Sports injuries are a significant concern for active South Asians, who often participate in culturally popular sports like running, cricket, badminton, field hockey, and soccer. This predisposition to injury is also attributable to lifestyle and genetic factors unique to the community. Sports injuries and daily activity require repetitive movements, quick directional changes, and high levels of physical exertion. While beneficial for health, these activities may lead to injuries, such as low back pain, knee ligament strains, and ankle sprains. Additionally, lifestyle factors—such as prolonged sedentary work—as well as genetic predispositions like diabetes, hypertension, metabolic syndrome, vitamin D deficiency, flat feet, or osteoporosis can increase the likelihood of injury. Understanding the patterns and causes of these injuries is crucial to promoting safe sports participation and ensuring the long-term health of the South Asian community.

Types of Injuries

There are several different types of sports-related injuries. This is a list of the most common for each of the listed sports. Other injuries may occur that are not listed.

Running (and other endurance sports):
A common injury to be aware of for long-distance running is iliotibial (IT) band syndrome. Pain may present on the outer hip and extend down the outer leg to the knee. Potential causes include improper footwear, overtraining, and weakness in the gluteal muscles and lower legs.
Hamstring strains are also associated with endurance exercise, especially the sprinting and jumping associated with track, football, and soccer.

Dancing:
Ankle sprains are prevalent in classical dance, such as Bharatanatyam and Kathak, which involve barefoot footwork. Ankle sprains should be managed by ice and NSAIDs (e.g., ibuprofen) for the first 24 hours after the injury. Providing optimal load to the foot—such as walking—will provide strength and stability for the ankle joint. Avoid dancing, running, and placing additional pressure on the ankle. As pain decreases, rehab exercises are crucial for return to sport and prevention of further injuries. Stress fractures may also occur in the feet due to prolonged impact from striking the floor with bare feet.

Cricket:
This sport’s demands—prolonged play, repetitive movements, and explosive actions—make certain injuries very common.

1. Lower Back Injuries (Stress Fractures & Strains)
• Common Among: Fast bowlers
• Reason: The repetitive high-impact bowling action, particularly the hyperextension and rotation of the spine, makes fast bowlers prone to stress fractures in the lower back (lumbar spine).
• South Asian Context: Due to limited access to structured strength and conditioning programs at the grassroots level, young fast bowlers may not develop adequate core strength, increasing injury risk (Ranson).
2. Shoulder Injuries (Rotator Cuff Strains & Labral Tears)
• Common Among: Bowlers and fielders
• Reason: The repetitive overhead motion of bowling and throwing can cause overuse injuries to the shoulder, including rotator cuff strain and labral tears.
• South Asian Context: Many players play on hard surfaces (such as concrete or dry, unmaintained grounds), requiring extra force when throwing. Additionally, lack of proper warm-up routines can contribute to injury (Aginsk).
3. Knee Injuries (Meniscus Tears, Patellar Tendinitis)
• Common Among: Bowlers and wicketkeepers
• Reason: The constant impact of landing during the bowling stride or sudden movements while wicketkeeping can lead to knee injuries.
• South Asian Context: Many grounds are poorly maintained, increasing the risk of awkward landings. Improper footwear and lack of strength training can exacerbate knee issues (Frost).

Contributing Factors Unique to South Asians

Navigating injuries requires an understanding of factors that predispose the South Asian community to specific types of injuries.

Metabolic Syndrome
South Asians are the fastest growing population in the U.S. with metabolic syndrome—a cluster of conditions that increase the risk of heart disease, stroke, and type 2 diabetes.

• Includes high blood pressure, elevated blood sugar, excess abdominal fat, and abnormal cholesterol or triglyceride levels.
• Can influence musculoskeletal injuries (Mahadevan).

Diabetes & Insulin Resistance
South Asians have a genetic predisposition to insulin resistance and a higher risk of developing Type 2 diabetes.

