MANAGEMENT OF MANAGEMENT OF SPORTS INJURIESSPORTS INJURIES

Dr. Yanuarso, SpOTDr. Yanuarso, SpOT

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

- Ralph Waldo - Ralph Waldo EmersonEmerson

Can’t Beat the First!Can’t Beat the First!

AcuteAcute ChronicChronic

Most are preventable!Most are preventable!Training Training Methods Methods

EquipmentEquipmentDietDiet

InjuriesInjuries

ACUTE INJURIESACUTE INJURIES

ContusionContusion

AbrasionAbrasion

LacerationLaceration

Sprain/StrainSprain/Strain

Subluxation/Subluxation/ DislocationDislocation

FractureFracture

ACUTE INJURIESACUTE INJURIES

Blunt injury to soft tissuesBlunt injury to soft tissues

SwellingSwellingHematomaHematomaBruiseBruise

Common in contact sportsCommon in contact sports

ContusionContusion

ACUTE INJURIESACUTE INJURIES

Management:Management:

Cold compressCold compress

Anti-inflammatories/Anti-inflammatories/ PainkillersPainkillers

Warm compress Warm compress *only after swelling *only after swelling subsidessubsides

ContusionContusion

ACUTE INJURIESACUTE INJURIESAbrasionAbrasion

Break in the skinBreak in the skin

Epidermis or DermisEpidermis or Dermis

Scratch,ScrapScratch,Scrapee

BleedingBleeding

InfectionInfection

ACUTE INJURIESACUTE INJURIESAbrasionAbrasion

Management:Management:

S-A-I-D protocolS-A-I-D protocolSS - soak- soak soapsoap scrubscrub

AA - antibiotics- antibiotics anti-tetanusanti-tetanus

II - irrigate- irrigate

DD - dress- dress*Painkillers*Painkillers

ACUTE INJURIESACUTE INJURIESLacerationLaceration

Extends to SubcutaneousExtends to Subcutaneous Tissue and FatTissue and Fat

CutCut - over bony prominenceover bony prominence- by a sharp object- by a sharp object

Greater amount of bleedingGreater amount of bleeding

BiteBite

ACUTE INJURIESACUTE INJURIESLacerationLaceration

Management:Management:

S-A-I-D protocolS-A-I-D protocol

Adhesive stripsAdhesive strips

SuturingSuturing

ACUTE INJURIESACUTE INJURIESStrainStrain SprainSprain

Different entitiesDifferent entitiesSame managementSame management

StrainStrain

-involves muscles involves muscles or tendonsor tendons

Tendon connects muscle to boneTendon connects muscle to bone

Example - Achilles tendonExample - Achilles tendonCalf muscle Calf muscle Calcaneus Calcaneus

Can progress to a tearCan progress to a tear

SprainSprain

- involves ligaments- involves ligaments

Connects one bone to anotherConnects one bone to another

Example - AnkleExample - Ankle

ACUTE INJURIESACUTE INJURIESSprain/StrainSprain/Strain

Management:Management:

C-R-I-M-E-S protocolC-R-I-M-E-S protocol

C C - compression- compression

R R - rest- rest

I I - ice- ice

M M - medication- medication

E E - elevation- elevation

S S - support- support

ACUTE INJURIESACUTE INJURIESSubluxation/Subluxation/ DislocationDislocation

Also involve jointsAlso involve joints

1 and 2 steps1 and 2 stepsbeyond a sprainbeyond a sprain

SprainSprain - normal joint - normal joint relationshiprelationship

SubluxationSubluxation - abnormal - abnormal

close proximityclose proximity

DislocationDislocation - complete loss - complete loss

dislocationdislocationsubluxationsubluxation

sprainsprain

Usually done in a hospitalUsually done in a hospitalCan also be done on the fieldCan also be done on the field

Put the joint in place then immobilizePut the joint in place then immobilizeX-rays!X-rays!

C-R-I-M-E-SC-R-I-M-E-S

ACUTE INJURIESACUTE INJURIES

surgerysurgery

FractureFractureInjuring force enough toInjuring force enough to break bonebreak bone

EmergencyEmergency

castingcastingsplintingsplinting

Immobilize prior Immobilize prior to moving patientto moving patient

C-R-I-M-E-SC-R-I-M-E-S

CHRONIC INJURIESCHRONIC INJURIES

Secondary to:Secondary to:Repetitive traumaRepetitive trauma

OveruseOveruse

Result of:Result of:Poor trainingPoor training

Bad formBad form

Lousy genesLousy genes

Improper equipmentImproper equipment

Faulty dietFaulty diet

CHRONIC INJURIESCHRONIC INJURIES

TrainiTrainingngRecovRecoveryery

FormForm TechniqueTechnique

EquipmentEquipment

GenesGenes

FluidsFluidsDietDiet

CHRONIC INJURIESCHRONIC INJURIES

Low Back PainLow Back Pain

Jumper’s KneeJumper’s Knee

Achilles TendinitisAchilles Tendinitis

Tennis ElbowTennis Elbow

Golfer’s ElbowGolfer’s Elbow

RC TendinitisRC Tendinitis

Stress FractureStress Fracture

CHRONIC INJURIESCHRONIC INJURIES

Low Back PainLow Back Pain*Very common*Very commonSeveral factors:Several factors:Over-trainingOver-training

