hospital, 700 Coronation Blvd., Cambridge

If you cannot get there safely, call 911.

After a blow to the head or body, treat any of Ontario’s concussion “red flags” as an emergency and call 911: neck pain or tenderness; double vision; weakness or tingling in the arms or legs; a severe or increasing headache; a seizure or convulsion; loss of consciousness; vomiting more than once; increasing restlessness, agitation or aggression; or growing confusion. Without red flags, a suspected concussion still means leaving the game or practice, even if you feel OK, and being checked by a physician or nurse practitioner. Concussion has what to watch for in the hours and days afterward.

Get medical care the same day, from a physician, a nurse practitioner, an urgent care clinic or an emergency department, if the injury is very painful or the pain is getting worse; there is a large amount of swelling or bruising, or either is getting worse; you cannot put any weight on it or walk more than a few steps; it feels very stiff or is difficult to move; or you have a very high temperature or feel hot, cold or shivery, which could be an infection. A hip, groin or shoulder injury comes under the stricter rule above first: there, severe hip or groin pain, not being able to put weight on the leg, and a painful, bruised or swollen shoulder are emergency signs. See a physician or nurse practitioner if it is not feeling any better after you have treated it yourself.

These lists follow NHS advice and Ontario’s concussion resources, using Ontario’s routes to care. None of these signs should wait for an appointment with us.

What the evidence says about recovery and return to sport

• Readiness is tested, not timed. The consensus statement says the time it takes to return varies independent of the type and severity of injury, and that functional and sport-specific tests play an important role in the decision. Workload may be linked to re-injury, so it should be taken into account. The statement acknowledges that research to support these decisions is scarce.
• The decision is shared among the athlete, the treating clinician and other stakeholders such as coaches, parents and managers, except where there is a health risk to the athlete.
• Confidence is part of it. In a review of 11 studies (983 athletes), motivation, confidence and low fear were associated with a greater likelihood of returning to the pre-injury level, and sooner. The review calls its evidence preliminary, and it shows a link, not the effect of any treatment.
• Preventing the next one. A meta-analysis of 25 trials of exercise programs (26,610 participants) included four trials of strength training, in which injuries fell to less than a third, and three of stretching, which showed no benefit. Across the six trials that counted overuse injuries, exercise programs almost halved them. The authors say strength training needs further research across a wider range of injuries.
• Sports massage. Across 29 randomized studies (1,012 participants) there was no evidence that massage improves strength, jumping, sprinting, endurance or fatigue; it may somewhat improve flexibility and muscle soreness.
• Eating for recovery. A 2020 practical guide, not a systematic review, warns that eating too little while injured is likely to make matters worse and says alcohol should be avoided. It finds the evidence for supplements mixed.

What a doctor may offer

CARESPACE does not provide these: casts, MRI scans, which are arranged through a physician or nurse practitioner, prescription medication, surgery, and medical clearance to return to sport after a concussion.

How each CARESPACE service treats a sports injury

Physiotherapy

A physiotherapist can work out which structure is injured, set what to protect in the first days, and build the exercise program from first movement to sport-specific drills, with the functional testing that informs a return. Our Sports Injury page has more.

See our physiotherapy team →

Chiropractic

A chiropractor can assess an injured joint or muscle, treat it by hand and prescribe exercise. None of the reviews here tested joint manipulation for sports injuries as a group; the pages on individual injuries say where it has support.

See our chiropractic team →

Massage Therapy

A Registered Massage Therapist comes in after the first couple of days: the NHS advises avoiding massage on a fresh sprain or strain until then. What it can and cannot be expected to do is in the evidence list above.

See our massage therapy team →

Kinesiology

A kinesiologist can run the strength and conditioning that carries you from pain-free to match-fit, adding load in steps. Strength training of this kind has support for preventing injuries in a small number of trials.

See our kinesiology team →

Mental Performance

A mental performance consultant can work with you on confidence, motivation and fear of re-injury. The review above links these to getting back; it did not test whether coaching changes who returns.

See our mental performance team →

Nutrition

A Registered Dietitian can plan energy and protein intake for healing and for the return to full training, and can go through any supplements you are considering. Our Sports Nutrition page has more.

See our nutrition team →

Personal Training

Personal training is fitness coaching, not injury treatment. It fits after rehabilitation, for an ongoing strength program.

See our personal training team →

Where most people start

With a physiotherapist or a chiropractor. A suspected concussion goes to a physician or nurse practitioner first, and any urgent sign above means medical care first. For a child or teenager, ask when you book who sees younger athletes.

How your team works together

Your physiotherapist or chiropractor leads while the injury is being treated; massage therapy can join after the first days. As you return to participation, a kinesiologist can build strength and sport-specific fitness, a dietitian can match your eating to the workload, and a mental performance consultant can help if confidence holds you back. After that, a strength program with a kinesiologist or a personal trainer can be the prevention plan.

