Sports Injuries

Sports Injuries 

Definition

Sports injuries result from acute trauma or repetitive stress associated with athletic activities. Sports injuries can affect bones or soft tissue (ligaments, muscles, tendons).

Professional dancers are increasingly recognized as performing athletes, and many of the treatments and preventive measures utilized in sports medicine are now applied to dance-related injuries.

It is also important to remember that many types of injuries that affect athletes may also occur in workers in certain occupations; for example, many people in the building trades develop tennis elbow or golfer's elbow. The principles of sports medicine can be applied in the treatment of most common musculoskeletal injuries.

Description

Adults are less likely to suffer sports injuries than children, whose vulnerability is heightened by immature reflexes, an inability to recognize and evaluate risks, and underdeveloped coordination.

In 2002, about 20.3 million Americans suffered a sports injury. Of those, 53% were minor enough to be self-treated or left untreated. However, about 10 million Americans annually receive medical attention for their sports-related injuries. That equates to almost 26 per 1,000 people. The highest rate is among children age five to 14 years old (59.3 per 1,000 people). As many as 20% of children who play sports get hurt, and about 25% of their injuries are classified as serious. Boys aged 12 to 17 are the highest risk group. More than 775,000 boys and girls under age 14 are treated in hospital emergency rooms for sports-related injuries.

Injury rates are highest for athletes who participate in contact sports, but the most serious injuries are associated with individual activities. Between one-half and two-thirds of childhood sports injuries occur during practice, or in the course of unorganized athletic activity.

Baseball and softball are the leading causes of sports-related facial trauma in the United States, with 68% of these injuries caused by contact with the ball rather than player-player collision or being hit by a swung bat.

Types of sports injuries

About 95% of sports injuries are minor soft tissue traumas.

The most common sports injury is a bruise (contusion). It is caused when blood collects at the site of an injury and discolors the skin.

Sprains account for one-third of all sports injuries. A sprain is a partial or complete tear of a ligament, a strong band of tissue that connects bones to one another and stabilizes joints.

A strain is a partial or complete tear of:

Inflammation of a tendon (tendinitis) and inflammation of one of the fluid-filled sacs that allow tendons to move easily over bones (bursitis) usually result from minor stresses that repeatedly aggravate the same part of the body. These conditions often occur at the same time.

SKELETAL INJURIES. Fractures account for 5-6% of all sports injuries. The bones of the arms and legs are most apt to be broken. Sports activities rarely involve fractures of the spine or skull. The bones of the legs and feet are most susceptible to stress fractures, which occur when muscle strains or contractions make bones bend. Stress fractures are especially common in ballet dancers, long-distance runners, and in people whose bones are thin.

Shin splints are characterized by soreness and slight swelling of the front, inside, and back of the lower leg, and by sharp pain that develops while exercising and gradually intensifies. Shin splints are caused by overuse or by stress fractures that result from the repeated foot pounding associated with activities such as aerobics, long-distance running, basketball, and volleyball.

A compartment syndrome is a potentially debilitating condition in which the muscles of the lower leg grow too large to be contained within membranes that enclose them. This condition is characterized by numbness and tingling. Untreated compartment syndrome can result in long-term loss of function.

BRAIN INJURIES. Brain injury is the primary cause of fatal sports-related injuries. Concussion, which is also called mild traumatic brain injury or MTBI, can result from even minor blows to the head. A concussion can cause loss of consciousness and may affect:

Causes and symptoms

Common causes of sports injuries include:

Symptoms include:

Diagnosis

Symptoms that persist, intensify, or reduce the athlete's ability to play without pain should be evaluated by an orthopedic surgeon. Prompt diagnosis often can prevent minor injuries from becoming major problems, or causing long-term damage.

An orthopedic surgeon should examine anyone:

The physician will perform a physical examination, ask how the injury occurred, and what symptoms the patient has experienced. X rays and other imaging studies of bones and soft tissues may be ordered.