Poor warm-up & cool downPoor warm-up & cool down

Weak abdominalsWeak abdominals

Tight hamstringsTight hamstrings

Improper shoe wearImproper shoe wear

Inappropriate bedInappropriate bed

Hard MassagesHard Massages

Low Back PainLow Back PainManagementManagement::

Anti-Anti-inflammatoriesinflammatories

Warm Compress/ShowerWarm Compress/Shower

PT ModalitiesPT Modalities- UltrasoundUltrasound- Electrical StimulationElectrical Stimulation- LaserLaser- Hot Moist PackHot Moist Pack- Traction- Traction

(SWAMP)(SWAMP)

CHRONIC INJURIESCHRONIC INJURIES

Self TherapySelf Therapy

Muscle RelaxantsMuscle Relaxants

ChiropractorsChiropractors

YogaYoga

AcupunctureAcupuncture

ReflexologyReflexology

PilatesPilates

Low Back PainLow Back PainManagementManagement::

CHRONIC INJURIESCHRONIC INJURIES

(CRAMP(CRAMPY)Y)

MagnetsMagnets

CHRONIC INJURIESCHRONIC INJURIESPatellar TendinitisPatellar Tendinitis

““Jumper’s Knee”Jumper’s Knee”

Excessive contraction of theExcessive contraction of the Quadriceps muscleQuadriceps muscle

CHRONIC INJURIESCHRONIC INJURIES

RR -- RestRest

SS -- Self TherapySelf TherapyII -- IceIce

PP -- PT ModalitiesPT Modalities

Infrapatellar Infrapatellar Brace/StrapBrace/Strap

AA -- Anti-inflammatoriesAnti-inflammatories

P-A-R-I-SP-A-R-I-Sprotocolprotocol

Patellar TendinitisPatellar TendinitisManagementManagement::

CHRONIC INJURIESCHRONIC INJURIESAchilles TendinitisAchilles Tendinitis

Common in RunnersCommon in Runnersand Sprintersand Sprinters

Management:Management:

SameSame

PPT ModalitiesT ModalitiesAAnti-inflammatoriesnti-inflammatoriesRRestestIIceceSSelf Therapyelf Therapy

CHRONIC INJURIESCHRONIC INJURIESAchilles TendinitisAchilles Tendinitis

Golfer’s ElbowGolfer’s ElbowTennis ElbowTennis Elbow

ExtensorsExtensors FlexorsFlexors

Lateral EpicondylitisLateral EpicondylitisMedial EpicondylitisMedial Epicondylitis

Faulty BackhandFaulty Backhand Faulty SwingFaulty Swing

Dominant HandDominant Hand Dominant Hand*Dominant Hand*

Tennis ElbowTennis Elbow Golfer’s ElbowGolfer’s ElbowBadminton ElbowBadminton Elbow

Principle of Counterforce Bracing:Principle of Counterforce Bracing:Constrains muscular expansionConstrains muscular expansionBroadens muscle originBroadens muscle origin

BraceBraceSteroidsSteroids

Golfer’s ElbowGolfer’s ElbowP-A-R-I-SP-A-R-I-Sprotocolprotocol

ManagementManagement::

Badminton ElbowBadminton Elbow

SurgerySurgery

Pain on Overhead ActivitiesPain on Overhead Activities

ROTATOR CUFF TENDINITIS ROTATOR CUFF TENDINITIS ““Impingement Syndrome”Impingement Syndrome”

AcromionAcromion

SupraspinatusSupraspinatus

ROTATOR CUFF TENDINITIS ROTATOR CUFF TENDINITIS ““Impingement Syndrome”Impingement Syndrome”

SurgerySurgery

Watch out forWatch out forFROZEN SHOULDER!FROZEN SHOULDER!

SteroidsSteroids

P-A-R-I-SP-A-R-I-S

ROTATOR CUFF TENDINITIS ROTATOR CUFF TENDINITIS ““Impingement Syndrome”Impingement Syndrome”

May also affect boneMay also affect bone

STRESS FRACTURESSTRESS FRACTURES

Responds to Responds to Conservative ManagementConservative Management

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

Casting?Casting?

Exertional Compartment SyndromeExertional Compartment Syndrome

PeriosteitisPeriosteitis

CHRONIC INJURIESCHRONIC INJURIES

Thank YouThank YouVery Much!Very Much!

AnyAnyQuestions?Questions?