Zusmanovich LP 21

Ankle Sprains in Young Athletes: When to Get Imaging

Avatar for adminUncategorized
Ankle sprains are one of the most common injuries in youth sports. Between soccer fields, basketball courts, football practices, and gymnastics gyms across Long Island, thousands of young athletes turn or roll an ankle every season. For most, the injury feels dramatic in the moment but resolves within a few weeks with rest, ice, and a return-to-play progression.
For some, though, a sprain masks a more serious injury—one that won’t improve with rest alone.
Knowing when a young athlete’s ankle sprain warrants imaging isn’t intuitive. Ankles are complex joints with multiple ligaments, bones, and growth plates, and the difference between a straightforward sprain and something more serious isn’t always visible from the outside. Getting it wrong in either direction has consequences: unnecessary imaging exposes young patients to costs and (in some cases) radiation, while missed injuries can turn into chronic instability, long-term joint damage, or worse.
Dr. Zusmanovich evaluates young athletes with ankle injuries every week across our West Babylon, Patchogue, Commack, and East Setauket offices. Here’s what parents, coaches, and young athletes should understand about when a sprained ankle actually needs a closer look.
Serving Long Island athletes at 4 convenient locations.

What Actually Happens During an Ankle Sprain

Most ankle sprains happen when the foot rolls inward (an “inversion” injury), stretching or tearing the ligaments on the outside of the ankle. The three ligaments most commonly involved are:
  • Anterior talofibular ligament (ATFL) — the most frequently injured
  • Calcaneofibular ligament (CFL) — often injured alongside the ATFL.
  • Posterior talofibular ligament (PTFL) — less commonly injured
Sprains are graded on severity:
Grade 1 (Mild) — Stretching of ligament fibers with minimal tearing. Mild swelling and tenderness, minimal instability, and usually resolves within 1-3 weeks.
Grade 2 (Moderate) — Partial ligament tearing. Moderate swelling, bruising, some instability, and typically requires 3-6 weeks of recovery.
Grade 3 (Severe) — Complete ligament tear. Significant swelling, extensive bruising, marked instability, and often requires 6-12 weeks or longer. May need surgical evaluation.
While most sprains fall into Grade 1 or 2, distinguishing them from more serious injuries — especially in young athletes with open growth plates — requires clinical judgment and, sometimes, imaging.

Why Young Athletes Are Different

Adult ankles and youth ankles are not the same, and this matters more than most people realize.
Open growth plates. Young athletes still have open growth plates (physes) in their ankle bones. Growth plates are made of cartilage and are structurally weaker than the surrounding bone. This means that in a young athlete, what appears to be a “sprain” can actually be a growth plate fracture — because the ligament pulled on the growth plate hard enough to fracture it before it stretched enough to tear.
Salter-Harris fractures — injuries involving the growth plate — are relatively common in young athletes with ankle injuries and can be missed on physical examination alone. If left untreated, they can cause growth abnormalities, limb length discrepancies, and long-term joint problems.
Different injury patterns. Young athletes tend to sustain avulsion fractures (small bone chips pulled off by ligaments) more often than adults. These may not be visible without imaging.
Reporting bias. Young athletes often minimize pain to keep playing. A high pain tolerance can mask a serious injury, and parents can miss warning signs when a child insists “it’s fine.”
Multiple potential injuries. A young athlete’s ankle sprain can coexist with a fibula fracture, a fifth metatarsal fracture, a talus injury, or an osteochondral defect — none of which are obvious without imaging.
For all these reasons, the threshold for imaging in young athletes is often lower than in adults.

When to Get Imaging: The Warning Signs

Not every ankle sprain needs an X-ray or MRI. In fact, imaging every sprain would create unnecessary cost and radiation exposure. But certain warning signs indicate that imaging is warranted.

