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SPORTS INJURIES

“Injuries may be forgiven,

but not forgotten.”
-Aesop
 Most Common Sports Injuries

• Groin Sprains • Rotator Cuff tendinopathy

• Shin Splints • Tennis Elbow
• Neck Stains • Ankle Sprain
• Lower Back Injury • Runner’s Knee
• Pulled Muscles • Achilles Tendiopathy
• Fractured bones • Knee Ligament rupture
Most Common Causes of Injury
• Failure to Warm UP
• Poor Exercise Technique
• Over training
• Reoccurring injury
• Excessive loading on the
• Genetic Factors
body
• Muscle weakness or
• Not taking safety
imbalance
precautions
• Lack of flexibility
• An Accident
• Joint laxity
• Inappropriate equipment
• SHARP
Swelling
Heat
Altered function
Red
Painful

SIGNS of injuries
• P.I.E.R principle
Pressure
Ice
Elevation
Restriction/Rest

Treatment
Sprains
• 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 *
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
• 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 2nd Degree 3rd Degree
Mild pain Partial tearing Complete
Point sensation felt tear/rupture
tenderness Swelling at Snap/Pop
Localized point tenderness sound
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 weight- X-ray X-ray
bearing activities Crutches 5-10 days Walking cast after
Wrap when weight Plantar and swelling
bearing dorsiflexion exercises
After
(if pain free)
No swelling – circumduction
1-2 weeks weight
circumduction exercises
bearing
activites Progressive
Taping with walking
Weight bearing – program of
Motion exercises
tape strengthening
Cold / heat
Exercises application Joint Laxity: no
end point
Anterior Cruciate Ligament (ACL)

• 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. Q-
angle)
** 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
• 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
• 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
• 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 (ex-
reduce 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
• 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.
• 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.