Managing Sports Injuries

Question 1

What are the 2 types of MSK sports injuries?

Answer 1

Acute and chronic/overuse

Question 2

Types of acute sports injuries?

Answer 2

Non-contact twisting (commonly ACL rupture), non-contact high force eccentric muscle contraction (force generated > ability of tendon to resist the force), fracture, periosteal contusion (bruising), dislocation

Question 3

Types of chronic/overuse sports injury?

Answer 3

• Tendonitis - e.g. tennis/golfers elbow, Patella tendon, Achilles tendon, Rotator cuff tendons
• Bursitis - Inflammation of the bursa (common in the knee and in workers who kneel lots)
• Stress fracture - Caused by multiple recurrent forces that occur repetitively without adequate recovery (most common in a susceptible athlete)

Question 4

How should acute soft tissue injuries be treated?

Answer 4

P.O.L.I.C.E
P = Protection
O.L = Optimal loading
I = Ice
C = Compression
E = Elevation

Question 5

How should acute fractures/dislocations be treated?

Answer 5

The 5 R’s of Orthopaedics.
- Resucitate, reduce (restoring the bone to its proper alignment - think dad and your toe), radiograph, restrict, rehabilitate

Question 6

How do you manage a chronic injury?

Answer 6

Remove the cause, introduce preventative measures and extend rehabilitation

Question 7

What is tendonitis/tendonosis?

Answer 7

Tendonitis = Acute micro-tearing of the tendon with associated inflammatory cells seen.

Tendinosis
Chronic changes seen due to repetitive tendonitis (i.e. tendon is changed at a micro and macro level). Results in:
- Increased type III collagen
- Separation of collagen fibres
- Over expression of VEGF- leads to neo-angiogenesis (these blood vessels are poorly organised and compromise the mechanical strength of the tendon - predisposing it to further injury/rupture)
- Tendon feels hard and thick and can appear dull and brown rather than shiny and white

Question 8

Treatment of tendinosis?

Answer 8

Remove the cause, introduce preventative measures and put in extended rehabilitation

Question 9

Why do stress fractures occur?

Answer 9

Stress fractures occur when bones are not given enough time to adapt to increased stresses (from frequency/force). E.g. going from running 5k’s to marathons too soon.

Individuals may also be susceptible due to poor nutrition (low Vit D) or the female triad of menstrual dysfunction, low energy availability (with/without eating disorder) and low bone density.

Question 10

Treatment of stress fractures?

Answer 10

Remove the cause, introduce preventative measures and put in extended rehabilitation

Question 11

How are tendon injuries such as A.C.L rupture or achilles tendon rupture treated?

Answer 11

P.O.L.I.C.E