Immediate Warning Signs (Consider Imaging Same Day)

Any of these signs suggest the injury may be more than a simple sprain and should trigger prompt medical evaluation:
Inability to bear weight — If the athlete cannot put weight on the ankle for more than 4 steps immediately after injury or in the emergency room, imaging is typically warranted. This is one of the clearest indicators from the Ottawa Ankle Rules—a widely used clinical decision guideline.
Bone tenderness in specific areas — Tenderness directly on the bone (not the surrounding soft tissue) at the:
  • Posterior edge or tip of either malleolus (the bony prominences on each side of the ankle)
  • Base of the fifth metatarsal (the outside of the midfoot)
  • Navicular bone (on top of the midfoot)
Significant deformity — Any visible deformity, angulation, or displacement of the ankle or foot.
Severe swelling within minutes — Immediate, dramatic swelling that develops within the first 30 minutes to an hour suggests a more significant injury than a simple ligament strain.
Numbness or tingling — Any nerve-related symptoms in the foot or toes.
Cold, pale foot — Signs of compromised blood flow (extremely rare but a genuine emergency).
Snap or pop at time of injury — An audible or felt “pop” often indicates ligament rupture or fracture.

Delayed Warning Signs (Consider Imaging Within 1-2 Weeks)

If any of these appear during recovery, imaging should be considered:
No improvement after 5-7 days — A simple sprain should show meaningful improvement within a week. Persistent significant pain or swelling suggests something more serious.
Ongoing inability to bear weight after 3-5 days — Most Grade 1 and mild Grade 2 sprains allow protected weight bearing within a few days.
Persistent pain over specific bony areas — Especially the growth plate regions in young athletes.
Repeat injury to the same ankle — Recurring sprains may indicate chronic instability or an underlying anatomical issue.
Symptoms worsening rather than improving
Locking, catching, or clicking sensations — May indicate an osteochondral injury (a piece of cartilage or bone knocked loose).
Feeling of instability — The ankle “giving way” during normal activity.

Sport-Specific Considerations

Certain sports create injury patterns that warrant a lower threshold for imaging:
Basketball, soccer, football — High rates of Grade 3 sprains and associated fractures.
Gymnastics and dance — Repetitive stress and high-impact landings create fracture risk.
Running and track — Stress fractures can mimic sprain symptoms.
Contact sports — Direct blows can cause combination injuries that pure ligament sprains don’t produce.

What Types of Imaging Are Used

Different imaging modalities serve different purposes:
X-ray — The first-line imaging study for suspected fractures. Effective for identifying most fractures, growth plate injuries, and dislocations. Low-cost and widely available.
MRI — More sensitive than X-ray for soft-tissue injuries. Detects ligament tears, cartilage damage, osteochondral defects, and bone marrow edema (early stress fractures). More expensive and time-consuming, typically not needed for straightforward sprains.
CT scan — Occasionally used for complex fractures. Provides detailed bone imaging but exposes the patient to more radiation than X-ray.
Ultrasound — Growing role in evaluating ligament injuries, particularly in specialized sports medicine settings.
An experienced sports medicine orthopedic surgeon will determine which (if any) imaging is appropriate based on the specific injury pattern.

Why Missed Injuries Matter

The consequences of missing a serious ankle injury in a young athlete can extend far beyond the initial healing period.
Growth abnormalities. Untreated growth plate injuries can cause the affected bone to stop growing normally, leading to limb-length discrepancies or angular deformities that may not become obvious for years.
Chronic instability. Ligament injuries that don’t heal properly can lead to recurring sprains, ankle looseness, and long-term joint problems.
Early arthritis. Unrecognized cartilage damage can accelerate ankle arthritis, sometimes appearing in patients as young as their 20s and 30s.
Missed fractures. Small avulsion fractures or stress fractures can worsen with continued activity, potentially requiring more invasive treatment later.
Return-to-sport delays. Athletes who return to play too quickly on an incompletely healed injury are far more likely to re-injure the same ankle, often more severely.
Getting the right diagnosis at the start doesn’t just protect the immediate injury — it protects the athlete’s long-term joint health.

