Many holiday gatherings include a little friendly outdoor competition. Young and old, fit and not-so-fit alike gather for a football, soccer or basketball game. Sometimes because of old sibling rivalries or a desire to show the kids that “they’ve still got it,” the play becomes intense, increasing the risk of injury.

Alexander Johnson, MD, of St. Luke’s Orthopedic Care in Lehighton has treated many such patients, injured while contorting their body to prevent plowing into a small child or trying to impress the teenagers. Holiday gathering games are risky because of everyone’s different sizes and athletic abilities.

“They say I tore my Achilles tendon or ACL playing with my family,” said Dr. Johnson, an orthopedic surgeon and sports medicine physician. “I recently saw a father who injured himself while getting out there and hanging with his older kids.”

To avoid injury, Dr. Johnson encourages daily exercise. Lift weights, walk or run. Work on your core muscles – abs, glutes and lower back – that form the foundation for most athletic movements. Also, warm up and stretch. Don’t just watch the football game, jump off the couch at halftime and start playing.

“Remember yourself,” he said. “You probably have it in your heart to do the moves you used to, but your body might not be the same anymore. I never tell patients not to do fun things because we have ways to take care of injuries.”

Dr. Johnson can relate to his sports injury patients because he injured his shoulder while playing football in high school.

“Shoulder surgery allowed me to play for several more years. As an orthopedic surgeon, I like that I can identify with my patients. I had to do the work and make the effort to get back to playing, but ultimately got there. It’s a worthwhile thing when it works out.” Dr. Johnson later played football at Randolph Macon College in Virginia, where he was captain.

The 10 Most Common Sports-Related Injuries to the Upper and Lower Body

1. Hand and wrist injuries: Any wrist pain after an acute fall can indicate something more serious. An evaluation by an orthopedic specialist determines the best treatment. Bones in the hand and fingers may also break, and ligaments can sprain.

2. Separated shoulders: When a direct blow or fall causes a gap to form in the acromioclavicular (AC) joint that connects the collar bone to the scapula.

3. Broken collar bones: Most often occur from falls directly onto the shoulder. If the collarbone is displaced, surgery may be required. Common after cycling crashes.

4. Rotator cuff injuries: Fall or throwing related, they can prevent overhead movements. Physical therapy and corticosteroid injections can provide very effective treatment, but surgery may be required in severe cases.

5. Bicep tendinitis/tears: Occur either at the shoulder end or the elbow end of the tendon. Patients generally hear a pop when the bicep tendon ruptures completely, and the bicep has a different appearance, usually with bruising. Tendinitis can be treated with an ultrasound-guided injection and physical therapy. Some bicep tears may require surgery.

6. Ankle sprains: The most common and easily treatable, ankle sprains sometimes require additional bracing and often benefit from physical therapy.

7. Hamstring strains: Pain in the back of your upper leg that limits motion. Hamstring strains can be avoided with proper warm-up and stretching.

8. Achilles’ tendinitis or tear: Pain from your heel to the lower part of your calf. Ruptures cause significant pain and require a six- to nine-month recovery period.

9. Knee sprains: Occur particularly in football, soccer and skiing. Complete tears may require surgery. Medial collateral (MCL) and lateral collateral (LCL) usually heal on their own. Tears to the anterior cruciate (ACL) or posterior cruciate (PCL) may require surgery.

10. Meniscus tears: The meniscus is soft cartilage that provides a cushion between the bones. If torn, you feel a sharp pain in the knee, or “locking,” when the torn tissue becomes wedged between the bones. Baker’s cysts may form when fluid from the swelling leaks through the tear like a one-way valve and gets stuck, forming an oftentimes painful cyst. It can be drained, but the meniscus tear also must be treated to prevent the cyst from reforming.