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• Youtube video http//www.youtube.com/watch?vMRGjy
  6AX69c

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SPORTS INJURIES

• Injuries may be forgiven,
• but not forgotten. -Aesop

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Most Common Sports Injuries

• Rotator Cuff tendinopathy
• Tennis Elbow
• Ankle Sprain
• Runners Knee
• Achilles Tendiopathy
• Knee Ligament rupture

• Groin Sprains
• Shin Splints
• Neck Stains
• Lower Back Injury
• Pulled Muscles
• Fractured bones

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Most Common Causes of Injury

• Failure to Warm UP
• Over training
• Excessive loading on the body
• Not taking safety precautions
• An Accident
• Inappropriate equipment

• Poor Exercise Technique
• Reoccurring injury
• Genetic Factors
• Muscle weakness or imbalance
• Lack of flexibility
• Joint laxity

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SIGNS of injuries

• SHARP
• Swelling
• Heat
• Altered function
• Red
• Painful

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Treatment

• P.I.E.R principle
• Pressure
• Ice
• Elevation
• Restriction/Rest

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Sprains

• Relate to ligaments
• Tendons are strained.
• Pulls are associated with muscles
• Overuse or successive force- stretches or tears-
  tissues that connects bone

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3 Categories (or Grades) of Injuries

• 1st degree mild, least severe, a couple days to
  heal if treated properly overstretched
• 2nd degree- moderate but more severe,
  physiotherapy may be needed
  partial tear
• 3rd degree- most severe, surgery, physiotherapy,
  up to 12 months to recover complete tear or
  rupture

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Ankle Sprain

• Most Common Plantar Flexion or Inversion
• Anterior talofibular ligament
• Calcaneofibular ligament
• Posterior talofibular ligament
• Tibiofibular ligament (severe injury)

Inversion sprain
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The Ankle Joint Medial View

• Eversion sprains
• Occurs to the deltoid ligament

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The Ankle Joint Lateral View
Tibia
Fibula
Lateral malleolus
Anterior tibiofibular ligament
Posterior tibiofibular ligament
Posterior talofibular ligament
Calcaneofibular ligament
Calcaneus
Anterior talofibular ligament
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Ankle Sprain

• 1st Degree inversion stress with foot in mild
  plantar flexion, stretching the
  anterior talofibular ligament
• 2nd Degree tear anterior talofibular ligament,
  stretch and tear the calcaneofibular ligament
• 3rd Degree grade III injury, varying
  degrees of injury to anterior
  talofibular,
  calcaneofibular, and
  posterior talofibular ligaments and
  joint capsule

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Symptoms and Signs
1st Degree 2nd Degree 3rd Degree
Mild pain Point tenderness Localized swelling (anterior talofibular ligament) Partial tearing sensation felt Swelling at point tenderness at sprain site Complete tear/rupture Snap/Pop sound Severe pain Tenderness and swelling over entire lateral area Tearing of three ligaments
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Treatment
1st Degree 2nd Degree 3rd Degree
PIER Limit weight-bearing activities Wrap when weight bearing No swelling circumduction activites Weight bearing tape Exercises PIER X-ray Crutches 5-10 days Plantar and dorsiflexion exercises (if pain free) 1-2 weeks weight bearing Taping with walking Motion exercises Cold / heat application PIER X-ray Walking cast after swelling After circumduction exercises Progressive program of strengthening Joint Laxity no end point
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Anterior Cruciate Ligament (ACL)

• Considered to be the most serious ligament injury
  to the knee
• Causes
• Direct blow to knee
• Single-plane force lower leg is rotated while
  the foot is fixed
• Sharp cutting motion
• Hyperextension from a force in front of knee
• Non-contact

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Females and ACL Injuries

• Extrinsic factors
• Level of conditioning, skill acquisition, playing
  style, amount of preparation and practice,
  environmental considerations, types of equipment
  used
• Intrinsic factors
• Femoral intercondylar notch size, ACl size, ACL
  laxity, lower extremity anatomic malalignment
  (ie. Q-angle)
• possible reasons why females are more likely
  to suffer noncontact ACL injuries

