MSK 10: Sports and Soft Tissue Injury

Question 1

What types of injuries require a physician consult?

Answer 1

• all traumatic joint injuries
• severe pain
• pain in joint or bone greater than 2 weeks
• neck injuries
• head injury headache
• eye injury with blurred vision, loss vision, moderate to severe eye discomfort or pain
• nosebleed lasting > 20 mins
• earache with any loss of hearing
• child < 12 years
• elderly

Question 2

What has been injured?

Answer 2

• hurts to touch or move joint – joint, ligament, or cartilage
• hurts to touch or move muscle – muscle or tendon
• hurts to touch or move bone (extremely painful) – bone

Question 3

Describe 2 types of physical protectors/interventions that have some evidence for helping reduce the risk of sports injuries.

Answer 3

-

Question 4

Common Treatments

Answer 4

• acetaminophen
• anti-inflammatories – oral and topical
• NSAIDs
• celecoxib (Celebrex)
• muscle relaxants (methocarbamol)
• narcotics – codeine, morphine
• combinations of the above
• steroids – prednisone, hydrocortisone and others (oral and injectable)

Question 5

Compare and contrast the use of NSAIDs, acetaminophen, muscle relaxants for the treatment of pain secondary to a sports injury.

Answer 5

-

Question 6

Describe the 4 key basic treatment recommendations for all sports injuries.

Answer 6

• MCE: if must use ice then 10 mins only, remove for 20 mins, and repeat 1-2 times, warm up before if return to activity
• treat pain as needed with painkillers – no great evidence to help choose between acetaminophen, NSAIDs, and topical NSAIDs
• severe pain – narcotics
• NO muscle relaxants

Question 7

Muscle Contusion

Answer 7

blood vessels are broken, and muscle is crushed

• MCE +/- NSAIDs/acetaminophen

Question 8

Tennis Elbow

Answer 8

• nitrate patches appear to provide benefit

Question 9

Plantar Fasciitis

Answer 9

• corticosteroid injections

Question 10

Grade I (Mild) Ankle Sprain

Answer 10

tissue is stretched

• slight swelling (hardly noticeable)
• mild loss of range of motion (ability to move in various directions) and strength
• no decrease in stability

Question 11

Grade II (Moderate) Ankle Sprain

Answer 11

involves stretching and some tearing of tissue
moderate swelling

• usually includes some bruising
• moderate loss of range of motion and strength
• some decrease in stability – difficulty weight bearing

Question 12

Grade III (Severe) Ankle Sprain

Answer 12

complete tearing of tissue

• signicant swelling and bruising
• marked decrease in stability – almost no weight bearing

Question 13

Ankle Sprain Treatment

Answer 13

• MCE +/- NSAIDs/acetaminophen if needed for pain
• early mobilization