Browse by service: physiotherapists, chiropractors, registered massage therapists, kinesiologists, mental performance consultants, registered dietitians and personal trainers.

What to expect at your first visit

1. How it happened. You may be asked about the moment of injury or the build-up, and about your sport and level, whether that is house-league hockey, varsity rugby or a Sunday running group.
2. The examination of the injured area and how you move.
3. What it is, and whether an X-ray or a physician’s opinion is needed first.
4. Treatment at that visit, and a staged plan, including what you can still train now.

What you can do at home

• Protect the injury with a support, and stop the activity; try not to put weight on it.
• Ice it for up to 20 minutes every two to three hours, with the ice pack wrapped in a towel.
• Wrap it with a bandage for support during the day, and keep it raised on a pillow as much as possible.
• Avoid heat, such as hot baths and heat packs, alcohol and massage for the first couple of days.
• Start moving it when pain allows.
• Ask a pharmacist about pain relief.

How long it takes

Most sprains and strains feel better after two weeks. Strenuous exercise such as running should wait up to eight weeks, because of the risk of further damage, and severe injuries can take months to get back to normal. Beyond that there is no single answer; the pages on individual injuries give their own timelines.

Sports injury treatment in Kitchener, Waterloo and Cambridge

Kitchener. Physiotherapy in Kitchener, Chiropractor in Kitchener, Massage Therapy in Kitchener, Kinesiology in Kitchener, Mental Performance in Kitchener, Nutritionist & Dietitian in Kitchener and Personal Trainer in Kitchener. Locations: Victoria North, Fischer-Hallman, Westmount East and Deer Ridge.

Waterloo. Physiotherapy in Waterloo, Chiropractor in Waterloo, Massage Therapy in Waterloo, Kinesiology in Waterloo, Mental Performance in Waterloo, Nutritionist & Dietitian in Waterloo and Personal Trainer in Waterloo. Locations: Weber North, Uptown Waterloo and Waterloo GoodLife.

Cambridge. Physiotherapy in Cambridge, Mental Performance in Cambridge and Nutritionist & Dietitian in Cambridge. Locations: Hespeler Road.

The city pages linked above show the locations and practitioners for each service, with their next availability.

Common questions

Should I see a physiotherapist or a chiropractor for a sports injury?

Either. Both assess the injury, treat it at that visit and set exercises.

When can I play again?

There is no fixed date. The 2016 consensus statement says return time varies independent of the type and severity of injury, so readiness is judged with functional and sport-specific tests, and the decision is a shared one.

I am cleared to play but nervous about getting hurt again. Is that normal?

Yes. Fear is a prominent emotion at the time of returning to sport, and confidence and low fear go with getting back to the previous level. Mental performance coaching is where to take it.

Who can clear me to play after a concussion?

In Ontario, a physician or a nurse practitioner. Under Rowan’s Law they are the only health care providers who can medically assess an athlete and confirm medical clearance to return to amateur competitive sport.

Where can I get a sports injury treated in Cambridge?

Book Physiotherapy in Cambridge, Mental Performance in Cambridge or Nutritionist & Dietitian in Cambridge, or call 519-208-2273 and our Central Reception Team will find the closest location with an opening.

Do I need a referral?

No. Book online or call 519-208-2273. You pay at each visit and receive a receipt for your extended health plan. More on fees and insurance →

Sources

• Ardern CL, Glasgow P, et al. 2016 Consensus statement on return to sport from the First World Congress in Sports Physical Therapy, Bern. British Journal of Sports Medicine, 2016;50(14):853.
• Lauersen JB, Bertelsen DM, Andersen LB. The effectiveness of exercise interventions to prevent sports injuries: a systematic review and meta-analysis of randomised controlled trials. British Journal of Sports Medicine, 2014;48(11):871.
• Ardern CL, Taylor NF, Feller JA, Webster KE. A systematic review of the psychological factors associated with returning to sport following injury. British Journal of Sports Medicine, 2013;47(17):1120.
• Davis HL, Alabed S, Chico TJA. Effect of sports massage on performance and recovery: a systematic review and meta-analysis. BMJ Open Sport & Exercise Medicine, 2020.
• Smith-Ryan AE, et al. Nutritional Considerations and Strategies to Facilitate Injury Recovery and Rehabilitation. Journal of Athletic Training, 2020;55(9):918-930.
• Government of Ontario. Rowan’s Law: concussion awareness resources (updated January 2026) and Rowan’s Law: concussion safety (updated August 2026).
• NHS. Sprains and strains. Reviewed April 2024.
• NHS. Hip pain in adults. Reviewed November 2025.
• NHS. Dislocated shoulder. Reviewed September 2026.
• NHS. Compartment syndrome. Reviewed September 2026.
• U.S. Centers for Disease Control and Prevention (NIOSH). Rhabdomyolysis: signs and symptoms. Published May 2024, updated October 2026.

Related conditions

Fracture Rehab

Knee Pain

Shoulder Pain

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