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Sports injuries are the injuries that most commonly occur during sports and exercises. These injuries may result from accidents, poor training practices, and use of improper protective gear, lack of conditioning, and insufficient warm up and stretching. The sports injuries may be either acute (sprains, fractures, tears) or chronic (tendinitis, overuse injury) injuries.
Sports Injury Management
When you suffer an injury during sports events, never try to continue the activity in pain because it may cause further harm. Some injuries may require prompt attention by a doctor, while others can be treated at home.
You should seek medical treatment if:
- The injury is causing severe pain, swelling, or numbness.
- You are not able to put any weight on the injured area.
- The pain or dull ache of an old injury has increased along with swelling and joint instability.
If you do not have any symptoms mentioned above, you can adopt self –care treatment at home. You should follow the RICE method immediately after injury to relieve pain and inflammation. These steps should continue for at least 48 hours.
- Rest: You should take rest from regular exercises or daily activities as needed.
- Ice: Apply an ice pack over the injured area for 20 minutes at a time. This should be done four to eight times a day. A cold pack, ice bag, or plastic bag filled with crushed ice and wrapped in a towel can be used.
- Compression: Compress the injured area with elastic wraps, special boots, air casts, and splints. This helps to reduce swelling.
- Elevation: Keep the injured elbow or wrist elevated on a pillow, above the level of the heart. This is to help decrease swelling.
Your doctor may recommend other treatments to help your injury heal. These include:
- Nonsteroidal Anti-Inflammatory Drugs: These drugs reduce swelling and pain.
- Immobilization: Immobilization is minimizing the movement of injured area to prevent further damage. It also reduces pain, swelling, and muscle spasm. Slings are given to immobilize the arms and shoulders.
- Rehabilitation: Rehabilitation involves exercises that get the injured area back to normal condition. Exercises start with gentle range-of-motion exercises followed by stretching and strengthening exercises.
- Other Therapies: Other common therapies that help in the healing of sports injuries include mild electrical currents (electrostimulation), cold packs or cryotherapy, heat packs or thermotherapy, high-frequency sound waves (ultrasound), massage and platelet rich plasma (PRP injections).
- Surgery: Surgery is the last resort for management of sports injuries and is indicated only if conservative techniques are not helpful. Surgeries are performed to repair torn tendons and ligaments or to realign the broken bones. Your surgeon may recommend arthroscopic procedure or open techniques to treat your sports injuries.
Arthroscopy
Arthroscopy is a surgical procedure in which an arthroscope is inserted into a joint. Arthroscopy is a term that comes from two Greek words, arthro-, meaning joint, and -skopein, meaning to examine.
Arthroscopy is performed in a hospital operating room under general anaesthetic.
The arthroscope is a small fiber-optic viewing instrument made up of a tiny lens, light source and video camera. The surgical instruments used in arthroscopic surgery are very small (only 3 or 4 mm in diameter), but appear much larger when viewed through an arthroscope.
The television camera attached to the arthroscope displays the image of the joint on a television screen, allowing the surgeon to look, for example, throughout the knee-at cartilage and ligaments, and under the kneecap. The surgeon can determine the amount or type of injury, and then do the repair.
The surgeon makes two small incisions (about 1/4 of an inch), around the joint area. Each incision is called a portal. These incisions result in very small scars which in many cases are unnoticeable. In one portal, an arthroscope is inserted to view the knee joint. A sterile solution is pumped to the joint which expands the knee joint, giving the surgeon a clear view and room to work. The sterile solution is regulated by a drainage needle for the amount of fluid in the joint during the procedure.
With the images from the arthroscope as a guide, the surgeon can look for any pathology or anomaly. The large image on the television screen allows the surgeon to see the joint directly and to determine the extent of the injuries and then to perform the particular surgical procedure if necessary.
The other portal is used for the insertion of surgical instruments. A surgical instrument is used to probe various parts within the joint to determine the extent of the problem. If the surgeon sees an opportunity to treat a problem, a variety of surgical instruments can be inserted through this portal. After treating the problem, the portals (incisions) are closed by suturing or by tape. Arthroscopy is much less traumatic to the muscles, ligaments, and tissues than the traditional method of surgically opening the knee with long incisions (arthrotomy).
Some of the common knee injuries experienced by sports individuals and the treatments include:
Meniscal tear
The two wedge-shape cartilage pieces present between the thighbone and the shinbone are called meniscus. They stabilize the knee joint and act as “shock absorbers”. Meniscal tear is the commonest knee injury in athletes, especially those involved in contact sports. A suddenly bend or twist in your knee cause the meniscus to tear. This is a traumatic meniscus tear.
Torn meniscus causes pain, swelling, stiffness, catching or locking sensation in your knee making you unable to move your knee through its complete range of motion. Knee arthroscopy is the commonly recommended surgical procedure for meniscal tears.
The surgical treatment options include meniscus removal (meniscectomy), meniscus repair, and meniscus replacement. Surgery can be performed using arthroscopy. During meniscectomy, small instruments called shavers or scissors may be used to remove the torn meniscus. In arthroscopic meniscus repair the torn meniscus will be pinned or sutured depending on the extent of tear. Meniscus replacement or transplantation involves replacement of a torn cartilage with the cartilage obtained from a donor or a cultured patch obtained from laboratory.
Patellar Instability
Patellar (knee cap) instability results from one or more dislocations or partial dislocations (subluxations). Patella is the small piece of bone in front of the knee that slides up and down the femoral groove (groove in the femur bone) during bending and stretching movements. The ligaments on the inner and outer sides of patella hold it in the femoral groove and avoid dislocation of patella from the groove. Any damage to these ligaments may cause patella to slip out of the groove. Once damaged, these soft structures are unable to keep the patella (knee cap) in position. Repeated subluxation or dislocation makes the knee unstable and the condition is called as knee instability.
Treatment for instability depends on the severity of condition and based on the diagnostic reports. Initially your surgeon may recommend conservative treatments however in severe cases may recommend arthroscopic surgery and correct the misalignment.
Posterior Cruciate Ligament Tears
Posterior cruciate ligament (PCL), one of four major ligaments of the knee is situated at the back of the knee. It connects the thighbone (femur) to the shinbone (tibia). The PCL limits the backward motion of the shinbone.PCL injuries are very rare and are difficult to detect than other knee ligament injuries.
The PCL is usually injured by a direct impact, such as in an automobile accident when the bent knee forcefully strikes the dashboard. In sports, it can occur when an athlete falls to the ground with a bent knee. Twisting injury or overextending the knee can cause the PCL to tear. Patients with PCL injuries usually experience knee pain and swelling immediately after the injury. There may also be instability in the knee joint, knee stiffness that causes limping, and difficulty in walking.
Generally, surgery is considered in patients with dislocated knee and several torn ligaments including the PCL. Surgery involves reconstructing the torn ligament using a tissue graft which is taken from another part of your body, or a cadaver (another human donor). Surgery is usually carried out with an arthroscope using small incisions.