Participation in sports always presents a risk of injury.
Generally, the mechanisms of sports injuries can be divided into
- Closed trauma
- Fractures and dislocations
- Acute Soft Tissue Stretches and Sprains
Most injuries (eg, fractures, dislocations, soft tissue bruises, blunt trauma, sprains, and stretches) are not unique to athletes and can occur in routine activities or accidents. These lesions are discussed elsewhere d that M Annual. But athletes need to learn how to modify failing techniques that predispose to injury or may be advised to take adequate rest to recover from a sports injury (overcoming pain).
Overuse is one of the most common causes of athletic injury and is the cumulative effect of excessive and repetitive stress on anatomical structures. It can traumatize muscles, tendons, cartilage, ligaments, pouches, fascia and bone in any combination. The risk of injury from overuse depends on complex interactions between individual and extrinsic factors.
Individual risk factors include
- Muscle weakness and inflexibility
- Joint laxity
- Anterior Injury
- Bone Misalignment
- Member Asymmetries
Extrinsic factors include
- Training errors (eg, exercise without sufficient recovery time, overloading, building a muscle group without training the opposite group, and extensive use of the same movement patterns)
- Environmental conditions (eg running excessively on slopes or busy roads – which stresses limbs asymmetrically)
- Characteristics of training equipment (eg unusual or unusual movements, such as those made on an elliptical trainer)
Runners, most of the time, are injured after a very rapid increase in intensity or duration of exercise. Swimmers may be less prone to over-injury, as floating has protective effects, although they are still at risk, particularly with regard to the shoulders, where most movements occur.
Sudden athletic trauma causes injuries such as soft tissue bruises, concussions, and fractures. Injury mechanisms typically involve high-impact collisions with other athletes or objects (eg, a football foul or being pressed against hockey trimmers), falls and direct blows (eg, boxing and martial arts).
Stretches and Sprains
Sprains are ligament injuries and stretches are muscle injuries. They typically occur with sudden, full force, most common during a race, particularly with sudden changes of direction (eg, deflecting and avoiding competitors in football). These injuries are also common in strength training when a person drops weight quickly rather than moving it slowly and gently with controlled constant tension.
Signals and symptoms
The injury always causes pain, which varies from mild to severe. Signs may be absent or include any combination of soft tissue edema, erythema, heat, tenderness, bruising, and loss of mobility.
- History and physical examination
- Sometimes imaging exams
The diagnosis should include total history and physical examination. History should focus on the mechanism of the injury, physical stress of the activity, previous injuries, pain onset time, extent and duration during and after the activity. Patients should be asked about exposure to quinolone antibiotics, which may predispose to tendon rupture. Diagnostic testing (eg, radiography, CT computed tomography], MRI], magnetic resonance imaging, bone scan, electromyography, and referral to a specialist may be required.
- Rest, ice, compression, elevation (RGCE)
- Cross training
- Gradual return to activity
The immediate treatment for most acute sports injuries is rest, ice, compression and elevation (RGCE).
Rest prevents further injury and helps reduce edema.
Ice (or commercial ice pack) causes vasoconstriction and reduces edema, inflammation and soft tissue pain. Ice and cold compresses should not be applied directly to the skin. They should be wrapped in a plastic or towel. Keep them in place for a maximum of 20 min at a time. Elastic bandage can be used around the tightly closed plastic package containing ice to keep it in place.
Wrapping an injured end with elastic bandage for compression reduces edema and pain. The bandage, however, should not be used too tightly as it can cause distal extremity edema.
The injured area should be raised above heart level so that gravity facilitates fluid drainage, reducing edema and pain. Ideally, the fluid should drain downward from the injured area to the heart (eg, in a hand injury, the elbow and hand should be raised). Ice and elevation should be used periodically within the first 24 hours after acute injury.
Pain management involves the use of analgesics, typically paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs). The use of NSAIDs should be avoided for patients with renal insufficiency, a history of gastritis or peptic ulcer. But if the pain persists for >72 h after an apparently simple injury, referral to a specialist for further or more serious injury is recommended. These lesions are treated appropriately (eg with immobilization, sometimes with oral or injectable corticosteroids). Corticosteroids should be applied only by the specialist and only when necessary, as they may slow soft tissue healing and sometimes weaken injured tendons and muscles. The frequency of injections should be monitored by a specialist, as very frequent injections may increase the risk of tissue degeneration and tendon or ligament rupture.
In general, injured athletes should avoid the specific activity that caused the injury even after healing has occurred. However, to minimize deconditioning, they can do cross training (ie, perform different or related exercises that do not cause recurrence of injury or pain). Injury may also require reduced range of motion in exercise if there is intolerable pain at certain points in the movement. Initially, exercises from previously injured areas should be of low intensity to gradually strengthen weak muscles, tendons, and ligaments without the risk of further injury. It is more important to maintain a good range of motion, which helps direct blood to the injured area and accelerate healing, than quickly resuming the full intensity of training for fear of losing conditioning. Resumption of total activity should be gradual as pain improves. Competitive athletes should consider consulting with a professional (eg, physical therapist, personal trainer).
Athletes should be placed on a graded exercise and physiotherapy program to restore flexibility, strength and endurance. They also need to feel psychologically ready before returning to a full-blown activity. Competitive athletes can benefit from motivational advice.
Exercise alone helps prevent injury as tissues become more resilient and tolerant during vigorous activity. In general, flexibility and widespread fitness are important to all athletes as a means of preventing injury.
General warm-up increases muscle temperature and makes muscles more flexible, strong and resistant to injury; It also improves fitness performance by increasing mental and physical fitness. However, stretching before exercise has not been shown to prevent injury. Cooling down (ie, a brief period of low-level exertion immediately after an activity) can prevent dizziness and syncope after aerobic exercise and help remove metabolic products from exercise such as lactic acid, muscles, and bloodstream. But studies do not show that cooling decreases stiffness and pain after exercise. The removal of lactic acid can help decrease muscle pain. Cooling down also helps to slow your heart rate slowly and gradually to near resting levels.