ERINDANLE COLLEGE SPORTS INJURIES TALK

• DAVE BERG, PHYSIO

• BERG PHYSIOTHERAPY AND SPORTS INJURY CENTRE AT ERINDALE MEDICAL CENTRE

• 6231 1155

Sport should be fun

ROLE OF PHYSIOTHERAPIST

• MANAGEMENT OF MUSCULOSKELTAL INURIES IN PRACTICE

• ON FIELD MANAGEMENT AND ASSESSMENT OF INJURIES

• SCREENING FOR THE PREVENTION OF INJURIES

MUSCULOSKELETAL INJURIES

• BONE – BREAKS, SPINAL INJURIES

• MUSCLE STRAINS– TEARS, CORKS

• TENDONS – IRRITATIONS, TEARS

• LIGAMENTS – TEARS, SPRAINS

Musculoskeletal Injuries Cont

• JOINT– MENISCAL, OSTEOCHONDRAL– DISLOCATIONS

• OTHER SOFT TISSUE INJURIES

“OTHER”

“OTHER CONT”

BONE INJURIES

Bone Injuries

• Usually high energy injuries

• Immediate pain, usually associated with an audible crack

• Deformity, Swelling, Pain to palpate, Pain to axially load.

• Types of breaks– stress fracture, spiral fracture, transverse break

Stress Fractures

• Begin as pain with activity

• Progress to pain with activity and constant pain

• Most commonly affected areas are the foot, shin and low back

Fracture Management

• Fingers. Sign if not obvious is to press through length of bone.

• Xray is gold standard test.• Surgery if displaced or rotated• four to six weeks if no surgery• Other breaks follow similar principles.

Immobilisation or surgery depending on displacement.

Traumatic breaks

Muscle Injuries

• Muscle Injuries are direct (corks), or indirect (tears).

• Muscle tears are known as strains, and are classed one to three

• Most commonly injured muscles are hamstring, calf, and quadriceps.

• Muscle Tears have a very high recurrence rate.

Muscle Tears

• Grade One Tear: 7-10 days

• Grade Two Tear: 4-7 weeks

• Grade Three Tears: >six weeks

• Rehab of the muscle tear very important. Regaining strength, length and power.

• Pain is not the guide. Tensile strength (ability to contract under load) does not recover till several weeks

Muscle Corks

• Impact injuries• Usually poorly

managed.• Immediate

management should be ice with full stretch.

• Definitely should not consume alcohol.

Ligament Injuries

• Can be contact or non contact injuries.

• Involve the joint being moved in a direction it does not want to go.

• Pain is immediate• Ligament in ankle and

knee are most commonly torn

Ligament Injuries Cont.

• Injuries are graded one to three

• Grade three injuries are full thickness tears and usually require surgery.

• Grade two tears can generally be managed conservatively. >four weeks

Ankle Ligaments

• Most commonly torn are the Lateral ligament and the syndesmosis)

• Mechanism is usually rolling over the ankle, twisting on a fixed foot (syndesmosis), or falling over the heel usually from a height

Management of Ankle Injuries

• Brace for four weeks if laxity present

• Strength training to improve peroneal and gastroc muscle strength

• Stretching to restore range of movement, particularly dorsiflexion

• Balance or proprioception retraining.

Knee Ligaments

• Most Commonly torn are the ACL and Medial Ligament.

• ACL requires surgery. Is a non contact injury. Happens when stepping or cutting.

• Medial ligament is usually a contact injury. Managed conservatively with a brace for four to six weeks.

• Posterior Cruciate Ligament rarer. Hardly ever managed surgically even if fully torn.

Head Injuries

Head Injuries

• Usually involve head contacting something solid eg another head or knee

• If player is knocked out they should definitely not continue to play.

• Aggression, twitching, vomiting, severe headache, amnesia, and blurred vision are all bad signs

• Mandatory three weeks out if knocked out

Head Injuries

• Three concussion episodes in one year should sit out the whole year.

• Two impacts in rapid succession can result in death.

• Should not consume alcohol, risk death

• If knocked out should not drive home, should be monitored and should not sleep till that night.

Eye Injuries

• Involves foreign object into eye socket.

• Can result in loss of vision or eye.

• Immediate hospital referral.

Joint Dislocations

• Occurs when a joint is taken out its socket

• Most commonly affected are the fingers shoulder, AC joint, and patella femoral joint. Ankles are uncommon

• Knee and hip dislocations are rare and VERY serious

DISLOCATIONS CONT

Shoulder disclocations

SHOULDERS CONT

Shoulder dislocations

• Mechanism outstretched arm forced backwards

• In someone under 25 years, greater than 90 percent chance of doing it again

• Once dislocated three times need surgery

• Surgery follows six to nine month rehab period

Shoulder dislocations

• Conservative approach after first dislocation MIGHT prevent subsequent episodes and therefore surgery.

• Four to eight weeks off.• Strengthening of back and rotator cuff

muscles.• Improved proprioception in shoulder. • Improved thoracic movement.

Other dislocations

• Knee and hip dislocations require immediate hospital review. Person can lose their limb

• Patellofemoral and AC dislocations are not surgical. Tend to respond very well to conservative treatment.

• Finger dislocations can be surgical depending on direction of dislocation

Finger dislocations

Hip dislocation

Other joint injuries

• Other intra articular structures can be damaged. These include bone cartilage interface, called osteochondral injuries, meniscus injuries.

• Osteochondral injuries require prolonged rest or surgery.

• Meniscal tears can settle with rest but often need surgery, especially if knee is locking

Tendon Injuries

• Usually occur in older athletes when blood supply starts to lessen.

• Can occur in younger athletes in high energy injuries.

• Tendons most commonly torn are rotator cuff, achillies, patella.

• These are usually surgical injuries.

Groin injuries.

Tendon Injuries Cont.

• More common than tears are inflammations

• Tendonitis starts as pain with activity and progresses to pain after activity.

• Very difficult to manage once established due to the poor blood supply of tendons.

• Best managed early with rest, anti inflams, and stretching and strengthening.

Back injuries

Back Injuries

• Can be traumatic or due to overuse.

• Stress Fractures can occur in sports where athletes bend backward a lot (gymnastics)

• Any number of structures can be damaged, and exact diagnosis is much more difficult.

• Back and neck injuries that occur on a football field or with high energy mechanism need to be taken very seriously

Many injuries can be prevented, but sometimes its just plain

luck...

But don’t worry too much. After all, sport shouldn’t be taken too

seriously, have fun!

AND BESIDES, INJURIES CAN HAPPEN ANYWHERE,

ANYTIME.