This or that? Conditions that mimic common sports injuries

From sprains to tendonitis, you’ve probably heard about — or even experienced — some of the most common sports-related concerns. While these familiar orthopedic injuries are possible when you’re having symptoms, they aren’t always the cause.

“It’s relatively common for patients to think they have one problem only for us to discover it’s something else,” says Michael Adams, MD, a board-certified orthopedic surgeon at Total Orthopedics Sports & Spine. “It’s not unusual for a less common condition to mimic the common problem.”

From your shoulders all the way to your toes, here are some of the most common sports injuries and other conditions that mimic them.

Shoulders

Common condition: Bursitis

This inflammation in the sacs that help cushion your joint causes pain in the shoulder, especially with movement like lifting your arms overhead. It generally gets better with rest, ice and pain relievers.

Mimic: Rotator cuff injury

A rotator cuff injury also causes pain in the shoulder with movement, as well as weakness and inability to lift the arm. This type of injury typically needs additional treatment, from at-home care to therapy to surgery.

Mimic: Calcific tendonitis

Calcific tendonitis happens when calcified deposits build up in the rotator cuff tendons. “This calcification develops in the rotator cuff for an unknown reason,” Dr. Adams says. “It’s much more intensely painful and can come on relatively quickly.” An X-ray often helps diagnose the condition because the deposits show up as bright spots.

Elbows

Common condition: Tennis elbow

One of the most well-known sports injuries in the elbow is tennis elbow. Often caused by chronic overuse in sports that use a racquet, this injury is inflammation and sometimes small tears in the tendon on the outside of the elbow.

Mimic: Radial tunnel syndrome

This condition is actually caused by a nerve in the arm that’s being compressed. Radial tunnel syndrome causes tenderness and weakness in the elbow and sometimes numbness or pain in the forearm.

Mimic: Ulnar collateral ligament injury

Overuse of the elbow can lead to a ligament injury, which is common in throwing athletes, like pitchers. “We see this in younger athletes who are throwing too much for their age or throwing the wrong kind of pitches,” Dr. Adams says. “Younger athletes who have middle elbow pain shouldn’t be ignored because it can be a severe injury.”

Wrists

Common condition: Sprain

Wrist sprains are typically minor injuries that happen when you bend or land on your wrist, causing the ligaments to stretch or slightly tear. You may have tenderness, bruising or swelling with a wrist sprain.

Mimic: Scaphoid fracture

A fall in sports might also cause a scaphoid fracture, which is a break in the small cashew-shaped bone at the base of your thumb. “Even X-rays may not show the fracture early on,” Dr. Adams says. “But recognizing this injury is important because it doesn’t heal well without treatment.”

Mimic: Growth plate fracture

In kids, a fracture in the growth plate, an area of growing tissue at the end of the bones in the wrist, can mimic a sprain. “This rubbery cartilage can be fractured, and if it’s not displaced, it doesn’t show up on the X-ray,” Dr. Adams says. “We often make the diagnosis by the location of tenderness.”

Hips

Common condition: Bursitis

Like in the shoulder joint, inflammation in the fluid-filled sacs in the joint, called bursitis, is also common in the hip. It causes pain and tenderness on one side that may get better with rest and stretching.

Mimic: Labral tear

This injury is a tear in the cartilage in the hip joint. It’s usually caused by an extreme amount of motion in the joint during sports or a twisting injury. Unlike bursitis, a labral tear can cause more pain in the groin and sometimes a catching sensation.

Mimic: Pinched nerve in lower back

Hip pain may not be a hip injury at all. “Patients may feel pain in the hip, buttock and thigh when, in fact, it’s a problem with a pinched nerve in the low back,” Dr. Adams says. The source of the pain can be confirmed with imaging tests, like an MRI.

Knees

Common condition: Meniscus tear

Tears in the meniscus — a piece of rubbery cartilage in the knee — are common due to sports injuries or as a natural byproduct of aging. Some of these tears will heal with rest, at-home care, or physical therapy, but others need surgery.

Mimic: Arthritis

Especially in middle-aged to older adults who have signs of a meniscus tear, the real source of their pain may be early arthritis. “It’s important to focus not just on imaging but the whole patient,” Dr. Adams says. “Treating the meniscus will not alleviate the pain if arthritis is the cause.”

Mimic: Stress fracture

Another cause of knee pain is a stress fracture in the tibia or fibula, the two lower leg bones. This injury is most common in adults who are involved in impact activities like running. “People will think they have a sprain or meniscus tear, but it’s really a small fracture,” Dr. Adams says.

Ankles and feet

Common condition: Tendonitis

This inflammation in a tendon can happen in several different places. One of the most common causes is overuse, such as in a sport that has abrupt or repetitive motions of the foot and ankle.

Mimic: Morton’s neuroma

Morton’s neuroma causes a burning pain or numbness in the middle toes due to a pinched nerve that travels from the bottom of the foot to the toes. It’s usually worse while you’re on your feet or wearing shoes.

Mimic: Stress fracture in the sesamoids

People who think they have tendonitis might really have a stress fracture in the sesamoid bones, which are located at the base of the big toe. “Particularly in runners or those who play impact sports, these little stress fractures can sometimes be difficult to recognize,” Dr. Adams says.

Getting to the source of your pain

In the end, it’s important to pay attention to any aches and pains in your joints and visit your doctor to get an evaluation. These are only a few of the many orthopedic conditions that share similar symptoms. With a diagnosis from a professional, you can work together to decide the next steps in your care and get back to the sports and activities you enjoy.