What Parents and Coaches Should Do

If a young athlete injures an ankle, here’s a practical framework:
Immediately:
  • Stop play immediately — do not “walk it off” for serious injuries.
  • Rest, ice, compression, elevation (RICE)
  • Assess weight-bearing ability
  • Check for the immediate warning signs listed above.
  • If any red flag signs are present, seek same-day medical evaluation.
  • If in doubt, get evaluated.
In the first 24-72 hours:
  • Continue RICE protocol
  • Use over-the-counter anti-inflammatories if appropriate (with parent/pediatrician guidance)
  • Monitor for worsening swelling, bruising, or pain.
  • Encourage rest, not activity.
  • Schedule an evaluation with a sports medicine orthopedic surgeon if symptoms are moderate to severe.
In the first week:
  • Look for improvement — some improvement should be visible each day.
  • Do NOT allow return to sport without professional clearance.
  • Watch for delayed warning signs.
  • If no meaningful improvement by day 5-7, schedule an evaluation.
Before return to play:
  • Full pain-free range of motion
  • Strength restored (compared to uninjured side)
  • Balance and proprioception restored.
  • Ability to perform sport-specific movements without pain
  • Professional clearance

Common Mistakes to Avoid

Certain patterns lead to poorly-healed ankle injuries and long-term problems.
“Walking it off.” Continuing to play or practice on a fresh ankle injury dramatically increases the risk of worsening the injury or developing chronic instability.
Waiting too long to get evaluated. Delayed diagnosis of fractures or growth plate injuries can lead to lasting complications.
Rushing return to play. Athletes who return before they’re truly ready re-injure at 2-3x the rate of those who complete a proper progression.
Skipping physical therapy. Even Grade 1 sprains benefit from targeted rehabilitation to restore strength and proprioception and prevent re-injury.
Trusting the athlete’s own assessment. Young athletes underreport pain to keep playing. Objective assessment matters more than what they say.
Ignoring recurring “sprains.” Repeated ankle injuries in the same athlete often indicate an underlying issue that needs professional evaluation.

Frequently Asked Questions

When should a doctor see a child’s ankle sprain?
Any ankle sprain with inability to bear weight, significant bone tenderness, deformity, or severe swelling should be evaluated the same day. Sprains that don’t improve within 5-7 days, that produce persistent bony tenderness, or that involve repeat injury to the same ankle should also be professionally evaluated.
Do all ankle sprains need X-rays?
No. Most straightforward sprains do not require imaging. However, young athletes have a lower threshold for imaging than adults because growth plate injuries can be missed on physical exam.
How long does an ankle sprain take to heal in a young athlete?
Mild sprains typically resolve in 1-3 weeks. Moderate sprains take 3-6 weeks. Severe sprains can require 6-12 weeks or longer. Rushing return to sport is one of the biggest predictors of re-injury.
Can a young athlete play sports with a sprained ankle?
Not until the athlete has pain-free full range of motion, restored strength, restored balance, and clearance from a sports medicine specialist. Playing on an incompletely healed sprain dramatically increases re-injury risk.
What’s the difference between an ankle sprain and a fracture?
Sprains involve ligament injury; fractures involve bone injury. The two can occur together. Distinguishing them requires clinical evaluation and often imaging — they’re not always distinguishable based on symptoms alone.
Are growth plate injuries in ankles serious?
They can be. Untreated growth plate injuries can lead to growth abnormalities, limb length discrepancies, and long-term joint problems. This is why young athletes have a lower threshold for imaging than adults.
Should a young athlete see a pediatrician or an orthopedic surgeon after a bad ankle sprain?
For minor sprains, a pediatrician or urgent care can typically provide adequate care. For moderate to severe sprains, sprains with any warning signs, or injuries in competitive athletes hoping to return to play, a sports medicine orthopedic surgeon is often the more appropriate specialist.
What causes recurring ankle sprains in young athletes?
Recurring sprains typically result from incomplete healing of the original injury, inadequate rehabilitation, chronic instability, or underlying anatomical issues. A sports medicine specialist should evaluate athletes with recurring sprains.
How can we prevent ankle injuries in young athletes?
Prevention strategies include proper warm-up, appropriate footwear for the sport, ankle strengthening exercises, balance and proprioception training, and gradual increases in training intensity. Athletes with a history of prior sprains may benefit from ankle braces during high-risk activities.
What’s a sports medicine specialist and how do they differ from a general orthopedic surgeon?
Sports medicine specialists have additional fellowship training focused on athletic injuries. They typically have deeper expertise in return-to-play decision-making, sport-specific injury patterns, and treatment strategies for competitive athletes.

