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SPORTS INJURIES
Dr.RAJAT JANGIR
Consultant Arthroscopy and Sports Injury
Ligament and Joints Clinic, Mansarovar, Jaipur
MS Ortho (Ahmedabad)
Fellow Arthroscopy(S.Korea)
Dip Sports Med IOC
Sports for Health
But for some people—particularly those who overdo or who don’t
properly train or warm up—these benefits can come at a price:
sports injuries.
SPORT INJURIES are those which occur in
Athletic activities or while exercising
SPORT MEDICINE study and research of
injuries in sport in order to prevent or reduce
the severity of injury.
EPIDEMOLOGY
 Kids ages 5-14 are most likely to hurt themselves on a playground or engaged
in "general exercise,”
 For ages 15-24, high school and college, team sports become common-
basketball, soccer, and football injuries make their main appearance, especially
for males
 After age 25, those sports become less common and people become more
likely to hurt themselves generally working out, running, biking
Knee injuries (55%) >Shoulder> Ankle
The most common injuries are
 strains or sprains (41%),
 broken bones (20%),
 bruises or superficial injuries (19%)
India: Data Sparse
 Journal of Athletic Enhancement: Prevalence of Sports Injuries in
Adolescent Athletes Ieleni Sreekaarini, KMC Manipal
Sports injury pattern in school going children Chandigarh
Dr.Ravi Gupta
French gymnast Samir Ait Said snapped his leg during a pommel horse
Australian javelin thrower Kim Mickle dislocated her right shoulder
Ankle Sprain
German Gymnast Adreas TOBA
Acute sports injuries
The ‘immediate’ cause may seem obvious
 but sports medicine clinicians think beyond the ‘immediate cause’
R Bahr, T Krosshaug
Understanding injury mechanisms: key component of preventing injuries in sport
Acute sports injuries
▪ Acute ankle sprain
▪ Acute knee injury (ACL)
▪ Acute hamstring strain
▪ Acute low back injury
Take home message for causes of ‘acute
injuries
 The key is to think about the cause…but not just the immediate cause
 The ‘upstream’ cause may include
 overtraining
 suboptimal proprioception/neuromuscular control
 regional muscle imbalance
 previous injury not full rehabilitated
 lack of skill!
 impaired eyesight or poor vision
Chronic sports injuries
 The ‘immediate’ cause may seem obvious but sports medicine clinicians
think beyond the ‘immediate cause’
 Chronic’ injuries may be ‘recurrences’ or ‘overuse’ type injuries
 They provide an even larger array of ‘upstream causes’
Chronic sports injuries
 Stress fracture (of the tibia)
 Achilles tendinopathy
 Osteoarthritis
Chronic sports injuries
Stress fracture
• Biomechanics (technique)
• Overtraining
• Nutrition
• Footwear
Chronic sports injuries
Tendinopathy
• Biomechanics (technique)
• Overtraining
• Genetics
Chronic sports injuries
Osteoarthritis
• Previous ACL injury
• Obesity
• Meniscal surgery
• Genetics
Role of Physician
 Diagnosis and Treatment
 Team Leader
 Decision Maker Return to Play
 Educator, Advisor
 Advocate & Confidant
PREVENTION
Primary
• Avoidance of
injury ( eg-
safety
helmets)
Secondary
• Early
diagnosis and
treatment
once the injury
has occurred
Tertiary
• Rehabilitation-
to reduce and
correct any
deformity
PRIMARY PREVENTION-
 Warm up
 Stretching
 Taping and Bracing
 Protective Equipment
 Suitable Equipment
 Environmental factors
 Appropriate Training
 Psychology
 Nutrition
 >100,000 ACL Injuries/Year
 NonModifiable: Anatomical Environmental Hormonal
 No single risk factor
Mandelbaum, B.R., et. al. Effectiveness of neuromuscular and proprioceptive training programin
preventing the incidence of ACL injuries in females athletes. AJSM 2005
Griffin, L.Y. et al. Non-contact anterior ligament injuries:risk factors and preventative strategies. J
Amer Acad Orthop Surg 2000
ACL INJURY
 70% ACL injuries are non-contact
 Most common biomechanical factor straight hips and knees, as well as
flat feet during landing.
Injury prevention program focus on
 Balance
 Eccentric Strength
 Proper Mechanics
 Flexibility
overall reduction of severe ACL injuries from 72 –89%.
