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SPORTS INJURIES
“Injuries may be forgiven,
but not forgotten.”
-Aesop
Most Common Sports Injuries
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Groin Sprains
Shin Splints
Neck Stains
Lower Back Injury
Pulled Muscles
Fractured bones
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Rotator Cuff tendinopathy
Tennis Elbow
Ankle Sprain
Runner’s Knee
Achilles Tendiopathy
Knee Ligament rupture
Most Common Causes of Injury
• Failure to Warm UP
• Over training
• Excessive loading on the
body
• Not taking safety
precautions
• An Accident
• Inappropriate equipment
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Poor Exercise Technique
Reoccurring injury
Genetic Factors
Muscle weakness or
imbalance
• Lack of flexibility
• Joint laxity
• SHARP
Swelling
Heat
Altered function
Red
Painful
SIGNS of injuries
• P.I.E.R principle
Pressure
Ice
Elevation
Restriction/Rest
Treatment
Sprains
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Relate to ligaments
Tendons are strained.
Pulls are associated with muscles
Overuse or successive force- stretches or tears- tissues that
connects bone
3 Categories (or Grades) of
Injuries:
• 1st degree – mild, least severe, a couple days to
heal if treated properly *overstretched
• 2nd degree- moderate but more severe,
physiotherapy may be needed
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partial tear
• 3rd degree- most severe, surgery,
physiotherapy, up to 12 months to recover
*complete tear or rupture
Ankle Sprain
Most Common: Plantar Flexion or Inversion
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Anterior talofibular ligament
Calcaneofibular ligament
Posterior talofibular ligament
Tibiofibular ligament (severe injury)
Inversion sprain
The Ankle Joint – Medial View
Eversion sprains
Occurs to the deltoid ligament
The Ankle Joint – Lateral View
Tibia
Fibula
Lateral malleolus
Anterior tibiofibular ligament
Posterior tibiofibular
ligament
Posterior talofibular
ligament
Calcaneofibular
ligament
Calcaneus
Anterior talofibular ligament
Ankle Sprain
1st Degree – inversion stress with foot in mild
plantar flexion, stretching the anterior
talofibular ligament
2nd Degree – tear anterior talofibular ligament, stretch
and tear the calcaneofibular ligament
3rd Degree – grade III injury, varying
degrees of injury to anterior
talofibular, calcaneofibular, and
posterior talofibular ligaments and
joint capsule
Symptoms and Signs
1st Degree
Mild
2nd Degree
3rd Degree
pain
Partial tearing
Complete
sensation felt
tear/rupture
Point
tenderness
Swelling at
Snap/Pop
point tenderness sound
Localized
swelling (anterior at sprain site
Severe pain
talofibular
Tenderness and
ligament)
swelling over
entire lateral area
Tearing of three
ligaments
Treatment
1st Degree
2nd Degree
3rd Degree
PIER
PIER
PIER
Limit
X-ray
X-ray
Crutches
Walking
weightbearing activities
Wrap when weight
bearing
No swelling –
circumduction
activites
Weight bearing –
tape
Exercises
5-10 days
Plantar and
dorsiflexion exercises
(if pain free)
1-2 weeks weight
bearing
Taping with walking
Motion exercises
Cold / heat
application
cast after
swelling
After
circumduction
exercises
Progressive
program of
strengthening
Joint Laxity: no
end point
Anterior Cruciate Ligament (ACL)
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Considered to be the most serious ligament injury to the knee
Causes:
Direct blow to knee
Single-plane force –lower leg is rotated while the foot is fixed
• Sharp cutting motion
• Hyperextension from a force in front of knee
• Non-contact
Females and ACL Injuries
Extrinsic factors
• Level of conditioning, skill acquisition, playing style,
amount of preparation and practice, environmental
considerations, types of equipment used
Intrinsic factors
• Femoral intercondylar notch size, ACl size, ACL
laxity, lower extremity anatomic malalignment (ie. Qangle)
** possible reasons why females are more likely to
suffer noncontact ACL injuries
Q-angle - Quadriceps angle
• Formed in the frontal plane by a
linedrawn from:
• the centre of the patella to the
anterior superior iliac spine,
• and from the centre of the tibial tuberosity to the
centre of the patella extending up the thigh
• If angle created by the intersection of
these two lines above the patella is
greater than twenty degrees, this puts
the individual at greater risk of
experiencing knee injury
Q-angle and ACL tears
• Width of the pelvis determines size of Q-angle
• women have a wider pelvis than men, the Q-angle tends
to be greater
• The forces are concentrated on the ligament each time
the knee twists increasing the risk for an ACL tear
• Proper stretching and strengthening is important
Symptoms and Signs
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Experience a pop
Immediate disability
Knee feels like it is “coming apart”
Rapid swelling at joint line
Positive anterior drawer sign
pivot-shift test, jerk test, and flexion-rotation
drawer test may be positive
• Decreased proprioception
Treatment
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PIER
Weight bearing support
Physiotherapy
Surgery?
