What are Sports injuries?

Sports injuries are injuries that occur during sporting activities. These injuries can occur in any type of sport but the extent of the injuries and the kind of damage they cause vary from sport to sport. Sports injuries cut across sports such as Football (Soccer), Hockey, Baseball, Golf, and many more. One sport could make the athlete sustain an injury that might end his or her career in sports whereas other sports injuries are less damaging and can easily be treated. The aspect of medicine that is concerned with management of sports injuries is referred to as Sports Medicine or Orthopedic medicine; the doctor that treats any related case of sports injuries is known as a sports doctor or an orthopedic surgeon.

Epidemiology and statistics of Sports Injuries

With more and more people taking sports as career, Sports Injuries are on the increase but statistics are not often recorded in most cases of injuries worldwide.

Structure of the Upper Limb showing the shoulder, the arm, the forearm, wrist and hand which are the structures affected mostly in sports injuries

Normal anatomy of the body structures commonly affected in Sports injurieswith pictures

In order for you to understand this article about Sports injuries; you must first of all understand how the normal structures of the human body are and how they can be affected by injuries. You must not know all the names of body structures in the pictures but you can always scroll back to check it while reading the description of the injury of that specific part.

Structure of the Lower Limb showing the Thigh, the Knee, Leg, Ankle and Foot which are affected mostly in Sports Injuries

The commonest parts of the body affected by injury during sports are the limbs. The limbs refer to the parts of the body you use for walking and for holding and carrying loads. To make it simple for you, your hand is not the same as your limb. Your hand, forearm and arm together make the UPPER LIMB. Since there is an upper limb, there is also a LOWER LIMB. The lower limb consists of the thigh, the legs and the foot. It therefore means that the common parts of the body affected by injury during sports are the upper and lower limbs. The discussion will be only on the injuries affecting the upper and lower limbs.

Structures of the body affected during Sports Injuries

Various structures of the body are affected in Sports Injuries and these may include bones, tendons, muscles, blood vessels, bursae and ligaments.

1. Muscles: there could be bleeding from muscles forming Hematoma (a swelling due to accumulation of blood) and sometimes the hematoma does not resolve and may cause cyst (collection of abnormal tissues) that may require surgery to remove it, with the associated risk of spread of infection. Deep bruising may sometimes lead to calcification (formation of hard stone-like contents) in the muscle that are difficult to treat and may require much time for treatment.
2. Tendons: rupture of a tendon could occur and inflammation of the tendons may cause severe pains. It takes about 6 months following tendon damage for a tendon to fully recover.
3. Bursae: these are structures that help reduce friction around joints. They could become inflamed, swell and painful. The symptoms are normally self-limiting but sometimes may require steroids injections, aspiration or excision by surgery.
4. Ligaments: these help in maintaining stability of joints and any injury to ligaments lead to joint laxity.
5. Bones: injury to bones during sports may lead to infection that can even be life threatening. Fractures cause inability to even move the injured part and prompt treatment is needed.

Causes of Sports injuries

1. Over stretching of muscles causing strain and avulsions
2. Compression of nerves
3. Fracture of bones as a result of falls or blows
4. Direct blows causing bleeding
5. Falls causing dislocations
6. Abnormal body structures causing injury that ordinarily would not have happened in a normal person
7. Tear of blood vessels
8. Direct contact causing impact on tissues especially the brain (concussion)

The Knee Joint showing the Anterior and Posterior Cruciate Ligament that helps in Joint stability and are often affected in Sports Injury

Common Types of sports injuries

Sports injuries can affect any part of the body from the head, neck to the abdomen and the thighs and legs, but this article will concentrate on the commonest Sports injuries. Below is a list of Sports injuries in order of their occurrence. The most common are listed first and the less common are at the end.

Sports injuries affecting the Upper Limb

List of Common Types of Sports injuries affecting the Shoulder

1. Rotator cuff injuries: the rotator cuff muscles are sets of muscles around the shoulder that help in the rotation of the arm. This injury is common in elderly athletes. Pain is felt in front of the shoulder and it moves down the arm. The pain is usually worst at night and you cannot raise the injured arm above the head due to the pains. It is usually diagnosed by the Speeds and Yergasons test which are found to be positive.
2. Shoulder dislocations
3. Fractures of the clavicle
4. Acromioclavicular injuries
5. Bicipital tenditis or rupture

List of Common Types of Sports injuries affecting the Elbow

1. Tennis elbow (lateral Epicondylitis): when you keep your arms horizontally so that your palms face up, the pain of tennis elbow is felt at the outer part of the elbow and the pain moves down the forearm, it is worst when you shake someone or try to open a door. Pain relievers or acupuncture can help; when left without medication, it might take a year to fully recover.
2. Golfers elbow (medial epicondylitis): in this, the pain moves from the inner aspect of the arm, starting from the elbow to the forearm and becomes worst by trying to turn your palm from facing up to the palm facing down (pronation).
3. Dislocations of the elbow

Some Common Types of Sports injuries affecting the Wrist

1. Wrist pains
2. Carpal tunnel syndrome

Compression to nerves of the hand could lead to tickling or pricking sensations being felt (paraesthesia). Other injuries could affect the limbs but may not be common in sports even though they could still occur. Dislocation of the wrist joint could occur but it is not common; hence it is not discussed here.