Assessment of injuries
ABC
TOTAPS
Treatment of injuries
PRICER
No HARM
Treatment
ABC
 Airway
 Breathing
 Circulation
TOTAPS
Talk
Observe
Touch
Active
Passive
Skills
Initial treatment of injuries
PRICER
 Protection
 Rest
 Ice
 Compression
 Elevation
 Referral
Protection
 Take player away from field to avoid further injury as soon as possible
Rest
 Remove player from field
 Rest injured area
 Immobilize area
 Why?
 Reduces further tissue damage
 Reduces blood flow
 Allows for full assessment of injury
Ice
 Ice bag, pack
 Ice water bath
 15 mins/ 5 times a day
 Why?
 Cool the area which constricts blood vessels, reduces blood flow and fluid
leakage, less swelling, pressures and pain
Compression
Compress injured area with
Elastic bandage
Cohesive bandage
Move distal to proximal
Why?
External pressure reduces fluid leakage and bleeding into tissues
Provide support the area
Elevation
 Elevate area above height
 Why?
 Reduces bleeding as blood has to flow up hill
 Gravity helps swelling to move towards lymph nodes
No HEAT
 Includes
 Hot packs
 Spas
 Saunas
 Why?
 Increases blood flow to area therefore increases swelling
No ALCOHOL
 Includes most things adults enjoy after a game of sports
 Why?
 Thins blood which increases swelling
 Less pain felt therefore more damage caused
 Adds toxins to already injured area
No RUNNING
 Includes running as well as any exercise that is painful
 Why?
 Increases in tissue damage
 Overload to other area as compensation
No MASSAGE
 Rub down
 Massage
 Mobilizations
 Why?
 May increases tissue damage
 Increases blood circulation to the injured area
Summary
 Diverse range of ‘causes’
 Understanding ‘cause’ may influence treatment and prevention
 No simple way to identify what the relative ‘mix’ of causes is for one
particular injury
 In clinical practice, think about the range of options and treat
THANK YOU
dr.rajatjangir@gmail.com
9461306495

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SPORTS INJURY I Dr.RAJAT JANGIR JAIPUR

  • 1. SPORTS INJURIES Dr.RAJAT JANGIR Consultant Arthroscopy and Sports Injury Ligament and Joints Clinic, Mansarovar, Jaipur MS Ortho (Ahmedabad) Fellow Arthroscopy(S.Korea) Dip Sports Med IOC
  • 3. But for some people—particularly those who overdo or who don’t properly train or warm up—these benefits can come at a price: sports injuries.
  • 4. SPORT INJURIES are those which occur in Athletic activities or while exercising SPORT MEDICINE study and research of injuries in sport in order to prevent or reduce the severity of injury.
  • 5. EPIDEMOLOGY  Kids ages 5-14 are most likely to hurt themselves on a playground or engaged in "general exercise,”  For ages 15-24, high school and college, team sports become common- basketball, soccer, and football injuries make their main appearance, especially for males  After age 25, those sports become less common and people become more likely to hurt themselves generally working out, running, biking
  • 6. Knee injuries (55%) >Shoulder> Ankle The most common injuries are  strains or sprains (41%),  broken bones (20%),  bruises or superficial injuries (19%)
  • 7. India: Data Sparse  Journal of Athletic Enhancement: Prevalence of Sports Injuries in Adolescent Athletes Ieleni Sreekaarini, KMC Manipal
  • 8. Sports injury pattern in school going children Chandigarh Dr.Ravi Gupta
  • 9. French gymnast Samir Ait Said snapped his leg during a pommel horse
  • 10. Australian javelin thrower Kim Mickle dislocated her right shoulder
  • 13. Acute sports injuries The ‘immediate’ cause may seem obvious  but sports medicine clinicians think beyond the ‘immediate cause’
  • 14. R Bahr, T Krosshaug
  • 15. Understanding injury mechanisms: key component of preventing injuries in sport
  • 16. Acute sports injuries ▪ Acute ankle sprain ▪ Acute knee injury (ACL) ▪ Acute hamstring strain ▪ Acute low back injury
  • 17. Take home message for causes of ‘acute injuries  The key is to think about the cause…but not just the immediate cause  The ‘upstream’ cause may include  overtraining  suboptimal proprioception/neuromuscular control  regional muscle imbalance  previous injury not full rehabilitated  lack of skill!  impaired eyesight or poor vision
