MANAGEMENT OF SPORTS INJURIES

Dr. Yanuarso, SpOT

Do not go where the path may lead, go instead where there is no path and leave a trail.

- Ralph Waldo Emerson

Cant Beat the First!

Acute

Injuries

Chronic

Most are preventable!

Training Methods Equipment Diet

ACUTE INJURIES
Contusion

Abrasion Laceration Sprain/Strain Subluxation/ Dislocation

Fracture

ACUTE INJURIES
Contusion
Blunt injury to soft tissues

Swelling Hematoma Bruise

Common in contact sports

ACUTE INJURIES
Contusion
Management:
Cold compress Anti-inflammatories/ Painkillers

Warm compress
*only after swelling subsides

ACUTE INJURIES
Abrasion
Break in the skin
Epidermis or Dermis

Scratch,Scrape

Bleeding Infection

ACUTE INJURIES
Abrasion
Management: S-A-I-D protocol
S - soak soap scrub A - antibiotics anti-tetanus I - irrigate D - dress
*Painkillers

ACUTE INJURIES
Laceration
Extends to Subcutaneous Tissue and Fat Cut - over bony prominence - by a sharp object Bite

Greater amount of bleeding

ACUTE INJURIES
Laceration
Management:
S-A-I-D protocol

Adhesive strips

Suturing

ACUTE INJURIES
Strain Sprain

Different entities Same management

Strain
-involves muscles or tendons
Tendon connects muscle to bone

Sprain
- involves ligaments
Connects one bone to another

Example - Achilles tendon Calf muscle Calcaneus

Example - Ankle

Can progress to a tear

ACUTE INJURIES
Sprain/Strain
Management: C-R-I-M-E-S protocol
C - compression R - rest I - ice M - medication E - elevation S - support

ACUTE INJURIES
Subluxation/ Dislocation
Also involve joints 1 and 2 steps beyond a sprain
Sprain - normal joint
relationship

dislocation

sprain

subluxation

Subluxation - abnormal
close proximity

Dislocation - complete loss

C-R-I-M-E-S

Usually done in a hospital Can also be done on the field Put the joint in place then immobilize X-rays!

ACUTE INJURIES
Fracture
Injuring force enough to break bone Emergency

casting splinting surgery

Immobilize prior to moving patient

C-R-I-M-E-S

CHRONIC INJURIES
Secondary to:
Repetitive trauma Overuse

Result of:
Poor training Bad form Improper equipment Faulty diet Lousy genes

CHRONIC INJURIES
Training Recovery Form Technique Equipment

Diet Fluids

Genes

CHRONIC INJURIES
Low Back Pain

Jumpers Knee
Achilles Tendinitis

Tennis Elbow
Golfers Elbow

RC Tendinitis
Stress Fracture

CHRONIC INJURIES
Low Back Pain
*Very common Several factors: Over-training Weak abdominals Tight hamstrings

Poor warm-up & cool down

Improper shoe wear

Inappropriate bed Hard Massages

CHRONIC INJURIES
Low Back Pain
Self Therapy Warm Compress/Shower Anti-inflammatories Muscle Relaxants PT Modalities
- Ultrasound - Electrical Stimulation - Laser - Hot Moist Pack - Traction

Management: (SWAMP)

CHRONIC INJURIES
Low Back Pain
Management: (CRAMPY)
Chiropractors

Reflexology
Acupuncture Magnets Pilates Yoga

CHRONIC INJURIES
Patellar Tendinitis
Jumpers Knee
Excessive contraction of the Quadriceps muscle

CHRONIC INJURIES
Patellar Tendinitis
Management: P-A-R-I-S protocol
P - PT Modalities A - Anti-inflammatories R - Rest I - Ice

S - Self Therapy

Infrapatellar Brace/Strap

CHRONIC INJURIES
Achilles Tendinitis
Common in Runners and Sprinters

CHRONIC INJURIES
Achilles Tendinitis Management:

Same PT Modalities Anti-inflammatories Rest Ice Self Therapy

Tennis Elbow Golfers Elbow

Extensors

Flexors

Badminton Tennis Elbow Golfers Elbow

Lateral Epicondylitis Faulty Backhand Dominant Hand Medial Epicondylitis Faulty Swing

Dominant Hand*

Badminton Elbow Golfers Elbow

Management: P-A-R-I-S protocol Principle of Counterforce Bracing: Constrains muscular expansion Broadens muscle origin

Brace Steroids

Surgery

ROTATOR CUFF TENDINITIS

Impingement Syndrome

Pain on Overhead Activities

ROTATOR CUFF TENDINITIS

Impingement Syndrome

Acromion

Supraspinatus

ROTATOR CUFF TENDINITIS

Impingement Syndrome

P-A-R-I-S
Steroids Surgery Watch out for FROZEN SHOULDER!

CHRONIC INJURIES
May also affect bone

STRESS FRACTURES
Exertional Compartment Syndrome Periosteitis

Responds to Conservative Management

Casting?
Takes longer to heal (2 to 3 months)

Thank You Very Much!

Any Questions?