When to See a Sports Medicine Orthopedic Surgeon

Long Island athletes and their families should consider scheduling an evaluation if:
  • An ankle sprain hasn’t improved within 5-7 days.
  • Weight-bearing is still painful or impossible after 3-5 days.
  • Any of the immediate warning signs described above appear.
  • A young athlete is having recurring ankle sprains.
  • The athlete needs professional clearance to return to competitive play.
  • Parents want a definitive answer on whether the injury is “just a sprain” or something more serious.
Early evaluation typically leads to faster, more complete recovery—and can prevent the frustrating cycle of re-injury that comes from returning to play too soon.

Schedule an Evaluation With Dr. Zus Orthopedics

Dr. Mikhail Zusmanovich is a board-certified orthopedic surgeon and Castle Connolly Top Doctor with fellowship training at the Cedars-Sinai Kerlan-Jobe Institute — one of the country’s premier sports medicine programs. He has served as an assistant team physician for the LA Galaxy, LA Angels, Anaheim Ducks, and LA Sparks, giving him a unique perspective on athletic injuries at every level, from youth sports to professional athletes. Call today or schedule an appointment online. Get the right diagnosis. Get back to your sport safely.
Zusmanovich LP 1

Hip Labral Tear: Why Does My Hip Click and Catch — and What Can Be Done?

Avatar for adminUncategorized
You stand up after a long drive and your hip clicks. You pivot on the soccer field, and something catches deep in your groin. You bend to tie your shoe and feel a pinch that stops you mid-motion.
​
If any of that sounds familiar, it describes one of the most common presentations of hip pain in younger, active patients: a tear of the acetabular labrum.
​
It is also one of the most commonly missed. Hip labral tears get attributed to a groin pull that never quite heals, or a tight hip flexor, or simply getting older. Patients often spend months — sometimes years — stretching something that stretching will not fix.
​
Here is what is actually happening, and what the treatment path looks like.

What the Labrum Does, and Why a Tear Makes Noise

The hip is a ball-and-socket joint. The labrum is a ring of tough fibrocartilage that runs around the rim of the socket, and it does three important jobs:
​
  • Deepens the socket, adding stability to the joint
  • Creates a suction seal that keeps a thin layer of joint fluid pressurized between the ball and socket
  • Distributes load across the cartilage surface so no single area takes too much
When the labrum tears, the free edge of that tissue can become an unstable flap. As the hip moves through certain positions, the flap gets caught between the ball and the socket — and then releases.
​
That is the click. That is the catch.
​
The mechanical sensation is not imagined, and it is not the joint “cracking” the way knuckles do. It is tissue getting trapped where it should not be. The loss of the suction seal also changes how fluid pressure and load are distributed inside the joint, which is why a labral tear can ache even at rest.

Symptoms that Point Toward a Labral Tear

Not every hip that clicks has a torn labrum. But this constellation of symptoms is characteristic:​

  • Deep groin pain. Usually felt in the front of the hip or deep in the groin rather than on the outside. Many patients instinctively cup a hand over the side of the hip in a C shape when asked to point to the pain — clinicians call this the C-sign.
  • Mechanical symptoms. Clicking, catching, popping, or a sensation of the joint briefly locking.​
  • Pain that is positional, not constant. Prolonged sitting. Getting out of a low car seat. Putting on socks and shoes. Deep squats. Pivoting or cutting.
  • Stiffness and lost rotation. Particularly a loss of internal rotation compared with the other side.
  • A feeling of instability. Some patients describe the hip as unreliable, as though it may give way, especially during rotation under load.
​
What labral tears usually do not cause: pain that is worse at rest than with activity, pain that wakes you at night, or an inability to bear weight. Those warrant prompt evaluation for other causes.

