Physio management of common sports injuries

Question 1

What are the most common types of injuries (3)?

Answer 1

Fracture - 18,000 cases 2011-12
Soft tissue injury - 7500 cases 2011-12
Dislocation - 3000 cases 2011-12

Question 2

What’s the most common areas of the body that are injured?

Answer 2

Knee/lower leg - 10,000 cases
Wrist/hand - 5500 cases
Head - 5600 cases

(generally UE > LE with exception of knee/lower leg)

Question 3

What are the different MOI for fractures?

Answer 3

• direct blow
• indirect trauma
  > awkward landing
  > twisting (spiral)
  > mm force (avulsion)

Question 4

S/Sx for fractures?

Answer 4

Pain+tenderness
Swelling
Deformity
Inabiltiy to WB
Inability to move injured part

Question 5

Management of #?

Answer 5

Non-displaced or minimally displaced?
- sling/cast/brace

Displaced and/or unstable?
- reduction + immob +/- surgical fixation (depending on instabilty)

Address:
ROM/Strength/RTS management

Question 6

Complications of #?

Answer 6

Bone:

• delayed union
• malunion

Nerve
- nerve/BV injury

Muscle
- compartment syndrome

Blood
- DVT/infection

Question 7

S/Sx of nasal fractures

Answer 7

Epistaxis
Nasal airway obstruction
Crepitus over nasal bridge
Swelling/bruising
Nasal asymmetry

Question 8

Management of nasal fractures

Answer 8

• ice; cool down the athlete if hot
• insert gauze to stop bleeding
• sit up/lean forward/pinch the ST of the nose
• be wary of concussion/head injury

Question 9

What is the difference between a dislocation and a subluxation?

Answer 9

Dislocation = complete dissociation of articulating surfaces
Subluxation = articulating surfaces remain in partial contact with each other

Question 10

S/Sx of disloc

Answer 10

1. Acute pain
2. Gross deformity
3. Pt holding the limb in a particular way
4. Loss of joint function

Question 11

Management of dislocations

Answer 11

1. Stay calm
2. Immob
3. Avoid relocating - call dr and get help if available; Jane gives eg of football player getting finger relocated and then needing 2 surgeries because the finger was fractured

F/U management:

• early protected mobs
• strength/neuromm exercises
• potential surgery

Question 12

What are complications of dislocations?

Answer 12

1. Bone - assoc fractures
2. Nerve/BV injury
3. ST damage to surrounding tissues

Question 13

Describe the 3 grades of lig sprains

Answer 13

Grade 1:

• localized TTP
• minimal inflammation/swelling
• no laxity but might be painful on lig tests

Grade 2:

• significant TTP
• considerable swelling
• increased laxity

Grade 3:

• audible pop may have been heard
• immediately painful but main become painless due to disruption of nociceptors; but pain can return later due to inflammation
• considerable swelling
• increased laxity

Question 14

Management of sprains Gr 1-3

Answer 14

Grade 1 & 2

• STW
• joint mobs
• electrotherapeutic modalities
• strengthening/proprioception

Grade 3

• surgery
• bracing
• strengthening/proprioception

Question 15

Complication of ACL sprains?

Answer 15

• bone bruise

- meniscal/MCL/LCL injury

Question 16

What are some of the factors that play into the RTS decision?

Answer 16

• history of injury
• physical exam/type of injury
• rehab
• type of activity (contact/non contact; team vs individual)
• psychological state
• ability to protect the injury
• competitive level