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Q-angle - Quadriceps angle

• Formed in the frontal plane by a linedrawn from
• the centre of the patella to the
• anterior superior iliac spine,
• and from the centre of the tibial tuberosity to
  the centre of the patella extending up the thigh
• If angle created by the intersection of these
  two lines above the patella is greater than
  twenty degrees, this puts the individual at
  greater risk of experiencing knee injury

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Q-angle and ACL tears

• Width of the pelvis determines size of Q-angle
• women have a wider pelvis than men, the Q-angle
  tends to be greater
• The forces are concentrated on the ligament each
  time the knee twists
  increasing the risk for an ACL tear
• Proper stretching and strengthening is important

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Symptoms and Signs

• Experience a pop
• Immediate disability
• Knee feels like it is coming apart
• Rapid swelling at joint line
• Positive anterior drawer sign
• pivot-shift test, jerk test, and flexion-rotation
  drawer test may be positive
• Decreased proprioception

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Treatment

• PIER
• Weight bearing support
• Physiotherapy
• Surgery?
• Depends on athletes age, type of stress applied
  to knee, amount of stability present, techniques
  available to surgeon
• May involve joint reconstruction, with
  transplantation of some external structure

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Achilles Tendon Rupture

• Sports with stop and go action
• Usually a result of sudden pushing-off action of
  the forefoot with the knee being forced into
  complete extension

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Symptoms and Signs

• Feel a sudden snap (felt like something kicked
  him/her in lower leg)
• This will often be accompanied by a loud crack or
  bang.
• Immediate pain
• Point tenderness, swelling, discoloration
• There may be a gap felt in the tendon.
• Toe raising impossible
• Usually occurs 2-6cm proximal to its
  insertion onto the calcaneus

Treatment - Surgical repair
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Rotator Cuff Tear

• Involve one or four muscles
• Supraspinatus, infraspinatus, teres minor, and
  subscapularis
• Supraspinatus, infraspinatus, and teres minor
  share a common tendinous insertion on the greater
  tubercle of the humerus

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Shoulder Dislocation

• Normal Dislocated

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Dislocation

• Bone displaced from position
• Damage to joint (synovial) capsule and ligaments
  between bones, muscles and tendons could tear
• Signs deformed joints, painful to move or touch,
  joint is unusable

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Shoulder Dislocation

• Humerus pops out of the glenoid fossa
• Usually a result of a hit or fall resulting in a
  tear to the glenohumeral ligament and joint
  capsule
• Treatment should be done by a professional
• Injury to the brachial plexus (vital nerves) and
  blood vessels if not done properly

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Shoulder Dislocation

• Inferior Dislocation
  Anterior Dislocation

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Separation

• Bones held by ligaments tear or separate from
  each other
• Shoulder separation
• Tearing of acromioclavicular ligament union of
  clavicle to acromion)
• Result from falls directly on shoulder (contact
  from another player or tumble on shoulder)

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Shoulder Separation
Shoulder separations are classified as either 1st
(mild), 2nd (moderate), or 3rd (severe) degree
sprains. A 3rd degree AC joint sprain is the most
severe with the result being what is termed a
stair step deformity. This is when the end of
the clavicle appears elevated because the
ligament connecting the bones is completely torn.
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Torn Cartilage

• Cartilage is avascular
• Takes time to heal
• Often use arthroscopy surgical procedure
  where incision made to allow a small fibre optic
  camera in to assess damage

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Shin splints

• Overuse without adequate recovery
• Pain along medial or lateral
  side of tibia along shaft
• Caused by tearing of interosseous membrane
  (between tibia and fibula) or periosteum (lining
  of bone)
• Causes change in training regimen (frequency,
  duration or intensity), training surface (hard),
  poor shoes
• Can develop into stress fractures

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Biceps Tendinitis

• Overuse injury
• Adequate rest is not given
  to the biceps brachii muscle when it has been
  worked or overloaded
• Pain on the proximal end of biceps
• Flexion of shoulder and elbow painful

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Tendinitis

• Inflammation of a tendon caused by irritation due
  to prolonged or abnormal use

itis means an inflammation to that particular
organ or tissue
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Hematoma

• A collection of pooled blood in the thigh within
  a relatively constricted area.
• Example thigh - probably accompany all serious
  contusions of the thigh
• they are difficult to diagnose because of the
  large muscle mass in the thigh
• may become calcified and form a hard lump in the
  quadriceps muscle. This lump is called
  osteomyositis ossificans and may cause stiffness
  or a bump in the muscle that may be very long
  lasting.