Why the Labrum Tore in the First Place

This is the part that matters most for treatment, and the part most often skipped.
​
A labrum in a normally shaped, uninjured hip does not usually tear on its own. In the majority of young, active patients, the tear is a consequence of something else:​
  • Femoroacetabular impingement (FAI). This is the most common underlying cause. Subtle differences in bone shape — extra bone at the femoral head-neck junction (cam morphology), a socket that covers the ball too far (pincer morphology), or both — cause the bone to pinch the labrum repeatedly during hip flexion and rotation. Over thousands of cycles, the labrum fails.
  • Trauma. A hip dislocation, a fall, a motor vehicle accident, or a direct collision.
  • Repetitive high-demand motion. Hockey, soccer, lacrosse, golf, dance, martial arts, and distance running all load the hip in flexion and rotation. Dr. Zusmanovich treated athletes across these sports during his sports medicine fellowship at the Cedars-Sinai Kerlan-Jobe Institute, and the pattern is consistent.
  • Hip dysplasia. The opposite of pincer FAI — a socket that is too shallow, leaving the labrum to absorb load it was never designed to carry.
  • Degenerative change. In older patients, labral tearing can be part of early osteoarthritis rather than an isolated injury.
​
Why does this distinction matter? Because repairing a labrum without addressing the bone shape that tore it is how surgery fails. If cam impingement caused the tear, the cam has to be addressed in the same operation — otherwise the repair is loaded by the same abnormal mechanics that broke it the first time.

One Honest Caveat About MRI Findings

Labral tears show up on hip MRIs in a meaningful number of people who have no hip pain at all. The imaging finding alone is not the diagnosis.
​
This is worth emphasizing, because patients sometimes arrive with an MRI report reading “labral tear” and understandably assume surgery is the next step. It is not automatic. The diagnosis is made by putting the imaging together with a patient’s history and a careful physical examination — and confirming that the labrum is genuinely the source of the symptoms.

How a Labral Tear Gets Diagnosed Properly

History and physical examination. Specific provocative tests — the FADIR test (flexion, adduction, internal rotation) and the FABER test — reproduce impingement-type pain and help localize the problem to inside the joint.
​
X-rays first. Before any advanced imaging, plain films reveal bone shape, whether cam or pincer morphology is present, how much cartilage space remains, and whether arthritis is a factor. This step gets skipped surprisingly often, and it is the one that determines whether arthroscopy is even appropriate.
​
MRI, ideally an MR arthrogram. Contrast injected into the joint dramatically improves visualization of the labrum.
​
Diagnostic injection. When the picture is unclear, numbing medication placed inside the hip joint is a useful tiebreaker. If pain substantially improves for a few hours, the problem is inside the joint. If nothing changes, the search moves elsewhere — the hip refers pain from the spine, the SI joint, the abdominal wall, and the hip flexors, and all of those can mimic a labral tear.

Treatment: Starting With What Does Not Involve Surgery

Most patients with a hip labral tear begin with non-surgical management, and a meaningful number never need an operation.
​
Activity modification. Temporarily reducing the specific positions that pinch — deep flexion, deep squats, aggressive pivoting.
​
Targeted physical therapy. This is the centerpiece, and targeted is the operative word. Effective hip therapy emphasizes gluteal and core strength, hip abductor control, correcting pelvic position, and motor control through the mid-range. What it deliberately avoids is aggressive hip flexor stretching and repeated end-range hip flexion — the exact positions that irritate an impinging labrum. Many patients report that therapy made them worse, and when the program is reviewed, this is usually why.
​
Anti-inflammatory medication, where clinically appropriate.
​
Intra-articular corticosteroid injection. Both diagnostic and therapeutic, and in some patients it provides durable relief.
​
A reasonable trial is generally 8 to 12 weeks of structured, well-directed therapy. That is long enough to know whether the hip will settle down.

When Hip Arthroscopy Makes Sense

If a well-executed course of conservative care has not worked and the mechanical symptoms persist, arthroscopic surgery becomes a reasonable conversation.
​
Hip arthroscopy is performed through two or three small portals with a camera, on an outpatient basis. Depending on what is found, the procedure may include:
​
  • Labral repair. Reattaching the torn labrum to the socket rim with small suture anchors. This is preferred whenever tissue quality allows, because preserving the labrum preserves the suction seal.
  • Labral debridement. Trimming an unstable flap when the tissue is not repairable.
  • Labral reconstruction. Rebuilding a deficient labrum with a graft, in cases where too little healthy tissue remains.
  • Osteoplasty. Reshaping the cam bump on the femur, or trimming an over-covering acetabular rim, to eliminate the impingement that caused the tear. As noted above, this is often the difference between a repair that lasts and one that does not.
  • Capsular closure. Repairing the joint capsule to maintain stability.

