TYPES OF SPORTS INJURIES
Achilles tendon injuries
- can affect professional and amateurs athletes
- one of the longest tendons in the body
- tendon can become swollen and painful – tendonitis
- too much force can cause partial tear or rupture
Causes:
- overuse - increasing physical activity too quickly
- insufficient stretching - wearing high heels
- flat feet - muscles/tendons that are too tight
Common in:
- running - gymnastics
- dance - football
- baseball/softball - basketball
- tennis - volleyball
Symptoms:
- pain in back of leg, above heel
- tenderness
- swelling
- stiffness
- snapping/popping during the injury
- difficulty in pointing toes up/down
Treatment:
- rest - ice
- compression - elevation
- NSAIDs - heel lift may be recommended
- stretching and strengthening exercises as recommended.
- in severe cases, casting or surgery may be indicated
Knee ligament injuries (ACL, PCL, MCL, LCL)
ACL injury causes:
- twisting of the knee with a planted foot
- getting hit in the knee
- extending knee too far
- jumping and landing on a bent knee
- sudden stop when running
- shifting weight suddenly from one leg to the onter.
- common in basketball, football, soccer, skiers, and gymnast
- common cause of disability in the US
- more common in women the men
Treatment
- rest
- ice
- compression
- elevation
- bracing
- NSAIDs
- stretching and strengthening is recommended by doctor
- surgery may be necessary for severe collateral ligament tears
- if the ACL or PCL is damaged, reconstruction may be indicated
PCL injury causes
- blow to the knee while it is bent
- striking knee against dashboard in car accident
- falling on knee while its bent
- common in football, soccer, baseball and skiing
Types:
- Grade I – partial tear
- Grade II – partial tear, looser than in Grade I
- Grade III – complete tear with instability of the knee
- Grade IV – PCL is damaged with another ligament in the knee
- can be acute or chronic
- acute are due to sudden injury
- chronic develop over time
Symptoms:
- most people think the problem is mild
- swelling – can be mild or severe
- pain
- difficulty with walking and weight bearing positions
- feeling of instability
- arthritis can develop over time
Diagnosis:
- history of injury mechanism, physical examination, x-rays and MRI
Treatment:
- bracing to protect from further injury
- rest
- ice
- compression
- elevation
- NSAIDs
Nonsurgical treatment (in addition to above)
- use of crutches with gradual weight bearing
- physical medicine modalities
Surgical treatment
- may be required if there are bone fragments present
- if more than one ligament injured
- chronic looseness of the PCL
- arthroscopically or open type surgery
Ankle injuries
- can happen to anyone
- men between 15-24 years old have higher incidence
- women older than age 30 have higher rates than men
- most common injuries are sprains and fractures
Causes:
- tripping/falling - landing awkwardly after a jump
- walking/running on uneven surfaces - sudden impact
- twisting or turning the ankle
Symptoms:
- pain - swelling
- bruising - inability to weight bear on the ankle/foot
Treatment:
- rest - ice
- compression - elevation
Fracture treatment:
- surgical
- non surgical - bracing/splinting or casting
Sprain treatment
- Grade I (mild) – rest, ice, compression and elevation until pain and swelling subside/improve
- when weight bearing is tolerated, then stretching, strengthening and range of motion exercises may begin. Only if you can tolerate it
- Grade II (moderate) – rest, ice, compression and elevation and boot or splinting
- physical medicine when can be tolerated
- Grade III (severe) – immobilization followed by physical medicine treatment
- if this type of sprain does not heal, surgery may be considered
Concussions/Head Injury (traumatic brain injury)
- most common and least serious type of traumatic brain injury
- commonly caused by blow or injury to the head
- can result in in bruising of the brain tissue, damage to blood supply and nerve injury
- results in abnormal function of the brain
- may cause unconsciousness, loss of balance and/or visual disturbances
- if child is suspected to have suffered a concussion, monitor them for the first 24 hours for changes in behavior.
