SPORTS INJURIESof The Lower Extremities

By: Jasneel ChaddhaStanford CSSSI 2013

AGENDA Classification of Sports Injuries Types of lower body injuries History of lower body injuries Causes of lower body injuries Signs and Symptoms of lower body injuries Treatment and Prevention of lower body injuries

WHAT ARE SPORTS INJURIES? Sports injuries result from acute trauma or

repetitive stress associated with athletic activities.

Sports injuries can affect bones or soft tissue, such as ligaments, muscles, and tendons.

CLASSIFICATION OF SPORTS INJURIES

Direct and Indirect 1. Direct injuries are sustained from an external force causing injury at the

point of contact.2. Indirect injuries usually involve the athlete damaging the soft tissues such

as the ligaments, tendons or muscles of the body through internal or external forces.

Soft and Hard Tissue 1. Soft tissue injuries are any injuries to the skin, muscles, tendons and

ligaments.2. Hard tissue injuries occur in bones and cartilages.

Overuse 1. Overuse injuries are sustained from continuous or repetitive stress, incorrect

technique or equipment, or too much training.

GENERAL FACTS ABOUT SPORTS INJURIES

About 95% of sports injuries are minor soft tissue traumas.

The most common sports injury is a bruise (contusion). It is caused when blood collects at the site of an injury and discolors the skin.

Sprains account for one-third of all sports injuries. Fractures account for 5-6% of all sports injuries. The

bones of the arms and legs are most apt to be broken. Stress fractures are especially common in ballet dancers,

long-distance runners, and in people whose bones are thin.

LOWER BODY INJURIES AND TERMS

Sports Injuries can be found in both the upper and lower body. 2 common lower body sports injuries (focus on this presentation):

I. Anterior Cruciate Ligament Tear (ACL) - An anterior cruciate ligament injury is the over-stretching or tearing of the ACL in the knee.

II. Torn Achilles Tendon - Overuse injury causing pain and inflammation over the Achilles tendon at the back of the lower leg.

VISUAL ILLUSTRATION OF LOWER BODY INJURIESACL Tear

Achilles Tendon Tear

HISTORY OF ACL INJURY• Ernest W. Hey Groves (Germany)

In 1917, performed first successful ACL reconstruction using an iliotibial band transplant.

• First reports of ACL related injuries came from military recruits during/after training.

• Willis Campbell (United States) In 1935, performs first ACL reconstruction

with tendon, using the patellar tendon located in the tibia.

• ACL Injuries extremely common today with athletes.

HISTORY OF ACHILLES TENDON• Achilles, the Greek Hero

Achilles Tendon gets its name from this Greek Hero.

Legend says Achilles’ mother dipped Achilles in the River Styx to protect him in battle. She forgot to dip his heel in the water, and he was killed in battle by Paris, who wounded Achilles in the heel.

• Achilles Tendon injuries are common with athletes who actively use their heel, such as basketball, football, and soccer players.

PATHOPHYSIOLOGYACUTE INJURY PROCESS

ACL Tear From abnormal motions of the knee. Subluxation (partial dislocation) episodes occur, creating abnormal shear forces on the meniscus. This will cause meniscus injuries, and ACL tears.

Achilles Tendon Tear Minor complications may occur, such as Achilles infection and/or reduced sensation near the tendon. Scarring and reduced Achilles size will almost always occur. Re-rupturing of the Achilles is a possibility.

CAUSES OF THESE INJURIESAchilles Tendon Tear

Overuse of tendon. Stepping up your level of physical activity too quickly. Not stretching enough before exercise. (especially the Achilles

tendon) Wearing high heels, which increases the stress on the tendon. Problems with the feet. An Achilles tendon injury can possibly result

from flat feet. Muscles or tendons in the leg that are too tight.

CAUSES OF THESE INJURIESACL Tear

Intense Impacts or Collisions

A Rapid Change in Direction

Suddenly Stopping Landing incorrectly from a

Jump

SOCIAL FACTS AND EPIDEMIOLOGY

Young women are two to eight times more likely than young men to injure the ACL..

Among high school athletes in 2005, 2,298 of 4,350 injuries (52.8%) were Lower Extremity sports-related injuries. Of these, 25% were due to knee injuries (ACL tear).

There are over 250,000 Achilles tendon injuries each year in the US.

3-5% of athletes are forced to leave their sports career due to Achilles tendon overuse injuries.

SIGNS AND SYMPTOMS ACL Tear

Feeling or hearing a pop in the knee at the time of injury.

Severe pain on the outside and back of the knee, causing inability to continue activity.

The knee swelling, which progressively worsens.

Achilles Tendon Tear

A sudden, sharp pain that feels like a direct hit to the Achilles tendon. There may be a pop when the rupture occurs. This may be followed by swelling and bruising.

Heel pain. Not being able to go on tiptoe

with the hurt leg. If a partial rupture (tear) occurs,

you may have near-normal strength and less pain after the initial injury.

TREATMENT, MEDICATION AND MANAGEMENT

ACL Tear Depending on level of injury, surgery may be needed to reconstruct the ACL within the knee. If surgery is not needed, then another form of treatment would be physical rehabilitation.

Achilles Tendon Tear In severe cases, a cast is needed for 6-10 weeks and surgery to repair the tendon/remove excess tissue. In minor cases, the tendon should heal on its own. Taking anti-inflammatory pain killers can help alleviate the pain.

ACHILLES TENDON SURGERYhttp://www.youtube.com/watch?v=nYeHu0-Viyg

PREVENTIONACL Tear

Avoid wearing shoes with cleats in contact sports.

Avoid wearing high-heeled shoes.

Avoid sports that involve lots of twisting and contact.

Stretch and strengthen the leg muscles (quadriceps and hamstrings).

Practicing landing with the knees bent after jumps.

Achilles Tendon Tear

Stretch and strengthen calf muscles.

Vary your exercises. Choose running surfaces

carefully. Increase training intensity slowly.

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Clinic . Web. 27 Jul 2013. <http://www.sportsinjuryclinic.net/sport-injuries>.II. "Sports Injuries Directory." Knee and Foot Injuries (2012): n.pag. WebMD. Web.

28 Jul 2013. <http://www.webmd.com/fitness-exercise/sports-injuries-directory>.III. "Sports Medicine ." How are sports injuries classified and managed? n.pag. NSW

HSC Online. Web. 28 Jul 2013. <http://hsc.csu.edu.au/pdhpe/options/medicine/4035/3-1/op3_1_1.htm>.

IV. "An Athlete's Nightmare." Tearing the ACL. 3.3 (2008): 24-26. Web. 28 Jul. 2013. <http://www.nlm.nih.gov/medlineplus/magazine/issues/summer08/articles/summer08pg24-26.html>.

V. "Everything About Achilles Tendon." Achilles Tendon Injury (2012): n.pag. AchillesTendon.com. Web. 28 Jul 2013. <http://achillestendon.com>.

VI. Mayo Clinic Staff, . "Plantar Fasciitis." All about Plantar Fasciitis (2013): n.pag. MayoClinic . Web. 28 Jul 2013. <http://www.mayoclinic.com/health/plantar-fasciitis/DS00508>.