Sports injuries affecting the Hand

1. Mallet injury
2. Baseball finger

Injuries affecting the fingers and joints

Demonstration of the Lachman’s Test while assessing Sports Injury affecting the Knee

Sports injuries affecting different parts of the Lower Limbs

Common Types of Sports injuries affecting the Hip

1. Iliotibial injuries or iliotibial tract syndrome
2. Quadriceps strain
3. Hip pains
4. Groin pains as a result of strain to the muscles that control the groin known as the adductor muscles

Quadriceps contusion (Also known as the cork thigh or Charley horse): This is also known as the cork thigh or charley horse and is caused by a direct blow to the thigh causing pains, swelling and stiffness of the thigh. The quadriceps refers to the muscles that form the front part of the thigh.

Quadriceps Rupture: This happens especially in football or in Rugby and occurs as a result of over stretching of the thigh while trying to kick a ball.

Harmstring injuries: This is common in football and it is caused by muscle contraction that occurred quickly. The Harmstring is a collective name for the muscles that form the back of the thigh.

Groin strain and pains: Sports Injuries affecting the groin area can be difficult to diagnose and treat as they can be confused with other disease conditions that could occur at the groin which may include hernia, tumors, sexually transmitted infections, or even Kidney diseases.

Osteitis Pubis: this is common in athletes that play crickets and it is self-limiting (it will heal on its own). Usually, pain is felt at the pubic area at the lower aspect of the abdomen.

List of Common Sports injuries affecting the Knee

1. Jumpers knee (also known as Patella tendinitis): it is associated with a grating sound (crepitus), swelling and pain. It rarely needs surgery and it is mainly treated by physiotherapy.
2. Chondromalacia patellae: this is common in adolescent women and is due to the softening of the articular cartilage of the patella and the cause is not known.
3. Patella fracture
4. Knee ligaments injuries
5. Meniscal injuries
6. Plica syndrome: plica are folds of membrane at the knee joint and the syndrome occurs following scarring or thickening resulting from trauma or over use of the knee and plica syndrome results with pain and clicking felt with use of the knee. It is common in skiing and football and also in Rugby.
7. Hoffas disease: very common in gymnastics and in sports requiring flexibility. It occurs commonly in adolescents. Symptoms are pains in the front part of the knee as a result of bleeding into the joint.

Demonstration of the Anterior Drawer Test in assessing the injury to the Anterior Cruciate Ligament

Knee ligaments injuries

Remember we said ligaments are structures that help the stability of joints. There are many ligaments at the knee joint but the most common knee joint injury in sports affects the ligament known as the cruciate ligament and there are two of them, one in front known as the anterior (front) cruciate ligament and one behind the knee joint known as the Posterior (back) cruciate ligament [See the picture]. The one commonly affected in Sports Injuries is the anterior cruciate ligament. The anterior cruciate ligament injury occurs as a result of twisting and rotation of the big bone of the leg (known as the Tibia) and it happens commonly in women, in footballers and in jumpers. There is usually severe pain at the knee joint and associated bleeding into the knee joint. It is diagnose by the anterior draw test or the Lachmans test.

List of Common Types of Sports injuries affecting the Legs

1. Calf muscle strain
2. Harmstrings injury
3. Stress fracture of the Tibia
4. Compartmental syndrome of the leg

Ankle Injuries in Sports

1. Ankle sprains
2. Injuries affecting the Achilles tendon

Common Foot injuries in Sports

1. March fractures
2. Injuries to the Sesamoid bones of the great toe
3. Mortons neuroma
4. Turf toe
5. Freibergs disease
6. Severs disease

Other injuries that could occur but not common in sports

1. Head injuries
2. Whiplash injuries
3. Ribs fracture
4. Muscle strain affecting the abdomen
5. Low back pains

Diagnosis of Sports Injuries

Various test and instruments are useful in diagnosis of sports injuries and these tools include:

1. Magnetic Resonance Imaging (MRI)
2. X-ray
3. Some clinical tests such as those mentioned above like the anterior drawer test etc.
4. Computed Tomography scan, especially in Head Injuries

Management and treatment of Sports Injuries

Sports Injuries are treated based on P R I C E M M principle, which is a mnemonic to guide in the management of Sports Injuries.

1. Protection: this should be the first step as it helps in the prevention of the injury
2. Rest the injured limb
3. Ice therapy
4. Compression bandaging
5. Elevation of the injured part
6. Medications such as pain killers (pain relievers) or sprays
7. Modalities like straps support

Analgesics such as NSAIDs (Non-Steroidal Anti-inflammatory Drugs) like Ibuprofen are commonly used to reduce pains and corticosteroids such as prednisolone and cortisone are also helpful in inflammatory conditions and prevention of edema but long term use can make the injury worst because it can cause rupture of tendons and using steroids for a long time can cause osteoporosis. Care must be taken to know the type of drug given to an athlete as there are drugs that are banned by the International Olympic Committee and it is good for the doctor to be aware of these drugs to prevent any Positive drug test that may end the career of an athlete as well as that of the doctor.

Prevention of Sports Injuries

1. Fitness training
2. Proper clinical examination to identify any body defects that may affect performance and cause injury during sports activity
3. Correcting wrong body postures
4. Conditioning exercises to overcome particular deficiencies
5. Cardiopulmonary conditioning exercises to help increase endurance during Sports.
6. Proper warm up exercise before starting any sport activity
7. Proper relaxation after sports
8. Wearing of protective wears such as shin guards to protect the legs, helmets to protect the head and gloves to protect the hands (especially goal keepers)
9. Avoid any sport activity in extremes of temperature such as extreme cold and hot temperature

Rehabilitation after Sports Injury

Restoration of movement is the aim of rehabilitation and the physiotherapist plays a role in the management team in order to monitor the progress and recovery. Passive movement should be encouraged at the beginning of the physiotherapy because the more the injured part is not being used, the more the muscles will waste away (muscle atrophy); hence, movement should be started passively at the initial stage and then gradually increased until full function and recovery is achieved.