Recovery, Realistically

  • Crutches for roughly one to three weeks
  • Physical therapy beginning within days of surgery
  • Return to running around three to four months.
  • Return to cutting and pivoting sports typically four to six months, sometimes longer.
  • Continued improvement for up to a year

Seeing a Hip Specialist in Patchogue

Hip labral tears reward early, accurate diagnosis. The longer an impinging hip grinds against an unstable labral flap, the more cartilage damage tends to accumulate — and cartilage is far less forgiving than labrum.
​
If your hip clicks, catches, or aches deep in the groin after sitting or activity, it is worth having it evaluated properly rather than stretching it for another six months.
​
Dr. Zusmanovich is a hip specialist in Patchogue who sees patients at 55 Medford Avenue, Suite E, as well as at three additional Suffolk County offices in West Babylon, Commack, and East Setauket. Every patient is evaluated and treated by Dr. Zusmanovich directly — the same physician who makes the diagnosis, performs any procedure, and follows the recovery through return to activity.
​
Zusmanovich LP 8

5 Summer Sports Injuries We See Most on Long Island — And How to Prevent Them

Avatar for adminUncategorized
Summer on Long Island means baseball diamonds, soccer fields, beach volleyball courts, golf courses, and more young athletes than ever pushing their bodies hard after months of winter inactivity. It also means our office sees a predictable surge in sports injuries, many of which could have been prevented with the right preparation and a little awareness.
Whether you’re a competitive athlete, a weekend warrior, or a parent watching your child play, this is your guide to the injuries we treat most from June through August, and what you can do to stay on the field all summer long.

1. Rotator Cuff Strains & Tears

Who we see: Baseball pitchers, swimmers, tennis players, and anyone returning to overhead activity after time off.
Summer is the prime season for shoulder injuries on Long Island, particularly among throwing athletes and swimmers who ramp up their activity quickly after the school year ends. The rotator cuff, the group of four muscles and tendons that stabilize the shoulder, is placed under significant stress during overhead movements, and it doesn’t take much to push an already fatigued or underprepared shoulder past its limit.
Symptoms to watch for:
  • Persistent shoulder pain, especially with overhead movement or throwing
  • Weakness when lifting the arm
  • Aching at rest or at night
  • Decreased velocity or endurance in throwing athletes
How to prevent it: The most important thing you can do is ease back in. Don’t go from zero to full intensity in the first week of the season. Build up gradually, prioritize a proper warm-up before throwing or swimming, and strengthen the rotator cuff with targeted exercises before symptoms develop. For pitchers, following age-appropriate pitch count guidelines and taking adequate rest between outings is non-negotiable.
If shoulder pain doesn’t resolve within a few days of rest, it’s worth getting evaluated. Rotator cuff injuries caught early, when they’re partial tears or strains, are far easier to treat than those that have been allowed to progress for weeks.

2. UCL Injuries (Tommy John) in Baseball Players

Who we see: Youth and high school pitchers, catchers, and position players, often after a busy spring season.
This is one of the most common and concerning injuries we treat on Long Island, particularly in the summer months when many young pitchers have just come off a demanding spring season and are jumping immediately into summer leagues and showcases without adequate recovery time.
The ulnar collateral ligament (UCL) on the inner side of the elbow absorbs an enormous amount of stress with every throw. When that stress accumulates faster than the body can recover, which is exactly what happens when athletes pitch year-round without rest, the UCL can fray, partially tear, or rupture completely.
Symptoms to watch for:
  • Inner elbow pain during or after throwing
  • A pop followed by sharp pain
  • Decreased velocity or loss of control on the mound
  • Numbness or tingling in the ring and pinky fingers
How to prevent it: Rest is the single most important preventive measure. USA Baseball recommends that young pitchers take at least four consecutive months off from throwing each year. Pitching for multiple teams simultaneously during the same season is one of the most significant risk factors for UCL injury and should be avoided. If your athlete is complaining of elbow pain, do not push through it; early evaluation can be the difference between physical therapy and surgery.