• Depends on athlete’s age, type of stress applied to knee, amount
of stability present, techniques available to surgeon
• May involve joint reconstruction, with transplantation of some
external structure
Achilles Tendon Rupture
• Sports with stop and go action
• Usually a result of sudden pushing-off action of
the forefoot with the knee being forced into
complete extension
Symptoms and Signs
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Feel a sudden snap (felt like something kicked him/her in lower leg)
This will often be accompanied by a loud crack or bang.
Immediate pain
Point tenderness, swelling, discoloration
There may be a gap felt in the tendon.
Toe raising impossible
Usually occurs 2-6cm proximal to its
insertion onto
the calcaneus
Treatment - Surgical repair
Rotator Cuff Tear
• Involve one or four muscles
• Supraspinatus, infraspinatus, teres minor, and
subscapularis
• Supraspinatus, infraspinatus, and teres minor
share a common tendinous insertion on the
greater tubercle of the humerus
Shoulder Dislocation
• Normal
Dislocated
Dislocation
• Bone displaced from position
• Damage to joint (synovial) capsule and ligaments between
bones, muscles and tendons could tear
• Signs: deformed joints, painful to move or touch, joint is
unusable
• Humerus “pops out” of the glenoid fossa
• Usually a result of a hit or fall resulting in a tear to the
glenohumeral ligament and joint capsule
• Treatment should be done by a professional
• Injury to the brachial plexus (vital nerves) and blood vessels
if not done properly
Shoulder Dislocation
Shoulder Dislocation
Inferior Dislocation
Anterior Dislocation
Separation
• Bones held by ligaments tear or separate from each other
• Shoulder separation
• Tearing of acromioclavicular ligament union of clavicle to
acromion)
• Result from falls directly on shoulder (contact from another
player or tumble on shoulder)
Shoulder Separation
Shoulder separations are
classified as either 1st
(mild), 2nd (moderate), or
3rd (severe) degree sprains.
A 3rd degree AC joint sprain
is the most severe with the
result being what is termed a
“stair step” deformity. This is
when the end of the clavicle
appears elevated because
the ligament connecting the
bones is completely torn.
Torn Cartilage
 Cartilage is avascular
 Takes time to heal
 Often use arthroscopy: surgical procedure where incision
made to allow a small fibre optic camera in to assess damage
Shin splints
• Overuse without adequate
recovery
• Pain along medial or lateral
side of
tibia along shaft
• Caused by tearing of interosseous membrane
(between tibia and fibula) or periosteum (lining of
bone)
• Causes: change in training regimen (frequency,
duration or intensity), training surface (hard), poor
shoes
• Can develop into stress fractures
Biceps Tendinitis
• Overuse injury
• Adequate rest is not given
to the biceps brachii muscle when it has
been worked or overloaded
• Pain on the proximal end of biceps
• Flexion of shoulder and elbow painful
Tendinitis
• Inflammation of a tendon caused by irritation due to
prolonged or abnormal use
“itis” means an
inflammation to that
particular organ or tissue
Hematoma
• A collection of pooled blood in the thigh within a
relatively constricted area.
