Sunday, November 27, 2011

Role of Physiotherapy in Sports Injuries



Role of Physiotherapy in Sports Injuries
(Written by Dr.Krishna N. Sharma and Published in The Stethoscope, The Independent Newspaper, Bangladesh on 14 June 2010). Author's Contact: dr.krisharma@gmail.com 
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The term ‘Sports Injury’ may be an ordinary term for people but it is a specialized branch of study in medical field and thrilling experience for a sports person as well. As normally thought, it is caused by not only sudden impact but also by repetitive stress and strain. It can affect the soft tissues like ligaments, meniscus, bursae, tendons, bones, and organs.

Classification: It can be classified into ‘Acute Injuries’ and ‘Chronic Injuries’.
            Acute Injuries: These are caused by any sudden trauma. These are also known as ‘Traumatic Injuries’. The significant feature of these kinds of injuries is sudden onset of pain. Usually the deformities and impaired functions accomplish the pain.
            Subacute/Chronic Injuries: These are caused by overuse or repetitive trauma and stress on the bones, ligaments, tendons, bursae, meniscus etc.

Common Injuries: The risk of sports injuries in various body parts vary according to the nature of the games.

Region
Head & Neck:
Shoulder:         
Elbow:                   
Wrist                     
Finger:
Low Back:
Groin and Thigh:               
Knees:
Legs:
Ankle & Foot:
%
0-2
5-10
5
5
5-10
15
5
10
20-25
5-10
25
Games
Gymnastics, Rugby , Hockey,
Cricket, Badminton, Tennis, Volleyball
Cricket, Badminton, Tennis, Gymnastics,
Gymnastics, Weight Lifting, Diving,
Volleyball, Basketball, Hockey, Cricket
Gymnastics, Badminton, Cycling,
Rugby, Soccer, Hockey
Athletics, Soccer, Martial Arts
Badminton, Football, Athletics
Athletics, Martial Arts
Gymnastics, Athletics, Basketball, Diving


The commonest sports injuries are:
a)      Bone Injuries- Stress fractures, Scaphoid Stress Fractures, Clavicle Fractures, Vertebral Fracture, Shoulder Dislocation etc.
b)      Ligament Injuries (Sprains)- Anterior Cruciate Ligament Injury, Medial Collateral Ligament Injury, Ankle Injury (Lateral Collateral Injury), Ulnar Collateral Ligament Injury, Acromio-Clavicular Sprain, Finger Sprain etc.
c)      Tendon Injury (Strains, Tendonitis etc)- Rotator Cuff Injuries, Tennis Elbow, Golfer’s Elbow, Hamstring Strain, Adductor Strain, Tendo-achilles Strain etc.
d)     Other Soft Tissue Injuries- Meniscus Tear, Planter Fascitis etc.

How to Avoid the Sports Injuries: The sports injuries can be avoided by following the guidelines given below:
1)      Warming Up: Every exercise or game session must be started from the sufficient warm-up by doing gentle, low intensity free exercises like jogging, jumping, march on place etc.
2)      Stretching: Stretching is a very effective tool in decreasing the risk of injuries. Static and Ballistic Stretching techniques are commonly used in the field which can be learned by any physiotherapist.
3)      Gradually Progressive Training: The new sportsmen want to become expert in short time. This desire tends to push them in the well of fast ‘n’ hurry which curses them the sports injuries. So they must follow the gradual progression under an expert trainer.
4)      Don’t train hard until the stiffness decreases: In starting of any game season or any training camp the stiffness or the muscle soreness is very common problem. The sportsmen must not train themselves hard in presence of the stiffness or soreness. They should do low intensity exercises to give the muscles time to regain their efficiency.
5)      Wearing right footwear: The more than stiff or more than soft footwear, inaccurately designed arches of the footwear are the common problems in the road-side footwear. The player may take assistance of a footwear-expert in selecting proper footwear for him.
6)      Training on different surfaces: Wearing the footwear, the sportsmen must be trained on various ground surfaces.
7)      Cooling Down: After every training or game session, the sportsmen must cool down. This induces the relaxation also.
8)      Bath and Change after Cooling down: Taking the shower and changing the dress fills a new energy in the player and produces relaxation.
9)      Comfortable journey: The players travel frequent for long journeys. If the journey is not comfortable enough, the players will be tiered. This will increases the risk of muscle injuries due to insufficient relaxation.
10)  Monitoring the body: The sportsmen must monitor their body and muscles for fatigue, cramps etc. They must respect the pain and never ignore it.

When to Report: Usually the sportsmen try to ignore the injury until it does not become intolerable. They must know the common course of the events of the sports injury and must report as soon as possible, preferably in the first stage. The sports injuries usually follow the following course of events:
·         Event 1: The sportsman feels pain during the session but he ignores it.
·         Event 2: The pain recurs and may be felt even after the training or game   session but he is still capable to ignore it.
·         Event 3: Now the pain interferes in the training or game session but the sportsman competes after rest.
·         Event 4: Now the pain is too bad to continue the game or training session.

What a Physiotherapist Do: Physiotherapy is defined as physiotherapeutic system of medicine which includes examination, treatment, advice and instructions to any person preparatory to or for the purpose of or in connection with movement dysfunction, bodily malfunction, physical disorder, disability, healing and pain from trauma and disease, physical and mental conditions using physical agents including exercise, mobilization, manipulation, mechanical and electrotherapy, activity and devices or diagnosis, treatment and prevention.
            The physiotherapist plays a vital role in all the curative aspects of sports injuries including post-traumatic, pre-operative and post-operative phases. The physiotherapist is intended to give quick relief to the player to let him continue his game within few minutes. The physiotherapist aims on three main objectives- protection, rehabilitation and re-evaluation.
a)      Protection- The physiotherapist assures the protection of the injured part to prevent the further damage or progression of the injury.
b)      Rehabilitation- The physiotherapist uses the measures to improve the strength, endurance, flexibility etc. In later cases he also trains the player for the correct movement pattern and corrects the deformities.
c)      Re-evaluation- After the rehabilitation, the physiotherapist assesses and re-evaluates the player to confirm whether he can return to the game activity.

            In acute injuries a very famous combination of measures is used for management which is known as RICE in short. The RICE stands for Rest, Ice, Compression and Elevation.
  • Rest: It is given by immobilizing the injured part.
  • Ice: Application of ice on the injured part reduces the inflammation and bleeding.
  • Compression: It is given by the compression bandages or the crepe bandages which prevents the swelling.
  • Elevation: The injured part is put in elevation by slings or suspension.  

            The physiotherapists use mainly two categories of treatment measures in sports injuries.
1-      Therapeutic Exercises- It includes various measures like:
·         Manual Mobilization
·         Stretching
·         Strengthening
·         Soft Tissue Manipulation
·         Myofascial Release
·         Muscle Energy Technique etc.
2-      Electrotherapy Modalities- It includes various measures like:
·         LASER
·         Interferential Therapy
·         Ultra Sound Therapy
·         Cryo Therapy
·         Infra Red Radiation
·         Short Wave Diathermy etc.

            The time taken for the recovery varies according to the conditions. It may be less than 10 minutes or it may be more than 10 years, so following the saying ‘Precaution is better than cure’ is preferred.

Author: Dr. Krishna N. Sharma (PT)
Email: dr.krisharma@gmail.com
Cont: +91-9320699167
(Written by Dr.Krishna N. Sharma and Published in The Stethoscope, The Independent Newspaper, Bangladesh on 14 June 2010)