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Sunday morning hikes leave you sore and limping into work on Monday morning? You are not alone. Sports injuries have become a leading cause of doctor visits especially among weekend warriors. We spoke to sports physician Dr. David Owens about preventing and treating common sports injuries.
All sports injuries can be divided into two different types: acute injuries, which are single traumatic events (a broken bone or dislocated shoulder for example); and repetitive overload injuries, which are caused by the repetition of a particular activity or action such as running or swimming. Examples include runner’s knee, swimmer’s shoulder or tennis elbow. Overload injuries are much more common.
There is very good evidence that the majority of sports injuries are preventable. Some of the more significant acute injuries occur without external contact. Rupturing your anterior cruciate ligament (ACL) is a significant injury which often requires surgery and benches you for months on end. This injury is more common in female athletes and 80% occur without external contact. It is estimated that up to 80% of these injuries could be prevented through exercise programs and training that improves strength, flexibility, balance and coordination.
There is also evidence that training and proper use of protective equipment can significantly reduce contact injuries. In theory it should be possible to eliminate overuse injuries. In practice of course, some injuries in contact sports are inevitable, but appropriate training should help prevent the majority of possible injuries.
The single greatest risk for injury is previous injury, so I cannot stress enough the importance of rehabilitation and graduated training before returning to competition after an injury. In contact sports, the greatest risk is miss-match which may be in size and/or ability. Some population groups are at increased risk of specific injuries: children and teens whose growth spurts change their centre of gravity, and whose changes in bone and ligament strength increase their vulnerability to injury and concussion; and female athletes have an increased risk of knee injury due to biomechanical factors in the female hip-to-knee ratio.
The majority of simple soft tissue injuries can be managed at home using the RICE method: Rest, Ice, Compress and Elevate for the first 48 hours after getting injured. When pain and/or swelling is settling it is good to begin to start activity. I try to keep people active as much as possible. Of course, with significant injury, it may be necessary to immobilize part of the body, but some activity enhances healing as well as keeps the mind healthy and positive. Exercises that enhance balance, core stability and flexibility are very important in both rehabilitation and injury prevention.
In general, it is good to seek medical attention for serious acute injuries. Significant pain, bleeding, deformity of limb, reduced range of motion or significant swelling of a joint may all indicate significant injury. Pain which reoccurs after intense, repeated activity or after a certain time, like by kilometer 7 of your run, or the later sets of tennis, may indicate overload injury. These injuries are much harder to deal with when they become chronic so it is worth getting them assessed early to identify and correct any risk factors in individual biomechanics, technique or training. It is generally a bad idea to take painkillers in order to exercise unless the underlying condition is clearly understood.
Hong Kong is fortunate to have an excellent public health system. This is especially the case in emergency care. In case of immediate severe and life threatening injury, call 999 and an ambulance will take you to the emergency department of the nearest public hospital. If you have private insurance, then private hospitals offer increased flexibility and choice of location and doctor.
Chronic sports injuries do not tend to have high priority in the public system and waiting times are long. If you are a keen sportsperson practicing higher risk contact sports, it is worth considering medical insurance to cover you in case of injury.
Acute injuries are generally treated by restoring the natural anatomy and resting and/or bracing the injured part. This may involve a brace, plaster, sling or even surgery. Overload injuries are managed with relative rest followed by active rehabilitation. The concept of relative rest rather than absolute rest is especially important in sports medicine. Athletes should rehabilitate actively; the idea of sitting around completely immobilised for six weeks until the bone heals is outdated. It is important to identify and manage any risk factors for future injury during rehabilitation.
There are a number of physical modalities used in rehabilitation. This may include physiotherapy, sports massage, osteopathy, acupuncture and chiropractic treatments. Sometimes the techniques used in these different disciplines overlap. I am also a huge fan of the role of the strength and conditioning coach. As a sports physician, my primary interest is in injury prevention. Using the rehabilitation period to correct underlying biomechanical imbalances and improve flexibility and core stability has the potential to not only reduce injury but also to increase performance.
Founding partner of OT&P, Dr. David Owens is a specialist in family medicine with a particular interest and experience in sports medicine. He is the Chief Medical Officer of the Hong Kong Rugby Football Union and Asia Rugby Union. Dr. Owens was a member of the World Rugby working group that developed pitch-side trauma training programs for rugby worldwide. He has provided medical cover to numerous international sporting events including the Hong Kong 7's, Bledisloe cup, British and Irish Lions and Asian games.
This article was independently written by Healthy Matters. It is informative only and not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be relied upon for specific medical advice.
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