Sports Injury

Question 1

What are the main causes of sudden death when exercising?

Answer 1

> 35- heart disease

<35 - congenital heart defects

Question 2

What sports pose the greatest risk in terms of fatalities?

Answer 2

Sports involving height, water

Question 3

How does injury differ based on usage?

Answer 3

Acute injuries (fractures) vs chronic use problems (stress fracture)

Question 4

What is microtrauma?

Answer 4

Injuries typically due to overuse

Involves: overload, tissue injury, inflammation, pain, continued activity/rehab

Question 5

What are some intrinsic and extrinsic factors contributing to overload?

Answer 5

Extrinsic: training error, poor technique, incorrect equipment, poor conditions
Intrinsic: anatomical, muscle imbalance

Question 6

What are possible causes of injury to bone?

Answer 6

Direct (tackle), indirect (twisting/fall)

Question 7

What are classifications of bone fracture injury?

Answer 7

transverse, oblique, spiral, comminuted (several fragments), avulsion (piece of bone attached to tendon/ligament is torn away)

Question 8

What are complications for bone injury?

Answer 8

Infection- particularly in open fractures,
Acute compartment syndrome- fracture where soft tissue damage present (local bleeding) in small area (calf), causes compression on structures in the area
Associated injury- nerve/blood vessels
DVT/Pulmonary embolism- especially in lower limbs (prevent with early movement, anticoagulants)
Delayed union/non-union
Malunion- not ideal healing of fracture

Question 9

How is articular cartilage injury evaluated?

Answer 9

Doesn’t show up in X-ray

MRI and arthroscopy

Question 10

How do we improve articular cartilage damage?

Answer 10

Perforation- try to stimulate localized response by perforating bone below injury
Alteration of joint loading
Cell transplantation- chondrocytes via donation or lab techniques onto injury

Question 11

What are some complications to joint injury?

Answer 11

Associated nerve or vessel damage (i.e. axillary nerve in shoulder)

Question 12

What is treatment for joint injury?

Answer 12

Reduction
Muscle relaxants
Protect to allow soft tissue to heal
Mobilization 
Rebuild muscle strength

Question 13

What is the function of the ligament?

Answer 13

To increase joint stability

Question 14

What are the grades of ligament injury?

Answer 14

1. Fibres stretched but integrity remains intact- no complete tear
2. More fibres involved, some torn, laxity on stressing but definite end point (when stretching it, there is an endpoint)
3. Complete tear, excessive laxity, no end point. May be less pain due to tear

Question 15

What are the different management approaches to ligament injury?

Answer 15

Grade 1/2- Promote tissue healing, prevent stiffness, protect, strengthen muscle,
Grade 3- Conservative (bracing) or surgical (direct repair)

Question 16

When does muscle injury occur?

Answer 16

When muscle demand exceeds muscle capacity

Question 17

What muscles are most commonly affected in terms of injury?

Answer 17

Hamstrings, quadriceps, and gastrocnemius

Question 18

What are the grades of muscle injury?

Answer 18

1: few fibres injured, localised pain, no loss of strength
2: Significant fibres injured, swelling, pain on contraction, reduced strength
3: complete tear, most common at musculotendinous junctions

Question 19

What is typical treatment of a muscle rupture?

Answer 19

Rice (rest, ice, compression, elevation)
Nsaids
Electrotherapy (not as common now)
Strength/ stretching 
Surgery

Question 20

What is a muscle contusion?

Answer 20

Direct blow to muscle
Common in contact sports
Results in local damage and bleeding
Avoiding heat, alcohol, and vigorous massage (initially)

Question 21

What is a myositis ossificans?

Answer 21

Bony calcifications within the muscle
Happens when haematoma in muscle calcifies
Diagnosed via x-ray
Most resolve spontaneously, recovery is slow

Question 22

Where do tendon injuries typically happen?

Answer 22

Point of least blood supply

Question 23

What is Achilles tendinopathy?

Answer 23

Tendon attaching calf muscle (gastrocnemius) inserting onto posterior calcaneum is injured
Local tenderness and pain (uphill)
As swelling is not typical, so called tendinopathy now

Question 24

What is the retrocalcaneal bursa?

Answer 24

small fluid filled sac (bursa) allowing for easy movement/reduced friction of Achilles tendon over calcaneus

Question 25

What is treatment of Achilles tendinopathy?

Answer 25

Active rest
Alter training schedule (no hills)
Heel wedge
Surgery
No steroid injections (inflammation is not common)
Immobilization

Question 26

What is neuropraxia?

Answer 26

Paralysis and weakness of muscles innervated by associated nerve loss.
Support in neck brace until spontaneous healing