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Signs Symptoms

• Swelling at the injury site.
• Feeling of tenseness to touch
• Tenderness.
• Redness that progresses through several colour
  changes--purple, green-yellow, yellow--before it
  completely heals.

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Treatment

• PIER
• anti-inflammatory medicine prescribed by your
  healthcare provider.
• wearing an elastic thigh wrap when you return to
  sports
• having prescribed physical therapy (including
  deep tissue treatments - ultrasound or electrical
  stimulation).
• Complications infection could develop in the
  wound,
• the signs and symptoms might be increasingly
  severe pain,
• a fever of 101 degrees or more,
• swelling with surrounding redness, and pus.

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Groin Strain

• Caused by strenuous stretching movements of the
  legs
• Also sometimes with overuse of the adductor
  muscles
• Symptoms mild discomfort, pain against
  resistance, swelling and bruising in inner thigh
• Usually take 4-6 weeks to heal but could be
  upwards of 8 weeks

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Patellofemoral Pain Syndrome

• Causes muscle weakness, muscle imbalance, tight
  tendons, abnormal movement of the kneecap
• Signs and Symptoms pain at front of knee, pain
  on pressure on knee, walking up stairs, running,
  swelling around kneecap, grinding or grating
• Should see improvement over the few weeks of
  treatment, looking at 4-6 months of recovery time
  completely

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Patellofemoral Pain Syndrome

• Treatment Rehabilitation
• Rest the joint or cut back on the intensity of
  activity (ex- reduce practice or training
  schedule)
• Strengthen the Quadriceps muscles (they support
  the knee)
• Wear a knee brace or sleeve during activity
• Wear an arch support or orthotic to prevent
  overpronation
• Replace old shoes, which have been worn down from
  pronation
• Anti-inflammatory drugs can be taken to reduce
  pain
• Rehabilitation can last anywhere from one to
  eight weeks depending on the severity of the
  injury. Typically, athletes can continue their
  regular activities if the level of pain allows
  them to participate.

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Osgood Schlatter Disease

• Description condition of the knee where the
  tibial tuberosity becomes inflamed. The patellar
  tendon inserts on the tibial tuberosity and
  through overuse can tug away at the bone, causing
  pain and inflammation.
• Symptoms Pain around one or both knees , Pain
  when straightening the leg through the knee joint
  or full squat , Tibial tuberosity is swollen ,
  Skin over tibial tuberosity is red, painful and
  inflamed , Pain when jumping or squatting

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Osgood Schlatter Disease

• Causes
• Growth spurt this condition tends to affect
  teenage children directly after a growth spurt.
  In addition, children that are active and engage
  in sports are at an increased risk.
• Treatment and Rehabilitation
• Strengthening the quadriceps and hamstring
  groups
• Avoiding physical activities that require
  frequent knee bending for two-four months
• Wearing a knee brace or knee sleeve to restrict
  movement
• Anti-inflammatory drugs may be taken to control
  pain and inflammation
• Increasing flexibility in the quadriceps and
  hamstring muscles

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Sports Injury Facts

• More than 3.5 million children ages 14 and under
  receive medical treatment for sports injuries
  each year.
• Injuries associated with participation in sports
  and recreational activities account for 21
  percent of all traumatic brain injuries among
  children in the United States.
• Overuse injury, which occurs over time from
  repeated motion, is responsible for nearly half
  of all sports injuries to middle-and high-school
  students. Immature bones, insufficient rest after
  an injury and poor training or conditioning
  contribute to overuse injuries among children.
• Most organized sports related injuries (62
  percent) occur during practices rather than
  games. Despite this fact, a third of parents
  often do not take the same safety precautions
  during their child's practices as they would for
  a game.
• A recent survey found that among athletes ages 5
  to 14, 15 percent of basketball players, 28
  percent of football players, 22 percent of soccer
  players, 25 percent of baseball players and 12
  percent of softball players have been injured
  while playing their respective sports.
• Children ages 5 to 14 account for nearly 40
  percent of all sports-related injuries treated in
  hospital emergency departments. The rate and
  severity of sports-related injury increases with
  a child's age.