- DO NOT give a child suspected of having a concussion any medications until consulted by a doctor
Symptoms:
• headache • memory loss
• vision problems • balance problems
• changes in personality • slurred speech
• memory loss • ear ringing
• nausea • vomiting
• difficulty with concentration • noise/light sensitivity
Types:
a) mild (grade I) – symptoms last for less than 15 minutes
- no loss of consciousness
b) moderate (grade II) – symptoms last longer than 15 minutes
- there is no loss of consciousness
c) severe (grade III) – there is loss of consciousness, sometimes just for a few seconds
What to do
go see a doctor
- further diagnostic testing may be recommended pending physical examination
rest to allow your brain time to heal
- if the concussion occurred during a sporting event, stop play and do not resume play the same day
protect against repeat concussions
- repeat concussions have a cumulative effect on the brain
- can result in brain swelling, permanent brain damage, disabilities or death
- do not return to work or play until cleared by doctor to do so
Prevention:
- wear protective gear to safeguard against traumatic brain injury
- wear seat belts
- don’t drink or use drugs and drive
- avoid fighting
Shoulder dislocation
- fall or blow causes the shoulder to pop out of the socket
- chronic dislocations can result in instability and weakness
- separated shoulder
- fall or blow tears one of the ligaments that connects the collar bone to the shoulder blade
- full recovery with time
Causes:
- fall onto shoulder
- blow to the shoulder
- breaking fall with outstretched hand
High risk sports are:
- football - hockey
- rugby - soccer
- skiing - volleyball
Symptoms of shoulder dislocation
- deformity of the shoulder
- pain in the shoulder and upper arm
Symptoms of shoulder separation
- immediate onset of pain - tenderness about the shoulder
- swelling - bruising
- deformity
- diagnosis is made by examination and x-ray
Treatment:
- dislocated shoulders should be treated ASAP, by putting the arm bone back in the socket
- ice
- sling
- NSAIDs – Advil, Aleve or Motrin
- stretching and strengthening exercises, if recommended by medical professional
- surgery may be indicated
Recovery
- depends of severity of the injury – usually 3 – 12 weeks is a good range
Prevention:
- stop activity if you experience pain
- exercise and stretch
- ice shoulder after physical activity if previous shoulder injury
- protect the shoulder with padding, if you are at risk of dislocation
Golfer’s Elbow (medial epicondylitis)
- pain and inflammation in the tendons that connect the inside of the forearm to the inside of the elbow
- usually caused by overuse of the muscles that allow you to grip and rotate your arm and flex your wrist
- repetition of this motion may cause tiny tears in the tendons on the inside of the elbow
- i.e. tennis, bowling, throwing a baseball using screw driver, painting
Groin pull/strain
- stretching or tearing of the muscles in the groin/thigh from putting too much stress on them
- common in running and jumping sports
Symptoms:
- pain and tenderness in groin/inner thigh
- pain with raising you knee
- popping sensation during the injury, followed by immediate pain
- pain with squeezing knees together
Types:
a) First degree – pain with little loss of strength or movement
b) Second degree – pain with some damage to the tissues
c) Third degree – pain with loss of function and compete tear of muscle
- diagnosis is made on physical examination, x-rays and/or MRI.
Treatment:
- usually heals on its own with rest and time
- ice the inside of your thigh
- compression
- NSAIDs
- stretching and strengthening exercises if recommended by doctor
Hamstring pull/strain
- are common and painful injuries to all types of athletes
- is a group of three muscles that enable you to bend the leg at the knee
- occurs during running, jumping or sudden stopping/starting
- can occur when: do not warm up/stretch prior to activity
hamstrings are weaker than quad muscles
teenager going through growth phase
Symptoms:
- sudden/severe pain during exercise with popping
- pain in back of thigh or buttock with walking or bending over
- tenderness in back of leg
- bruising in back of leg
- diagnosis is made on physical examination and questioning on how injury occurred
Treatment:
- usually will heal on their own over time
- rest the leg
- ice
- compression
- elevation of the leg
- NSAIDs
- practice stretching/strengthening if recommended by doctor
- severe cases may require surgery
- recovery time depends on severity of the injury
Prevention:
- adequately stretch before/after activity
- stop exercising/activity if you experiencing pain in back of thigh
- stretch and strengthen the hamstrings
Muscle strain
- damage to a muscle or its attaching tendons
- caused by placing undue pressure on muscles during normal activities, heavy lifting,
sporting activities or work activities
- can cause damage to small blood vessels, resulting in bruising
- can cause irritation to nerves, resulting in pain
Symptoms:
- swelling - bruising
- redness - pain at rest or with use
- weakness of the muscle
- inability to use the muscle
- diagnosis is determined by history and physical examination
- x-rays may be indicated, if injury is severe
Treatment:
- rest
- ice
- compression
- elevation
- NSAIDs
- avoid activities until pain subsides
- most strain injuries fully resolve with proper treatment
- more serious injuries should be evaluated and treated under supervision of doctor
Prevention:
- stretch daily and after exercise
- warm-up prior to exercise
Repetitive motion injuries
- common injuries in the U.S.