Anyone who has suffered a blow to the head should be examined immediately, and at five-minute intervals until normal comprehension has returned. The initial examination measures the athlete's:

Subsequent evaluations of concussion assess:

Treatment

Treatment for minor soft tissue injuries generally consists of:

Anti-inflammatories, taken by mouth or injected into the swelling, may be used to treat bursitis. Anti-inflammatory medications and exercises to correct muscle imbalances usually are used to treat tendinitis. If the athlete keeps stressing inflamed tendons, they may rupture, and casting or surgery is sometimes necessary to correct this condition.

Orthopedic surgery may be required to repair serious sprains and strains.

Controlling inflammation as well as restoring normal use and mobility are the goals of treatment for overuse injuries.

Athletes who have been injured are usually advised to limit their activities until their injuries are healed. The physician may suggest special exercises or behavior modifications for athletes who have had several injuries. Athletes who have been severely injured may be advised to stop playing altogether.

Prevention

Every child who plans to participate in organized athletic activity should have a pre-season sports physical. This special examination is performed by a pediatrician or family physician who:

Telling the physician which sport the athlete plays will help that physician determine which parts of the body will be subjected to the most stress. The physician then will be able to suggest to the athlete steps to take to minimize the chance of getting hurt.

Other injury-reducing game plans include:

On a larger scale, sports injuries are becoming a public health concern in America. Prevention efforts include wearing protective devices (such as bicycle helmets and pads when skating or skateboarding), and educating both children and adults about safety. Other preventive efforts include changes in the rules of the game or sport to minimize injuries. For example, wearing goggles will be mandatory in women's lacrosse as of 2005 in order to reverse the rising rate of eye and other facial injuries in that sport. Research also continues on improving equipment. For example, thick rubber insoles can help prevent against repetitive injuries from running, but scientists recently observed that they can add to injuries in sports such as soccer, where athletes need to make quick changes of direction. On the other hand, recent improvements in the design and construction of football helmets have been credited with a significant decline in the frequency and severity of head injuries among football players.

Resources

Books

Beers, Mark H., MD, and Robert Berkow, MD., editors. "Common Sports Injuries." Section 5, Chapter 62 In The Merck Manual of Diagnosis and Therapy. Whitehouse Station, NJ: Merck Research Laboratories, 2004.

Periodicals

Bak, M. J., and T. D. Doerr. "Craniomaxillofacial Fractures during Recreational Baseball and Softball." Journal of Oral and Maxillofacial Surgery 62 (October 2004): 1209-1212.

Bernhardt, David T., MD. "Concussion." eMedicine July 6, 2004. http://www.emedicine.com/sports/topic27htm.

Chaudry, Samena. "Insoles Help Prevent Sports Injuries." Student BMJ May 2003: 137.

Conne, J.M., J.L. Annest, and J. Gilchrist. "Sports and Recreation Related Injury Episodes in the U.S. Population." Injury Prevention June 2003: 117.

Koutedakis, Y., and A. Jamurtas. "The Dancer as a Performing Athlete: Physiological Considerations." Sports Medicine 34, no. 10 (2004): 651-661.

Levy, M. L., B. M. Ozgur, C. Berry, et al. "Analysis and Evolution of Head Injury in Football." Neurosurgery 55 (September 2004): 649-655.

Matz, S. O., and G. Nibbelink. "Injuries in Intercollegiate Women's Lacrosse." American Journal of Sports Medicine 32 (April-May 2004): 608-611.

Rupp, Timothy J., MD, Marian Bednar, MD, and Stephen Karageanes, DO. "Facial Fractures." eMedicine August 29, 2004. http://www.emedicine.com/sports/topic33.htm.

Organizations

American Academy of Orthopedic Surgeons. 6300 North River Road, Rosemont, IL 60018-4262. (800) 346-2267. http://www.aaos.org.

American Academy of Otolaryngology—Head and Neck Surgery. One Prince Street, Alexandria, VA 22314-3357. (703) 836-4444. http://www.entnet.org.

American College of Sports Medicine (ACSM). 401 West Michigan Street, Indianapolis, IN 46202-3233. (317) 637-9200. Fax: (317) 634-7817. http://www.acsm.org.

Institute for Preventative Sports Medicine. P.O. Box 7032, Ann Arbor, MI 48107 (313) 434-3390. 〈http://www.ipsm.org〉.