Sports injuries and their prevention

What is it about ?

Sports injuries are very common. They represent by far the largest group of injuries caused by (sports) accidents. It is most often a sudden trauma, but overwork can also be the cause. The injuries are usually harmless and involve muscle and tendon damage, bruising and pain. More than a quarter of these injuries affect the knee or ankle. Back injuries are also common.

The cause is often a sudden stop of movement or a sudden change in direction, weak muscle strength, flabby ligaments, poor technique, postural abnormalities such as knuckle knees (X-shaped legs) and legs. flat feet, and poor vision of space. The speed of first aid promotes healing. For the rest, prevention is very important.

The number and severity of injuries depend in particular on the nature and intensity of the sport practiced. Walking, cycling, swimming, cross-country skiing, aerobics, skating, dancing, fitness, and golf are relatively safe sports. Sports practiced professionally and involving extreme training and intensive competition, as well as contact sports carry a greater risk of injury. Serious injuries can also cause problems later in life. Osteoarthritis of the knee is therefore more common in athletes who have suffered a tear in the cruciate ligaments in the past.

What is their frequency?

Recreational sports carry a low risk of injury – 0.7 per 1,000 hours of practice. In fitness and competitive sports, this figure climbs to 3.1 per 1,000 hours. The risk is highest between the ages of 15 and 34. Men have a slightly higher risk of sports injury than women, but women’s knee injuries are more serious.

Recovery after a sports injury

Recovery after injury to soft tissues (muscles, tendons and ligaments) generally follows a set pattern:

• The inflammatory phase, 0-7 days after the injury: pain, redness, swelling and warmth develop around the injury.
• The regeneration or proliferation phase, 1 to 3 weeks after the trauma: healing begins, but is still too weak to support new activity.
• The maturation and remodeling phase, from 4 weeks: a new, solid tissue is formed.

Normally, all normal sports activities can be resumed 6 to 8 weeks after the injury. A full charge is then possible. However, full recovery can take up to a year. After a cruciate ligament repair operation in the knee, for example, running can be resumed slowly after only 3 months, and intensive training after 6 months.

It is therefore important to start treatment and rehabilitation as soon as possible. The initial treatment is based on the RICE principle: Rest, Ice (application of an ice pack), Compression (placement of a compression bandage) and Elevation (heightening of the affected limb). Depending on the severity of the injury, this phase lasts between 3 and 7 days. You can and should then begin rehabilitation immediately. In principle, the mobilization must be done within the limits of the pain. So you don’t necessarily have to suffer to heal faster. The ideal is to follow a medical gymnastics program with the physiotherapist. The controlled movements promote the formation of a beautiful scar, solid and flexible.

Prevention of sports injuries

Prevention is essential and is based on 2 pillars: good equipment and suitable training. On the material side, for example, we think of appropriate sports clothing, such as good shoes and good protection (bicycle helmet, knee pads, elbow pads, etc.), good equipment, soles, support straps, etc. . Training should be individualized and ideally supervised by a qualified trainer. A good warm-up, a slow increase in intensity, the gradual introduction of new exercises, … are of great importance.

Some common sports injuries

Head injuries

If you suspect a concussion (headache, nausea, vomiting, inability to remember precisely what happened, …), you must immediately stop the physical effort. During the next 24 hours, you will be watched closely for possible bleeding in a timely manner. Symptoms of decreased level of consciousness or paralysis are warning signs.
Convalescence lasts between 7 and 10 days. If you can then complete normal training without complaints, you can resume all activities, including competitive sport.

Jumper’s knee

It is actually an inflammation of the tendon of the kneecap. This inflammation results from repeated overwork due to jumps (high jump, volleyball, basketball, etc.) and can be localized on the upper edge, on the kneecap itself or on the tendon attachment below the knee. .

At first, the person only feels pain in motion, especially when jumping, running, or squatting. Then the pain is present continuously, including at rest. Any pressure exerted on the inflammation is painful. In extreme cases, a small piece of bone can even come loose at the tendon attachment. Calcifications can then form in the inflamed part of the tendon.

