Sports Medicine

Sports injuries occur when playing indoor or outdoor sports or while exercising. Sports injuries can result from accidents, inadequate training, improper use of protective devices, or insufficient stretching or warm-up exercises. The most common sports injuries are sprains, strains, fractures, and dislocations.

The most common treatment recommended for injury is rest, ice, compression, and elevation (RICE).

Rest: Avoid activities that may cause injury.
Ice: Ice packs can be applied to the injured area which will help to diminish swelling and pain. Ice should be applied over a towel to the affected area for 15-20 minutes four times a day for several days. Never place ice directly over the skin.
Compression: Compression of the injured area helps to reduce swelling. Elastic wraps, air casts, and splints can accomplish this.
Elevation: Elevate the injured part above heart level to reduce swelling and pain.

Some of the measures that can be taken to prevent sports-related injuries include:

Following an exercise program to strengthen the muscles.
Gradually increasing your exercise level and avoid overdoing the exercise.
Ensuring that you wear properly-fitted protective gear such as elbow guards, eye gear, facemasks, mouthguards, pads, comfortable clothes, and athletic shoes before playing any sports activity which will help to reduce the chances of injury.
Making sure that you perform warm-up and cool-down exercises before and after and sports activities. Exercises will help to stretch the muscles, increase flexibility, and reduce soft tissue injuries.
Avoiding exercise immediately after eating a large meal.
Maintaining a healthy diet which will nourish the muscles.
Avoiding playing when you are injured or tired.
Learning all the rules of the sport you are participating in.
Ensuring that you are physically fit to play the sport.

Some of the common sports injuries include:

Foot and Ankle Injuries

Foot and ankle injuries include the injuries in the lower leg below the knee and they are common while playing sports such as football, soccer, skating, and basketball. Treatment for some of these conditions may be orthotics, braces, physical therapy, injections, or surgery. Common sports injuries of the ankle and foot include sprains, strains, ankle fractures, and Achilles tendonitis.

Shoulder Injuries

Severe pain in the shoulder while playing your favorite sports such as tennis, baseball, and gymnastics may be because of damage to ligaments or muscles. These may be caused by overuse of the shoulder while playing sports. Simple pain or acute injuries may be treated with conservative treatment and chronic injuries may require surgical treatment.

Knee Injuries

Anterior cruciate ligament (ACL) is a major stabilizing ligament in the knee which may tear with overuse of the knee while playing sports. The ACL has poor ability to heal and may cause instability. Other common sports injuries in the knee are cartilage damage and meniscal tears. Knee injuries of sports may require surgical intervention that can be performed using open surgical or minimally invasive techniques. Your surgeon may also recommend physical therapy to strengthen your muscles, improve elasticity and improve the movements of the bones and joints.

Concussions

A concussion, also known as minor traumatic brain injury, is the sudden and temporary loss or disturbance in nerve cell function of the brain that occurs as a result of a blow or an injury to the head. It is common among schoolchildren between the age of 8 and 13 who are involved in playing sports such as football, ice hockey, snow skiing, and bicycling.

Usually, concussions are mild and do not result in long-term damage but repeated concussions can cause permanent brain damage. This condition can become life threatening if blood accumulates in the skull.

Some of the most common symptoms of concussions include loss of consciousness, mild to moderate headache or feeling of pressure in the head, difficulty in remembering things, slurred speech, difficulty in thinking and making decisions, lack of concentration, and feeling confused and dazed.

Your pediatrician will ask you about the incidence of head injury and symptoms observed. The doctor may also ask some basic questions to assess the child’s level of consciousness. In addition, he may perform other tests such as physical examination, neurological examination, or scanning procedures such as X-ray, CT and MRI.

The main treatment for a concussion is complete rest from physical and mental activities. Children must refrain from playing sports while being treated for a concussion. It is important that your physician clears your child before he/she returns to sports activities.

Tendon and Ligament Damage

A sprain is an injury or tear of the ligaments and a strain is injury to the muscle or tendons. Sprains and strains are common in ankle, spine, knee, thigh, hip, elbow, and wrist joints.

A sprain is caused by trauma and/or overstretching of the joints during sports activities. A strain is caused by overuse of the muscles and inadequate rest during breaks while playing sports. Sprains and strains are common in sports such as gymnastics, basketball, football, hockey, and running.

The muscles injured during sports include hamstring and quadriceps muscles of the thigh, calf and knee muscles, and flexor muscles of the joints. The commonly observed symptom is pain and inflammation. In addition to these symptoms muscle spasm, muscle weakness, and cramping may be observed.

Immediately following an injury and before being evaluated by a medical doctor, you should initiate the R.I.C.E. method of treatment:

Rest: Rest the knee as more damage could result from putting pressure on the injury.
Ice: Ice packs applied to the injury will help diminish swelling and pain. Ice should be applied over a towel to the affected area for 15-20 minutes four times a day for several days. Never place ice directly over the skin.
Compression: Wrapping the knee with an elastic bandage or compression stocking can help to minimize the swelling and support your knee.
Elevation: Elevating the knee above heart level will also help with swelling and pain.