3. ACL Tears

Who we see: Soccer, lacrosse, and basketball players, most commonly in the 14–25 age range, with a higher rate among female athletes.
ACL tears are among the most dreaded sports injuries, and for good reason. They almost always require surgery, followed by 9–12 months of rehabilitation. Summer is a high-risk time because athletes are playing in multiple leagues, training intensively, and often fatiguing their bodies without adequate recovery.
The ACL is the primary ligament stabilizing the knee against rotational forces. It is most commonly torn during non-contact mechanisms, such as planting the foot and cutting, landing from a jump, or decelerating suddenly, all movements that are central to soccer, lacrosse, and basketball.
Symptoms to watch for:
  • A loud pop at the time of injury
  • Immediate swelling of the knee
  • Instability: the knee feels like it’s giving way.
  • Inability to continue playing
How to prevent it: ACL injury prevention programs, such as the FIFA 11+ warm-up protocol, have been shown to significantly reduce ACL injury rates in female soccer players and are increasingly being adopted across other sports. These programs focus on landing mechanics, neuromuscular control, and hip and core strengthening. Coaches and parents should prioritize proper technique over pure athleticism, particularly during growth spurts when coordination and strength can temporarily fall out of sync.

4. Meniscus Tears

Who we see: Athletes of all ages, from teenage soccer players to adult recreational athletes and golfers.
The meniscus is the cartilage cushion inside the knee that absorbs impact and distributes load across the joint. It can be torn during a sudden twisting movement, such as pivoting in soccer or planting to swing a golf club, or through gradual degeneration in older athletes.
Meniscus tears are among the most common knee injuries we treat in the summer, often occurring in athletes playing on natural grass fields with irregular surfaces, or in adult recreational athletes who are pushing their bodies harder than their joints are prepared to handle.
Symptoms to watch for:
  • Pain along the inner or outer edge of the knee
  • Swelling that develops gradually after activity
  • A locking, catching, or clicking sensation in the knee
  • Pain with deep bending, squatting, or pivoting
How to prevent it: Strengthening the muscles around the knee, particularly the quadriceps, hamstrings, and hip abductors, reduces the load placed on the meniscus during activity. Proper warm-up before play, gradual increases in training volume, and avoiding sudden spikes in activity (like going from no exercise all winter to full-intensity summer leagues) all significantly reduce the risk of meniscus injury.

5. Ankle Sprains

Who we see: Athletes in virtually every sport, basketball, soccer, volleyball, trail running, and recreational beach sports.
Ankle sprains are the single most common sports injury we see across all age groups in the summer. They occur when the foot rolls inward or outward, stretching or tearing the ligaments that stabilize the ankle joint. While often dismissed as minor injuries, untreated and under-rehabilitated ankle sprains can lead to chronic instability, recurrent sprains, and long-term joint problems.
Beach sports pose a particular risk on Long Island; soft, uneven sand creates an unstable surface that significantly increases the risk of ankle rolls, especially during volleyball, touch football, and recreational soccer.
Symptoms to watch for:
  • Pain, swelling, and bruising around the ankle after a roll or twist
  • Difficulty bearing weight
  • A feeling of instability when walking
How to prevent it: Proprioceptive training, exercises that improve your body’s awareness of joint position, is one of the most effective ways to prevent ankle sprains and reduce the risk of re-injury after a previous sprain. Balance exercises, single-leg strengthening, and sport-specific agility drills all contribute to ankle stability. Proper footwear appropriate to the playing surface also matters more than most athletes realize.
If you do sprain your ankle, don’t assume it will heal on its own without any intervention. A proper evaluation ensures the injury is accurately graded, rules out a fracture, and gets you started on the right rehabilitation program to prevent future sprains.

The Bottom Line: Don’t Play Through Pain

The common thread running through all five of these injuries is this: playing through pain almost always makes things worse. What starts as a manageable strain or partial tear can quickly become a surgical-level injury when athletes push through warning signs rather than seeking early evaluation.
On Long Island, where youth sports culture is intense and the pressure to perform is real, it can be tempting to push through discomfort and get back on the field as quickly as possible. But the athletes who take early pain seriously, get evaluated promptly, and follow through on treatment are the ones who have longer, healthier athletic careers.
If you or your athlete is dealing with a shoulder, elbow, knee, or ankle injury this summer, Dr. Zusmanovich and his team are here to help. With locations in Commack, East Setauket, and Patchogue, getting evaluated is straightforward, and getting the right answer early makes all the difference.

Schedule a Consultation

Don’t wait for an injury to get worse before getting it looked at. Request an appointment with Dr. Zusmanovich.