  • 18. Chronic sports injuries  The ‘immediate’ cause may seem obvious but sports medicine clinicians think beyond the ‘immediate cause’  Chronic’ injuries may be ‘recurrences’ or ‘overuse’ type injuries  They provide an even larger array of ‘upstream causes’
  • 19. Chronic sports injuries  Stress fracture (of the tibia)  Achilles tendinopathy  Osteoarthritis
  • 20. Chronic sports injuries Stress fracture • Biomechanics (technique) • Overtraining • Nutrition • Footwear
  • 21. Chronic sports injuries Tendinopathy • Biomechanics (technique) • Overtraining • Genetics
  • 22. Chronic sports injuries Osteoarthritis • Previous ACL injury • Obesity • Meniscal surgery • Genetics
  • 23. Role of Physician  Diagnosis and Treatment  Team Leader  Decision Maker Return to Play  Educator, Advisor  Advocate & Confidant
  • 24. PREVENTION Primary • Avoidance of injury ( eg- safety helmets) Secondary • Early diagnosis and treatment once the injury has occurred Tertiary • Rehabilitation- to reduce and correct any deformity
  • 25. PRIMARY PREVENTION-  Warm up  Stretching  Taping and Bracing  Protective Equipment  Suitable Equipment  Environmental factors  Appropriate Training  Psychology  Nutrition
  • 26.  >100,000 ACL Injuries/Year  NonModifiable: Anatomical Environmental Hormonal  No single risk factor Mandelbaum, B.R., et. al. Effectiveness of neuromuscular and proprioceptive training programin preventing the incidence of ACL injuries in females athletes. AJSM 2005 Griffin, L.Y. et al. Non-contact anterior ligament injuries:risk factors and preventative strategies. J Amer Acad Orthop Surg 2000 ACL INJURY
  • 27.  70% ACL injuries are non-contact  Most common biomechanical factor straight hips and knees, as well as flat feet during landing.
  • 28. Injury prevention program focus on  Balance  Eccentric Strength  Proper Mechanics  Flexibility overall reduction of severe ACL injuries from 72 –89%.
  • 29. Assessment of injuries ABC TOTAPS Treatment of injuries PRICER No HARM Treatment
  • 32. Initial treatment of injuries PRICER  Protection  Rest  Ice  Compression  Elevation  Referral
  • 33. Protection  Take player away from field to avoid further injury as soon as possible
  • 34. Rest  Remove player from field  Rest injured area  Immobilize area  Why?  Reduces further tissue damage  Reduces blood flow  Allows for full assessment of injury
  • 35. Ice  Ice bag, pack  Ice water bath  15 mins/ 5 times a day  Why?  Cool the area which constricts blood vessels, reduces blood flow and fluid leakage, less swelling, pressures and pain
  • 36. Compression Compress injured area with Elastic bandage Cohesive bandage Move distal to proximal Why? External pressure reduces fluid leakage and bleeding into tissues Provide support the area
  • 37. Elevation  Elevate area above height  Why?  Reduces bleeding as blood has to flow up hill  Gravity helps swelling to move towards lymph nodes
  • 38. No HEAT  Includes  Hot packs  Spas  Saunas  Why?  Increases blood flow to area therefore increases swelling
  • 39. No ALCOHOL  Includes most things adults enjoy after a game of sports  Why?  Thins blood which increases swelling  Less pain felt therefore more damage caused  Adds toxins to already injured area
  • 40. No RUNNING  Includes running as well as any exercise that is painful  Why?  Increases in tissue damage  Overload to other area as compensation
  • 41. No MASSAGE  Rub down  Massage  Mobilizations  Why?  May increases tissue damage  Increases blood circulation to the injured area
  • 42. Summary  Diverse range of ‘causes’  Understanding ‘cause’ may influence treatment and prevention  No simple way to identify what the relative ‘mix’ of causes is for one particular injury  In clinical practice, think about the range of options and treat

Editor's Notes

  1. In recent years, increasing numbers of people of all ages have been heeding their health professionals’ advice tIn recent years, increasing numbers of people of all ages have been heeding their health professionals’ advice to get active for all of the health benefits exercise has to offer.
  2. The story of how it happened tells you a lot about the injury Compare the bad side to the good side