Sports Injuries

Dr Christopher Tong

Sports Medicine Specialists8/F AON China Building29 Queens Road Central

Hong Kong

Today’s talk

• Overview of sports medicine

• Review of anatomy

• General principles of sports injuries management including clinical examination

• lower limb injuries

Anatomy and Function

Symptoms of Meniscal tear

• Symptoms– Pain– Locking– Knee swelling

• Signs– Knee effusion– Joint line tenderness– Apley grinding test– McMurray test

Finished Product

Acute Knee Injury

Clinical Problem

Clinical Examination (Anatomical

Knowledge Needed)

Diagnosis

Common Structures Damaged

• Cruciate ligaments

• Collateral ligaments

• Menisci

• Nerve (common peroneal)

Knee Arthroscopy

Normal ACL Ruptured ACL

Knee Arthroscopy

Management of acute knee injuries

• Rest

• Ice

• Compression

• Elevation

• Complete examination to diagnose structures damaged

• MRI or arthroscopy

Cartilage Injuries

The Challenge

Drilling

Replacement

• Osteochondral graft– autograft, mosaicplasty, OATS– allograft

Ankle Sprains

Acute Managemen

t

Acute Managemen

t

Common Peroneal Nerve Function

• Sensory

• Motor– Anterior compartment (deep peroneal

nerve)– Lateral compartment (superficial peroneal

nerve)

My Work

• PWH Orthopaedics Sports Team– Knee and shoulder surgery 80%– Foot and Ankle surgery 20%

• Hong Kong Sports Institute– Honorary Sports Medicine Consultant– Care of HK elite athletes

Scope of Sports Medicine

• Sports injuries and management• Sports psychology• Sports nutrition• Physical conditioning and training• Doping• Medical aspects of sports medicine• Rehabilitation• Sports physiology

Multidisciplinary Team

• Sports physician

• Orthopaedic surgeon

• Sports psychologist

• Sports nutritionist

• Coaches

• Physiotherapists

• Sports physiologist

Sports physician

• Overall care of athlete

• Medical aspects

• Non-operative aspects of sports injuries

• Team doctor and travel medicine

• Liaison role with other specialists

Sports psychology

• Enhance performance– 100 m sprinter vs. Olympic archer

• Injury prevention and rehabilitation

• Tools:– Relaxation techniques– Goal setting– Visualization

Sports nutritionist

• Macronutrients– CHO, lipids, protein

• Micronutrients– Vitamins, minerals, antioxidants

• Fluid balance

• Supplements– Creatine, bicarbonates, caffeine

Doping

• Blood doping

• Anabolic steroids

• Erythropoietin

• Growth hormone

• Stimulants– e.g. amphetamines

• Diuretics

Coaching

• Fitness– Strength training– Speed– Endurance– Flexibility

• Injury prevention

Principles of training

• Progressive overload

• Specificity

• Periodization

• Tapering

Progressive overload

• Overuse injuries are often the result of training which is ‘too much, too soon’.

• Training load:– Frequency– Duration– Intensity

Sports physiology

• Energy systems– Anaerobic

• ATP + phosphocreatine system• Glycolytic system

– Aerobic• Carbohydrate oxidation• Fat oxidation

• Muscle physiology– Training implications

Sports Medicine

Multidisciplinary business