Types:
a) tendinitis - inflammation of a tendon
1. tenosynovitis – inflammation of the sheath where the tendon connects to the muscle
b) bursitis - inflammation of a bursa
- bursa is a small fluid sac that cushions the area between the tendon and the bone
Causes:
- repetitive activity - trauma
- deposits of crystals (gout) - friction
- rheumatoid arthritis
Symptoms:
- pain over site - worsened with activity
- tenderness - decreased range of motion
- swelling
seek medical advice when:
- pain with movement
- tenderness at the joint
- redness and warm skin over joint
- waking from sleep due to pain
- inability to sleep due to pain
- difficulty with performing normal daily activities
- go to hospital when:
- joint pain associated with fever, chills, nausea or vomiting
- severe joint pain
- treatment:
- immobilization
- NSAIDs
- injections may be recommended
- physical medicine modalities
- rest, ice and elevation
- if there is infection associated with the condition, anti-biotics may be prescribed
- prevention:
- proper warm up
- avoid activities that cause pain
- use of splints or braces
- range of motion exercises to maintain motion of the joint
- surgery may be indicated if conservative measures are unsuccessful
Rotator cuff tear
- rotator cuff is comprised of four muscles that about the shoulder that holds the arm in
place and allows for movement of the shoulder
- increased stress on the rotator cuff can lead to partial tears
- some causes include: throwing a ball, falling on shoulder or outstretched hand
- symptoms: pain, weakness, decreased or difficulty in moving the shoulder
- diagnosis is confirmed by history, physical examination, x-ray and MRI
- treatment:
- rest, ice, NSAIDs, physical medicine
- surgery is an option if conservative treatment fails or if the injury is serious
- prevention:
- keep the muscles about the shoulder strong
Running injuries
- runner’s knee
- stress fractures
- shin splints
- tendonitis
- pulled muscles
- sprains
- plantar fasciitis
- iliotibial band syndrome
- blisters
- temperature related injuries:
- sunburn, frost bite, heat exhaustion, hypothermia
- prevention:
- warm up
- stretch
- strength train
- wear proper clothing and shoes
- drink plenty of fluids
- treatment:
- rest, ice, compression, elevation
- stretch
- NSAIDs or over-the-counter pain medications
Shin Splints
- are common running injuries
- can be caused by: muscle irritation/inflammation, stress fractures or being flat footed
- symptoms:
- dull, achy pain in the front of the shin bone (tibia)
- diagnosis:
- history, physical examination and x-rays may be needed
- treatment:
- rest, ice, elevation, NSAIDs
- physical medicine treatments
- orthotics for the shoes
- prevention:
- wear proper shoes
- warm up
- stop the activity when you experience pain
- avoid activity on hard surfaces
Skier’s thumb/Gamekeepers thumb
- injury to the ulnar collateral ligament of the thumb
- causes:
- fall on outstretched hand with ski pole in palm
- car crash with thumb on steering wheel
- any time where thumb is bent backward or sideways
- symptoms:
- pain at base of thumb with swelling
- difficulty with grabbing
- tender to touch
- bruising or discoloration of the thumb
- pain with movement of the thumb
- may have wrist pain
- diagnosis:
- history, physical examination, x-rays
- treatment:
- self treatment: ice, compression/bracing, NSAIDs and evaluation by doctor
- medical treatment:
immobilization for partial tears
surgery for complete rupture
- prevention:
- teach how to fall properly while skiing without the pole
- keep thumbs on the outside of the steering wheel
Coccyx injury (tailbone injury)
- causes:
- trauma to the area
- fall onto buttocks/tailbone
- direct blow to the tailbone
- childbirth
- bicycling or rowing
- other causes
- unknown
- osteophytes
- pressure on nerves
- infection(s)
- tumors
- symptoms:
- pain and tenderness to the area
- pain worse with sitting
- pain with bowel movements
- women may have pain with sexual intercourse
- diagnosis:
- history and physical examination and x-rays may be recommended
- treatment:
- home treatment – avoid sitting positions, ice, NSAIDs, donut pillow to sit on, high fiber diet to soften stools
- medical treatment – prescription pain medication, stool softeners, injections
- surgical removal is a rare option
- prevention:
- are difficult to avoid, due to the fact that this area is usually injured as a result of an accidental fall
- prognosis:
- depends on cause of pain, compliance with treatment and your bodies ability to heal
Tendon injuries
- tendonitis - inflammation of the tendon
- tendinosis – small tears in or around the tendon
- tendinopathy – both inflammation and small tears of the tendon
- causes:
- gradual wear from overuse and/or aging
- acute/sudden injuries
- trauma
- symptoms:
- pain, stiffness, weakness
- tenderness, inflammation, skin may be warm to touch
- diagnosis:
- history, physical exam and x-rays may be ordered
- additional diagnostic testing such as ultrasound or MRI scan may be ordered
- treatment:
- home treatment: rest, ice, NSAIDs, avoid painful activities, gradual introduction to stretching and range of motion to the area
- medical treatment: physical medicine treatment, bracing or casting
Tennis elbow (lateral epicondylitis)
- is a tendonitis
- swelling of the tendons that causes pain in the elbow/arm region
- common reason why people see doctor for elbow pain
- usually develops over time
- symptoms:
- pain with lifting- pain with making a fist
- pain with opening an object- pain with grabbing an object
- diagnosis:
- history, physical examination and x-rays or MRI may be ordered
- treatment:
- rest, ice, compression, NSAIDs, physical medicine treatment, or injections
- surgery is an option if conservative measures fail
- prevention:
- avoid activities that cause the pain
- warm up prior to activity and ice after activity
Exercise injuries
- strained or pulled muscles
- joint sprains
- joint injuries
- dislocations
- prevention:
- consult you medical professional prior to starting a program
- warm up prior to starting program
- have variety in your work out
- discontinue an exercise if you experience pain
- drink plenty of fluids
- use proper technique; if unsure about proper technique seek instruction from a certified trainer
- rest to allow your body to recover
- treatment: rest, ice, compression, elevation and NSAIDs