Sports Medicine / Sports Injury

Sports injuries often occur during sports and exercise activities, but sometimes simple everyday activities can cause an injury.

Sports injuries can be a result of accidents, improper use of protective equipment, inadequate training or insufficient stretching / warm-up exercises. Sports injuries can often lead to soft tissue injuries inform of sprains, strains, contusions, tendinitis and bursitis. Fractures and dislocations can occur but are rare. Even with appropriate treatment, these injuries may require a prolonged amount of time for healing.

Soft-tissue injuries can be grouped into two basic types; acute injuries and chronic (overuse) injuries. Acute injuries are caused by fall, twist or blow to the body; examples include sprains, strains, and contusions. Overuse injuries occur gradually over time, when an activity is repeated frequently and the body do not get enough time to heal; examples include tendinitis and bursitis.

Common Acute Soft-Tissue Injuries

Acute soft-tissue injury severity can vary. Initial treatment with the RICE protocol is usually very effective. RICE stands for Rest, Ice, Compression and Elevation.

  • Rest – Take a break, use crutches to avoid putting weight or use Air/Moon Boot.
  • Ice – Cold packs 20 minutes at a time, several times a day. Do not apply ice directly to the skin as it can cause skin burns.
  • Compression – Use an elastic compression bandage, to prevent additional swelling and blood loss.
  • Elevation – Elevate the injured part higher than your heart level, to reduce swelling.
Sprains

Sprain is a stretch and/or tear of a ligament. Ligaments are strong band of connective tissue that connects the end of one bone with another at the body’s joints to stabilize and support them.

The areas of your body that are the most vulnerable to sprains are your ankles and knees. A sprained ankle can occur when your foot turns inward, placing extreme tension on the ligaments of your outer ankle. A sprained knee can be the result of a sudden twist or a fall.

While the severity varies, pain, bruising, swelling, and inflammation are common to all categories of mild, moderate and severe sprains. Treatment for mild sprains includes RICE and sometimes physiotherapy exercises. Moderate sprains often require a period of bracing. The most severe sprains may require surgery to repair the torn ligaments.

Strain

Strain is an injury to a muscle and/or tendons. Tendons are fibrous bands that attach muscles to the bone. Strains often occur in your foot, leg (typically the hamstring) or back.

Similar to sprains, strains can vary in severity from a simple stretch in your muscle or tendon to a partial or complete tear in the muscle-and-tendon combination. Common symptoms of a strain include pain, muscle spasm, muscle weakness, swelling, inflammation and cramping.

Contact sports such as soccer, hockey and squash put athletes at risk of strains, as do the sports that involve quick starts, such as running races.

The recommended treatment for a strain is the same as for a sprain: rest, ice, compression and elevation. This should be followed by simple exercises to relieve pain and restore mobility. Surgery may be required for a more serious tear.

Contusions (Bruises)

Contusion is a bruise caused by a direct blow or repeated blows, crushing underlying muscle and soft tissue without a break in the overlying skin. Contusion can result from falling or jamming the body against a hard surface. The discoloration of the skin is caused by blood pooling around the injury.

Most contusions are mild and respond well with the RICE protocol. If symptoms persist, medical assessment should be sought to prevent permanent damage to the soft tissues.

Common Overuse Soft-Tissue Injuries

Tendinitis                                                                                                                        

Tendinitis is an irritation or inflammation of a tendon or its covering sheath. It is caused by a series of small stresses that repeatedly damage the tendon. Symptoms typically include swelling and pain that worsens with activity.

Soccer, football and basketball players, runners and dancers are prone to tendon inflammation in their legs and feet.

Tendinitis is treated by rest to eliminate stress, anti-inflammatory medication, steroid injections in to the tendon sheath, splinting, and exercises to correct muscle imbalance and improve flexibility. Persistent inflammation may cause significant damage to the tendon, which may require surgery.

Bursitis   

Bursae are small, jelly-like sacs that are located throughout the body, including around the hip, knee, and heel. Bursa contains small amount of fluid and are positioned between bones and soft tissues, acting as cushions to reduce friction.

Bursitis is inflammation of a bursa. Repeated small stresses and overuse can cause the bursa in the hip, knee or ankle to swell. Many people experience bursitis in association with tendinitis.

Bursitis can usually be relieved by changes in activity and possibly with anti-inflammatory medication. If swelling and pain do not respond to these measures, removing fluid from the bursa and injecting corticosteroid medication into the bursa may be recommended. Corticosteroid injections usually work well to relieve pain and swelling.

Although surgery is rarely necessary for bursitis, if the bursa becomes infected, an operation to drain the fluid from the bursa may be necessary. In addition, if the bursa remains infected or the bursitis returns after all nonsurgical treatments have been tried, removal of the bursa may be recommended. Removal (excision) of the bursa can be done using skin incision (cut) known as open procedure or as an arthroscopic procedure with small incisions and surgical instruments.

Prevention

Most sports injury occurs when there is a sudden change in the activities; increase in duration, intensity or frequency. Most soft-tissue injuries can be prevented through proper conditioning, training and equipment.

Prevention tips include

  • Replace shoes as they wear out
  • Use proper equipment
  • Balanced fitness program that incorporates cardiovascular exercise, strength training and flexibility
  • Drink enough water to prevent dehydration, heat exhaustion, and heat stroke
  • Warm up even before stretching
  • Begin stretches slowly and carefully until reaching a point of muscle tension
  • Cool down is the final phase of exercise routine and should take twice as long as the warm up time
  • Schedule regular days off from vigorous exercise and rest when tired
  • Fatigue and pain are good reasons to not exercise
  • Avoid the “weekend warrior” syndrome and try to get at least 30 minutes of moderate physical activity every day