Taiba Hospital & Taiba Specialized Clinics UNDERSTANDING SPORTS INJURIES AND EFFECTIVE PREVENTION

Sport is a form of recreation and an

effective fitness modality for any individual. Viewing it in the context of the current world scenario, sport has become segregated into two realms- the professional sportsman and the occasional enthusiast. The consequence of such extremism has lead to many a lifestyle related problem like Hypertension, Diabetes and Dyslipedemia (altered cholesterol). Add to this conundrum, the boom of so-called health and fitness machines and spa-gyms that are not properly run and what do you find? Increased hospital visits to the Orthopedic Surgeon and burgeoning medical bills! Sports injuries involve the soft tissue structures of the body in a good majority of the cases and to smaller extent, the bones. The tissues involved in the former are either, tendons, ligaments, muscle, menisci or cartilage. Ligament injuries are more commonplace and this is due to the fact that, the joint is subjected to sudden, unexpected twisting (like sudden enthusiastic diving and turning, twisting etc ;) The different grades of ligament injuries are: grade 1 is a sprain with no tearing of the ligament grade 2 is a partial tear of the ligament grade 3 is a complete tear of the ligament Our traditional bone setting colleagues, be it in India or Yemen or even around here in Kuwait become famous by treating grade 1 and grade 2 injuries. The above only requires splintage of some form and adequate rest. Modern splinting techniques are very good in aiding a faster recovery without disturbing lifestyle activities to a great extent. The crux of the matter is to reach and obtain a specialist advice. Whatever you do, DO NOT MASSAGE!!!!! the area. The golden acronym used to manage such injuries is: - RISE R- Rest the injured part I- apply ice to the area (reduces swelling and pain) S- Splint the joint (prevents movement of the injured portion) E- Elevate the portion (reduces swelling) What is a meniscus? The menisci are semi lunar shaped cartilaginous structures (pic.2) present in between two bony surfaces as in the knee, sterno-clavicular (Collar bone), acromioclavicular (shoulder) and temporo-mandibular (jaw) joints. The key role of these structures is to increase the surface area of the joint and act as shock absorbers of the joint. By their intricate relationship with the ligaments and other surrounding soft tissue structures of the joint, they can easily be injured but a greater than normal force is required. Generally these injuries require an MRI evaluation and Surgery. Non-medical people generally refer to the injury of these structures as cartilage injuries What is cartilage? Cartillage is the structure which covers all the rubbing surfaces of the joint and is not as hard and rigid as bone but is stiffer and less flexible than muscle. The note of caution is that it does not have blood vessels and hence heals slowly. THIS IS the culprit for the evolution of OSTEOARTHRITIS of the joint. The professional athletes tend to have a softening of the cartilage referred to as CHONDROMALACIA. Overweight, elderly, enthusiastic athletes need to pay attention to their joints and resist overworking them too much which can cause increased wear and tear of the cartilage. Muscle injuries are more common and should be treated like ligament injuries (RISE) and generally heal better. Remember, NO MASSAGE! Bone Injuries: Any sporting activity precludes the risk of injury and bony injuries are not uncommon. When there is a fracture (bony injury) one can immediately picture the type of force delivered and they are usually HIGH VEL L LOCITY injuries. Before the bone breaks, there must be considerable damage to the supporting soft tissue structures especially if the joint is involved. If a long bone breaks (pic.3; x-ray), then the force is usually a direct blow. Depending upon the x-ray picture, the good doctor can always re-create the possible type of injury pattern and thereby determine the seriousness of the damage. This helps a great deal in planning out the treatment. Surgeons are (the good ones!) so revered and also, one of the reasons that I took up orthopedic surgery. Here is a situation where a person is in pain, unable to use his limb and feels totally incapacitated with a deformity to boot and then I come in, fix his problem, the deformity is corrected, the patient is able to move his/her limb, pain settles down quickly and I am his/her hero! What can be more satisfying to a doctor? The word of caution though is to institute the right treatment at the right time. DO NOT TREAT THE XLRAY but TREAT THE PATIENT has been a dictum that I strictly adhere to and sometimes find it difficult to explain to patients, especially when it comes to fracture management. A perfectly aligned and fixed fracture is desirable but not necessarily achievable all the time. When patients bring in x-rays and are worried that the bones are not looking straight or are not perfect, it is a good clinicians responsibility to explain(without being irritated) that there are certain accepted norms in the medical fraternity under the guidelines of which, a doctor works. TIPS to Healthy Playing: Exercise regularly to maintain a good level of fitness. This will mean your muscles are stronger and better able to support your joints, including your knees. If you haven>t been active for a while, start gently and gradually increase the intensity. Spend five to 10 minutes warming up before exercise to increase blood flow to your muscles and reduce the chance of an injury. Many sports professionals advise stretching your joints before playing Proper footwear to be employed according to the surface Hydrate yourself adequately and munching on fruits like banana, pear etc., may be beneficial during heavy workouts or competitive games. Relax! Enjoy your game! After all- it is only a game! TIME IS A GREAT HEALER and this holds true for most sports injuries but then the euphemism of WHERE IS THE TIME is such a reality in modern times! SPORT is an opportunity for promoting peace and camaraderie and a great leveler because, the higher they are, the greater they fall!! - MMC

What is a tendon? A tendon is a tough band of tissue connecting the muscle to bone so that the mechanical action of the muscle becomes enhanced and energy saving. The complex properties of the tendons make them elastic and resistant to a lot of force (explains why we see some drivers are able to perform gymnastics while driving automatic cars!) The most vivid example of a tendon is the Achilles Tendon running on the back of ones leg from the lower calf down to the bone of the heel. It can be felt as a chord-like structure and is commonly injured in footballers.

Dr. Manimara Chozhan Specialist Orthopedic Surgery MB; MCh.Orthopedic Surgery (UK) Ortho, Trauma & Adult Reconstruction Surgeon Taiba Specialized Clinic L Fintas
When one injures the tendon, the healing process takes from few days to almost a year! The various processes of inflammationrepair and consolidation takes all this time and you can see people back in action after an hour or few weeks. THIS is why such injuries tend to become chronic if not properly treated. What is a ligament? A ligament is a dense band of tissue which connects bone to bone thereby strengthening the joint and regulates joint motion. The commonly injured tendon is that of the ACL (anterior cruciate ligament) of the knee.

Joint injuries have a chance to heal slowly but with the risk of developing arthritis. This is referred to as Secondary Osteoarthritis. The type of primary treatment, the proper follow-up and rehabilitation is crucial in limiting the occurrence of this problem. A fracture is usually presented with a dramatic turn of events. There is sudden swelling at the site of the injury ( blood collection ), there is intractable pain ( inflammation) and the person is unable to move the part (mobility is affected). This is why Orthopedic