common Sports Injuries

COMMON SPORTS INJURIES

Sports medicine usually deals with minor orthopedic problems like soft tissue trauma. Figure 34.1 shows common sites of injuries in sports. Frequent falls, contact injuries and high speed activities are the common causes of sports injuries (Fig. 34.2). Very rarely there may be serious fractures, head injuries or on the field deaths. There is nothing unusual about these injuries except that a sportsperson demands a 100 percent cure and recovery while an ordinary person is satisfied and happy with a 60-80 percent recovery. The difference is because of the desire of the sportsperson to get back to the sport again which require total fitness.

Note The incidence of sports injuries among all orthopedic injuries is 5-10 percent.

The following are some of the most common sports relate injuries one encounters in clinical practice.

Upper Limbs

Shoulder complex

Rotator cuff injuries

Shoulder dislocations

Fracture clavicle

Acromioclavicular injuries

Bicipital tendinitis or rupture.

Elbow

Tennis elbow (Fig. 34.3)

Golfer's elbow

Dislocation of elbow.

Wrist

Wrist pain

Carpal tunnel syndrome

Hand

Mallet injury (Fig. 34.4)

Baseball finger

Jersey thumb

Injuries to the finger joints

Head, Neck, Trunk and Spine

Head injuries

Whiplash injuries

Rib fractures

Trunk muscle strains

-Abdomen muscle strain

Low backache.

All these injuries have been discussed in relevant sections.

Investigations

These are the same as for any orthopedic related disorders and consists of plain X-rays, CT scans, bone scans, MRI, arthroscopy, arthrography, stress X-rays, etc.

Treatment of Sports Injury

This is discussed under three headings prevention, treatment proper and training.

Preventive Measures

The best way to treat a sports injury is to prevent it from happening. Nothing is better than preventing the injury.

General Principles

Concept of RICEMM This sums up the early treatment methodology of sports injuries and consists of:

R-Rest to the injured limb

I-Ice therapy

C-Compression bandaging

E-Elevation of the injured part M Medicines like pain killers, etc.

M-Modalities like heat, straps, supports, etc. After immobilization and rest, early vigorous exercises should be commenced at  earliest to prevent muscle weakness and atrophy.

To prevent joint stiffness early mobilization has to be done first by passive movements and later by active movements. To improve the strength resistive exercises are added.

Unlike the conventional once a day treatment, a sports person needs to be seen at least 2-3 times a day.

As mentioned earlier allow resumption of sporting activity only after the sportsperson assumes 100 percent fitness.

Mind training is as important as physical training. By repeated counseling improve the psychological status of the patient to avoid depression, anxiety and negative attitudes which may develop during the injury.

Orthopedic and surgical treatment to be undertaken at appropriate situations.

Training

The physiotherapist has to train a sportsperson in various exercises to enable him to keep his fitness level very high. After conducting a fitness testing, (mentioned earlier) the therapist has to subject an athlete to various forms of exercises to increase the endurance, strength, running, weight bearing, etc. The following are the various forms of exercises.

Exercises to Increase the Cardiopulmonary Capacity

These exercises are done to increase the endurance level of an athlete or sportsperson. This has been discussed at length in the first chapter (see page 9).

Exercises to Increase the Muscle Strength

By carefully planned graded progressive resistive exercises, the therapist aims at reproving the strength of the muscles of the upper limbs, lower limbs, trunk and spine.

Exercises for Free Weight Training

Strength training with machines has a disadvantage in training only the prime movers. This anomaly is converted by free weight training which helps to strengthen not only the prime movers but also the synergistic and stabilizing groups of muscles (e.g. exercises with dumbbells). They are also known to increase the tensile strength of the muscles, ligaments and tendons.

Measures to Improve the Agility

The measures to improve the agility levels of sportsperson are two leg hops, one leg hop, cross over-run turning, bending and backward running. These exercises help to improve balance, co-ordination and movements at a faster rate.

Measures to Improve the Stars Polymetrics

In this the neuromuscular system is trained to such an extent that it can react very quickly to sudden increase of speed and power which is so often required in sporting activities.

Measures of Relaxation

After the vigorous workout mentioned above the sportspersons are taught methods of relaxation and body stretches.

Before an athlete or a sportsperson resumes his sporting activities, a fitness testing is carried out (see page 318) anc only then he is allowed to take to the sports provided he is 100 percent fit.