• Example: thigh - probably accompany all serious
contusions of the thigh
• they are difficult to diagnose because of the large muscle
mass in the thigh
• may become calcified and form a hard lump in the
quadriceps muscle. This lump is called osteomyositis
ossificans and may cause stiffness or a bump in the muscle
that may be very long lasting.
Signs
&
Symptoms
• Swelling at the injury site.
• Feeling of tenseness to touch
• Tenderness.
• Redness that progresses through several colour changes-purple, green-yellow, yellow--before it completely heals.
Treatment
• PIER
• anti-inflammatory medicine prescribed by your healthcare
provider.
• wearing an elastic thigh wrap when you return to sports
• having prescribed physical therapy (including deep tissue
treatments - ultrasound or electrical stimulation).
• Complications: infection could develop in the wound,
• the signs and symptoms might be increasingly severe pain,
• a fever of 101 degrees or more,
• swelling with surrounding redness, and pus.
Groin Strain
• Caused by strenuous stretching
movements of the legs
• Also sometimes with overuse of the
adductor muscles
• Symptoms: mild discomfort, pain
against resistance, swelling and
bruising in inner thigh
• Usually take 4-6 weeks to heal but
could be upwards of 8 weeks
Patellofemoral Pain
Syndrome
• Causes: muscle weakness, muscle
imbalance, tight tendons, abnormal
movement of the kneecap
• Signs and Symptoms: pain at front
of knee, pain on pressure on knee,
walking up stairs, running, swelling
around kneecap, grinding or grating
• Should see improvement over the
few weeks of treatment, looking at
4-6 months of recovery time
completely
Patellofemoral Pain
Syndrome
• Treatment & Rehabilitation:
• Rest the joint or cut back on the intensity of activity (exreduce practice or training schedule)
• Strengthen the Quadriceps muscles (they support the
knee)
• Wear a knee brace or sleeve during activity
• Wear an arch support or orthotic to prevent overpronation
• Replace old shoes, which have been worn down from
pronation
• Anti-inflammatory drugs can be taken to reduce pain
• Rehabilitation can last anywhere from one to eight weeks
depending on the severity of the injury. Typically,
athletes can continue their regular activities if the level of
pain allows them to participate.
Osgood Schlatter
Disease
• Description: condition of the knee where the tibial
tuberosity becomes inflamed. The patellar tendon inserts
on the tibial tuberosity and through overuse can tug away
at the bone, causing pain and inflammation.
• Symptoms: Pain around one or both knees , Pain when
straightening the leg through the knee joint or full squat ,
Tibial tuberosity is swollen , Skin over tibial tuberosity is
red, painful and inflamed , Pain when jumping or
squatting
Osgood Schlatter
Disease
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Causes:
• Growth spurt: this condition tends to affect teenage
children directly after a growth spurt. In addition,
children that are active and engage in sports are at an
increased risk.
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Treatment and Rehabilitation:
• Strengthening the quadriceps and hamstring groups
• Avoiding physical activities that require frequent knee
bending for two-four months
• Wearing a knee brace or knee sleeve to restrict movement
• Anti-inflammatory drugs may be taken to control pain
and inflammation
• Increasing flexibility in the quadriceps and hamstring
muscles
Sports Injury Facts
• More than 3.5 million children ages 14 and under receive medical treatment for sports injuries
each year.
• Injuries associated with participation in sports and recreational activities account for 21
percent of all traumatic brain injuries among children in the United States.
• Overuse injury, which occurs over time from repeated motion, is responsible for nearly half of
all sports injuries to middle-and high-school students. Immature bones, insufficient rest after
an injury and poor training or conditioning contribute to overuse injuries among children.
• Most organized sports related injuries (62 percent) occur during practices rather than games.
Despite this fact, a third of parents often do not take the same safety precautions during their
child's practices as they would for a game.
• A recent survey found that among athletes ages 5 to 14, 15 percent of basketball players, 28
percent of football players, 22 percent of soccer players, 25 percent of baseball players and 12
percent of softball players have been injured while playing their respective sports.
• Children ages 5 to 14 account for nearly 40 percent of all sports-related injuries treated in
hospital emergency departments. The rate and severity of sports-related injury increases with a
child's age.