The treatment consists of rest, taking anti-inflammatory drugs and practicing appropriate stretching exercises by the physiotherapist. In refractory cases, cortisone infiltration may be administered. If this treatment is not effective, all that is left is surgery.

Shin splints (medial tibial stress syndrome)

This syndrome is characterized by pain on the inside of the shin, sometimes in a small area, sometimes along most of the length of the shin, from the top of the ankle to the bottom of the knee. At first, the pain only occurs after weight-bearing, so after exercise. But, after a while, it is also felt during sports practice, and even at rest.

The cause is not entirely clear. A combination of inflammation of the periosteum (the membrane that surrounds the tibial bone), tendons and bone itself is suspected. The cause of this inflammation is often an abnormality in the position of the leg, the course of the foot or the mobility of the joints. Before treatment, the doctor will first and foremost examine these items. If necessary, the shoes can be adapted by inserting soles. Anti-inflammatory drugs are of no use. In severe cases, an operation may be performed.

Achilles tendon inflammation

This is a characteristic overuse injury in runners. The Achilles tendon may be inflamed in the last portion above the heel or at the attachment to the heel bone (calcaneus). Often the inflammation also spreads to the bursa below the tendon attachment (bursitis).

At first, the pain appears after running, then also during exercise, and even at rest. Palpation of the site of inflammation is painful. After a while, the tendon is also noticeably thickened. In the long term, calcifications develop in the tendon.

Treatment consists of not straining the Achilles tendon. To do this, you can use heels about 1 cm thick. They raise the heel slightly, reducing the strain on the tendon. Frequent stretching is also helpful, but you need to make sure you keep your heel on the floor. You must maintain the final position for about ten seconds, without bouncing. Repeated short stretches are better than two or three extended sessions.

Osgood-Schlatter disease and Sever’s disease

These injuries occur in children. They correspond respectively to an inflammation at the level of the attachment of the Achilles tendon to the heel bone and at the level of the attachment of the tendon of the patella to the tibia. There may be pain, redness, and slight swelling.

Treatment consists of relative rest and the use of insoles that absorb shock.

Iliotibial band syndrome

This is a characteristic overuse injury in runners. It is caused by the repeated rubbing of the outer knee band against the bone.

Pain is felt on the outside of the knee while running. The pain disappears at rest, but reappears with each new effort.

Treatment consists of stopping sports activity until the complaints disappear. Massages and stretching can be helpful. Refractory cases can sometimes be treated with 3 injections of cortisone, given 2 weeks apart. Surgery is only very exceptionally necessary.

Sports hernia

This injury consists of a tear of tendon fibers in the groin.

At first, pain occurs in the groin with rapid movements, stretching, and straining of the stomach muscles. The pain can radiate to the lower abdomen, pubic area, thigh, lower back, sacrum, and buttocks. Locally, there are painful pressure points.

The treatment consists of rest and rehabilitation at the physiotherapist. Chronic cases are operated.

Tennis player’s elbow (tennis-elbow) and golf player’s elbow (golf-elbow)

These inflammations occur at the attachment of the tendons on the elbow. They are mainly observed in racket and throwing sports.

The cause is usually overexertion, but poor technique and unsuitable equipment, such as an overly thick racket shaft, can also be to blame.

In the acute phase, it is recommended to apply ice packs on the elbow several times a day and to temporarily stop practicing sports. After a 2-week rest period, stretching exercises and medical gymnastics are started at the physiotherapist. An elbow splint can relieve the affected tendon. Cortisone injections are effective in the short term, but they increase the risk of relapse. If there is no improvement after 6 months, an operation may be considered.

Source

Foreign clinical practice guide ‘Sports injuries and their prevention’ (2012), updated on 31.10.2016 and adapted to the Belgian context on 02.06.2017 – ebpracticenet