SPORTS INJURIES

    
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SPORTS INJURIES

I being a physiotherapist at RNH hospital came across many patients of sports injuries who came for their rehabilitation. I remember one such football player who was seasoned to visit me almost every 5 to 6 months with same recurrent grade 1 ACL injury. Every time he use to come with his sports injury, I use to follow our routine protocol of history, assessment and then treatment. I was very particular to ask him about his warm –up, footwear and training ground surface in history. You must be wondering how these things matter because he got injured while playing?!?! So one day I decided to visit this training ground .What I saw took me to surprise. He wasn’t in his football shoes. But according to him, he was. He was not aware what proper football shoes are. A simple footwear was the reason for his recurrent injury took him by surprise. Eventually he took my advice, with proper rehabilitation and footwear change he got back to his game. It’s been more than 6 months, I haven’t seen him yet. He called me up to inform that the change of footwear worked well for him.

There are many types of sport injuries

· Sprains

· Strains

· Knee injuries ( Torn ACL, Torn MCL)

· Shin splints

· Swollen muscles

· Stress Fractures

· Achilles tendon rupture

· Rotator cuff injury

· Dislocations

· Runners knee

· Plantar Fasciitis

· Tennis Elbow

Below is a simplified version on how one can differentiate if it is acute or overuse sports injuries.

Site

Acute injuries

Overuse injuries

Bone

Fracture

Stress fracture

Joint

Dislocation

Osteoarthritis

Ligament

Sprain/tear

Inflammation

Muscle

Strain,cramp

DOMS,fibrosis

Tendon

Tear

Tendinopathy

Nerve

Neuropraxia

Entrapment,neural tension

Courtesy-Clinical sports medicine by Peter Brukner and Karim Khan

Here we are going to discuss how we can prevent sports injuries. There are few important factors one must consider.

· Warm up

· Stretching

· Taping and bracing

· Protective and suitable equipment

· Playing surface

· Training

· Nutrition

Warm-up:

Warm –up prepares our body for exercise. It has many benefits like increase in blood flow ,decrease number of sports injuries due to increase in range of motion, decrease stiffness of connective tissues with increased contraction and relaxation.

Stretching:

Stretching can be static or ballistic.

In static stretching, the stretch position is assumed slowly and held for 30 seconds.

Ballistic stretching, the muscle is stretched near to its limit, then stretched further with a bouncing movement which causes a reflex muscle contraction.

Taping and bracing:

These are used to restrict undesired motion or allow the desired motions.

Eg: taping of ankle joint

Protective and suitable equipment:

These includes helmets, guards, knee braces

Also proper shoes like running spikes, ski boots ,football shoes or proper tennis racket or badminton racket.

For eg: a football shoe should be of adequate depth ,have a rigid heel counter and forefoot flexibility ,wide sole and cleats should be placed to allow forefoot flexibility.

Playing surface:

Training and playing surface should be similar to prevent sports injuries

Training:

Training should be specific to individual

Nutrition:

Inadequate nutrition increases the chances of sports injuries.

With all these principles of prevention of sports injuries one can prevent them.

Taking all these prevention, sometimes a player does suffer from sports injuries due to some physical factors like body biomechanics or external factors hit my another player or wet playing surface etc.

I will give you a brief about one of the most common sports injuries- ACL injury

ACL (Anterior Cruciate Ligament) occurs in football players, gymnasts or athletes. It majorly occurs due to a pivot motion of the knee due to external force .

Patient will complain of some pain after an immediate injury and also some giving away feel in the knee. After a few investigations like x-ray and MRI of knee, depending on the grade of injury , further treatment is decided.

Grade 1 -25% or fewer fibers are disrupted.

Grade 2- >25% to 50 % fibers are disrupted

Grade 3- 75% fibers are disrupted or a complete tear

Depending on the grade of injury, your orthopedic will suggest you the line of treatment.

In grade 1 tear, initially rest in advised with some compression bandage or knee brace and medications. After a few weeks, physical therapy is advised

In grade 2 tear, similar treatment is given as grade 1 , but if the ACL tear is accompanied with some other injuries to knee like meniscal or MCL injury, surgery may be advised

In grade 3 tear. Surgery is advised

What to expect in surgery?

Knee arthroscopy is done which is a minimal invasive procedure. After the procedure, generally rest is advised on the day of operation. From next day, your physical therapist will visit you for some knee exercises and also help you move out of the bed. Here in RNH hospital, knee movement of around 30 degree is advised for week 1 post op , gradually increasing it 30 degree every week. Patient moves out of the bed with a help of a walker without putting any weight on the operated leg. In gradual follow ups with the orthopedic, further line of treatment is advised.