Dislocations Subluxations Cuff tears Osteolysis of distal clavicle (power lifters) Fractures

TONY JABBOUR, MD

SPORTS MEDICINE

Elbow – high stress during throwing. MCL stretching leads to valgus instability. Radial head osteochondritis dissecans

(younger pitchers). Lateral epicondylitis (tennis elbow, injury

to extensor tendons of the wrist).

TONY JABBOUR, MD

SPORTS MEDICINE

Mallet finger – extensor tendon rupture from the distal phalanx, splinting usually.

Jersey finger – Football. Flexor digitorum profundus (FDP) of tackling player. Flexor tendon avulses from distal phalanx. Surgery is usual treatment.

Skiers thumb – ulnar collateral ligament sprain of the thumb.

TONY JABBOUR, MD

SPORTS MEDICINE

Avulsion injuries from anterior superior iliac spine or ischial tuberosity. Younger athletes, usually around 14 years of age.

Hamstring strains – usually older athletes. Femoral neck stress fractures (rare but

require pinning).

TONY JABBOUR, MD

SPORTS MEDICINE

Second most frequently injured in regard to soft tissue injuries.

Overuse injuries lead to tendinitis. Traumatic – Patellar dislocations, ACL tear,

cartilage damage (articular cartilage or meniscus).

MCL – Soccer, hockey. ACL – Non-contact, high speed, change of

direction. Tibia subluxes onto femur.

TONY JABBOUR, MD

SPORTS MEDICINE

Shin splints – Non-specific term, should be avoided.

Stress fracture of tibia. Exertional compartment syndrome –

different from post-traumatic compartment syndrome in that pressure never gets high enough to cause permanent damage.

Increased pressure leads to increased lactic acid, which leads to increased pain which leads to athlete having to stop activity.

TONY JABBOUR, MD

SPORTS MEDICINE

Most common of all soft tissue athletic injuries.

Ligaments prone to injury. Complete ligament tears can heal non-

operatively. Achilles rupture – middle-aged athletes.

Thompson test.

TONY JABBOUR, MD

SPORTS MEDICINE

Plantar fasciitis and stress fracture of calcaneus, common causes of heel pain.

Stress fracture of metatarsals and sesamoid bone.

TONY JABBOUR, MD

SPORTS MEDICINE

Cervical injuries – spearing in football is illegal which can lead to quadriplegia.

TONY JABBOUR, MD

SPORTS MEDICINE

Keep helmet and shoulder pads on during transport to ER by ambulance.

Stingers/Burners – painful sensations radiating down arm and possibly numbness and weakness secondary to forceful shoulder depression or lateral bending of neck during tackling.

Low back pain common with gymnastics and football.

TONY JABBOUR, MD

SPORTS MEDICINE

•Stress fracture of pars interarticularis (spondylolysis).•Axial loads on spine in extension.•MRI/bone scan.•Treatment – Rest and bracing.•Spondylolisthesis – progressive instability of one vertebral body onto the one below – “rare complication in athletes”.•Contusions.•Fractures.•Sprains.•Dislocations.•Turf toe hyperextension injury.TONY JABBOUR, MD

SPORTS MEDICINE

Especially pitchers: Shoulder instability with secondary impingement.

Valgus overload of elbow (younger athletes).

Osteochondritis dissecans of elbow.

Hook of hamate fracture, batting.

TONY JABBOUR, MD

SPORTS MEDICINE

High risk of knee and ankle injuries.

TONY JABBOUR, MD

SPORTS MEDICINE

ACL injuries Ankle injuries with landing. Hyperextension of spine leads to

spondylolysis. Eating disorders – Female triad:

Eating disorder Abnormal menses Stress Fracture

TONY JABBOUR, MD

SPORTS MEDICINE

Shoulder instability (younger athletes). Rotator cuff tears (older athletes). Low back pain. Lateral epicondylitis (older athletes).

TONY JABBOUR, MD

SPORTS MEDICINE

Finger injuries. Jumper’s knee (chronic tendinosis of

patellar tendon, usually at distal pole of patella.

Treatment – hamstring stretches and quadriceps strengthening.

Knee/ankle injuries most common.

TONY JABBOUR, MD

SPORTS MEDICINE

Year-round Sport. Overuse injuries. Low back pain. High number of catastrophic injuries (neck

and head injuries) secondary to basket tosses and pyramids.

TONY JABBOUR, MD

SPORTS MEDICINE

Knee/ankle injuries most common.

Osteitis pubis – Repetitive stress on symphysis pubis from high kicking.

TONY JABBOUR, MD

SPORTS MEDICINE

Lacerations from skates and fighting. AC joint clavicle fracture because of body

checking. Catastrophic neck injuries. MCL injuries.

TONY JABBOUR, MD

SPORTS MEDICINE

AC joint injuries secondary to landing on point of shoulder.

TONY JABBOUR, MD

SPORTS MEDICINE

Jumper’s knee. ACL meniscal injury. Shoulder instability in younger patients. Finger tip injuries.

TONY JABBOUR, MD

SPORTS MEDICINE

Shoulder injuries.

Breaststroker’s knee ( MCL strain).

TONY JABBOUR, MD

SPORTS MEDICINE

Inferior shoulder instability.

TONY JABBOUR, MD

SPORTS MEDICINE

Stress fractures of metatarsals and tibia.

Exertional compartment syndrome.

TONY JABBOUR, MD

SPORTS MEDICINE

Lower center of gravity. Wider pelvis which leads to high valgus angle

at knee (knock-kneed). Wider pelvis also leads to high patellofemoral

tracking problems. Smaller notch in knee leads to high ACL

tears. Monthly fluctuation of Estrogen levels. If Estrogen is down, this leads to

osteoporosis which leads to decreased repair of stress fractures.

TONY JABBOUR, MD

SPORTS MEDICINE

•FEMALE TRIAD:•Eating disorders•Osteoporosis•Abnormal menses

TONY JABBOUR, MD

SPORTS MEDICINE

Definition of aging? More sprains and strains. Increased risk of stress fractures. Vascular claudication (peripheral vascular

disease). Neurogenic claudication (spinal stenosis).

TONY JABBOUR, MD

SPORTS MEDICINE

Open physes (growth plates). Physis tends to fail before ligament fails. All sprains in children/adolescents – think

physis fracture. Apophysitis – inflammation at attachment

of tendons. (Osgood-Schlatter’s disease). Avulsion fracture (ischial tuberosity). Osteochondritis dissecans (elbows of

pitchers). Tarsal coalition in 11-15 year olds.

TONY JABBOUR, MD

SPORTS MEDICINE

Special Olympics.

Down’s Syndrome – Cervical spine C1-2 instability.

Wheelchair athletes – rotator cuff tears.

TONY JABBOUR, MD

SPORTS MEDICINE