• Impact on Sports Injuries:
• Delayed wound healing, increasing the recovery time from injuries like cuts, abrasions, or surgical procedures.
• Reduced blood circulation, particularly in the extremities, leading to complications like slower muscle recovery.
• Management:
• Monitor blood sugar levels, especially for active individuals.
• Promote a balanced diet with low glycemic index foods, increased fiber, and balanced protein intake.
• Examples:
• Pair rice, potatoes, and dal with protein and fat such as dahi, paneer, tofu, or meat.
• Low GI foods: chana dal, rajma, spinach/leafy greens, okra, berries, lean meats, plain Greek yogurt.
• Spices like haldi, methi, and cinnamon can help lower blood sugar.
• Encourage consistent aerobic and resistance exercise:
• Aerobic: dancing, biking, walking
• Resistance: pilates, weight lifting, yoga

Vitamin D Deficiency
South Asians are more prone to Vitamin D deficiency due to increased melanin, which reduces Vitamin D synthesis from sunlight.

• Impact on Sports Injuries:
• Weak bones, increasing risk of stress fractures.
• Prolonged recovery times for bone-related injuries.
• Management:
• Regular supplementation (under medical advice).
• Daytime outdoor activities for natural synthesis.
• Vitamin D-rich foods: fortified milk, salmon, mackerel.

Higher Rates of Cardiovascular Issues

• Impact on Sports and Recovery:
• Lower cardiovascular endurance affects performance and recovery.
• Slower injury recovery due to circulatory issues.
• Management:
• Cardiovascular training: walking, swimming, cycling.
• Heart-healthy foods: leafy greens, nuts, omega-3-rich fish.

Management of Injuries

Access to the right healthcare provider is essential for effective treatment and recovery.

• Orthopedist:
  Medical doctor focused on bones, joints, and musculoskeletal system; uses surgical and non-surgical methods and can order imaging.
• Sports Medicine Specialist:
  Medical doctor specializing in non-surgical sports injury treatment and rehabilitation.
• Physical Therapist:
  Helps with recovery, posture, flexibility, and muscular endurance; plays a key role in rehab and injury prevention.
• Musculoskeletal Care (Sports Chiropractic):
  Improves spinal health and biomechanics; addresses posture, mobility, and repetitive strain.
• Acupuncture:
  Increases blood flow, promotes healing, and reduces pain through stimulation of specific points.

Important Notes:

• For acute injuries with worsening symptoms (e.g., pain, numbness, tingling), consult a primary care physician, orthopedist, or urgent care center.
• A prescription is often not required for physical therapy, chiropractic, or acupuncture.
• For emergent issues, call emergency services or go to the emergency room.

Managing an injury can feel overwhelming, but identifying the type of injury and getting appropriate care can help South Asians return to their active lifestyles safely. Imaging may help with diagnosis, and awareness of genetic or autoimmune conditions can inform the healing process.

References:

1.      Mahadevan M, Bose M, Gawron KM, Blumberg R. Metabolic Syndrome and Chronic Disease Risk in South Asian Immigrants: A Review of Prevalence, Factors, and Interventions. Healthcare (Basel). 2023;11(5):720. Published 2023 Mar 1. doi:10.3390/healthcare11050720

2.      Ranson C, Kerslake R, Burnett A, Batt M. Injuries to the lower back in elite fast bowlers: acute stress changes on MRI predict stress fracture. J Bone Joint Surg Br. 2005;87(8):1111-1116.

3.      Aginsky KD, Lategan L, Stretch RA. Shoulder injuries in provincial male fast bowlers—prevalence and risk factors. S Afr J Sports Med. 2004;16(1):25-28.

4.      Frost WL, Chalmers DJ. Injury in elite New Zealand cricketers 2002–2008: descriptive epidemiology. Br J Sports Med. 2014;48(12):1002-1007.

About the Author:

Jasmine Bhoola DC, LAC
Dr. Bhoola is a chiropractic physician and licensed acupuncturist practicing in Midtown. A graduate of the University of Bridgeport School of Chiropractic and Acupuncture Institute, she specializes in manual therapy and biomechanical assessments to treat the root cause of injury, not just symptoms.

Practice Location: Fuel Sport & Spine – 7 W 36th St
Website: fuelsportandspine.com
Instagram: @dr.jasminebhoola