Your doctor may prescribe nonsteroidal anti-inflammatory drugs to reduce the pain and inflammation. Physical therapy is recommended for people injured by sports which helps to regain strength and allow fast recovery. Physical therapy includes healing treatments and various strengthening, stability, and stretching exercises which should be carried out on a regular basis.

Shin Splints

“Shin splints” is used to describe the pain and inflammation of the tendons, muscles, and bone tissue around the tibia or shin bone (a large bone in the lower leg). It occurs as a result of vigorous physical activity such as exercise or sports. The condition is also referred to as medial tibial stress syndrome (MTSS).
The common cause of shin splints is overuse of the muscles and bone tissue of the tibia because of repetitive sports activity and a sudden change in the physical activity level. The other causes of shin splints include:

Stress fractures (tiny, hairline breaks) of the leg bone may cause sharp pain.
Tendonitis caused by partial tear of the tendon.
Chronic exertional compartment syndrome: swelling of the muscles with exertion. As a result, pressure is increased within the muscle compartment. Pain is severe because of loss of blood supply to the muscle.
Flat feet or a rigid arch and use of improper or worn-out footwear while exercising. Runners and dancers are at a higher risk of developing shin splints.
The treatment for shin splints consists of non-surgical and surgical procedures. The non-surgical or conservative procedure includes:
- Rest: Ensure that your child takes adequate rest and avoid activity that causes pain for at least 2-4 weeks. They can try low-impact exercises, such as swimming or bicycling.
- Nonsteroidal anti-inflammatory medicines are given to reduce pain and swelling.
- Ice: Apply ice packs wrapped over a cloth to the affected area for 15-20 minutes four times a day for several days. Never place ice directly over the skin.
- Compression: Wrap the leg with an elastic bandage which helps to reduce swelling.
- Flexibility exercises: This involves exercises to stretch the leg muscles to reduce pain and improve muscle strength.
- Supportive shoes: Ensure that your child wears shoes that provide good cushioning and support for the feet as it helps reduce stress on the shin bone.
Surgical treatment is an option that is considered only in very severe cases when conservative methods fail to relieve pain. Surgery may be needed in conditions where the pain becomes severe due to compartment syndrome. Fasciotomy is a surgical procedure where the tough and fibrous tissue (fascia) is split to relieve the pressure built up within muscle compartments.

Shin splints can be prevented by following these measures:
- Ensuring that your child always wears proper fitting athletic shoes with good support.
- Making sure that your child is aware of warm up exercises and stretching the leg muscles before starting any vigorous activity.
- Avoiding running on hard surfaces like concrete.
- Ensuring that your child starts any new activity slowly and progresses gradually by increasing the duration and frequency of an exercise regimen.
  
  Orthopaedic Trauma
  
  Orthopedic trauma refers to injuries of the muscles, tendons, ligaments, joints, nerves, blood vessels, or related soft tissues that most commonly occur during sports, exercise, or any other physical activity. Trauma may be a result of accidents, poor training practices, or with use of improper gear. Injuries may also be caused when an individual is not medically fit or because of insufficient warm up and stretching exercises. Musculoskeletal injuries are a group of painful disorders that arise due to wear and tear resulting in impairment in the functioning of the musculoskeletal system.
  
  Acute injuries are the sudden injuries that occur during playing or exercising and include sprained ankles, strained backs, and fractured hands.
  
  Chronic injuries happen from overusing one part of the body for playing a sport or exercising, preferably when practiced for a longer duration
  
  The treatment of musculoskeletal injuries includes both non-surgical and surgical methods. Non-surgical methods are the initial line of management and include:
  - Restriction of movement of the injured part
  - Heat or cold treatment that may relieve pain and accelerate repair process
  - Exercise and physical therapy to help in stretching the injured muscle
  - Medication such as anti-inflammatory drugs and analgesics
  In cases where non-surgical methods are not effective, surgical repair of the underlying muscle, tendon, or ligament is recommended.
  
  Regardless of the type of injury, acute or chronic, avoid working through the pain of an injury. When experiencing pain from a particular movement, stop playing or exercising. Continuing the activity may worsen the condition. Some injuries may require immediate medical intervention while others can be self-treated.
  
  Consult your doctor if:
  - You experience severe pain, swelling, or numbness
  - You cannot bear any weight on the area
  - You experience pain or dull ache of an old injury
  - Your pain is accompanied by swelling or if you feel the joint is unstable
  All injuries need time to heal and proper rest helps the process. Be sure to take time to rest after an injury.
  
  Sports Medicine Topics
  
  Click on the topics below to find out more from the orthopaedic connection website of American Academy of Orthopaedic Surgeons.