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What is a Sports Injury?

A ‘sports injury’ can be defined as an injury that occurs during sporting activities or exercise. This can be broadened to include injuries affecting participation in sports and exercise and affecting athletes of all ages and all levels of performance. Patients who seek medical attention at sports injury clinics represent the spectrum from top professional to recreational athletes. Even though we can identify the mechanism of an injury and its pathoanatomical correlate or diagnosis, its consequences may be very different for different athletes. If you are a professional player, there may be loss of earnings and the risk of losing your contract and even your career. If you are a club manager, it may mean losing an important player, perhaps at a crucial time, and the financial costs of a replacement player. If you are the team doctor, physiotherapist, fitness trainer or coach, you will want to know how the injury will affect your plans for the players’ ongoing dietary and physical training programmes. If you are the medic in charge, it will mean having to convince not only the player but also the club’s other staff that you have the situation under control. The stakes are high. If a player goes back too early, they risk relapse or further injury but if they are held back, they
might ask for a second opinion.

For younger athletes trying to establish themselves in their sport, an injury can result in major family-related conflicts. Over-ambitious or over-protective parents and pressure from coaches and team-mates can put stresses on to a young athlete not able to participate in their sport. For recreational athletes, injuries may mean loss of regular physical and social activities and problems with general health, such as blood pressure, insulin control or secondary problems to the lower back from limping. A shoulder injury from squash may cause difficulties for a builder or plumber with their own business or raise concerns about the safety of a police officer or firefighter. Completely irrational charity bets – ‘I must run the Standard Charthered Marathon or the Adidas Sundown Marathon or the Osim Triathlon in a few months even though I have never run more than three miles because my honour is at stake’ – are another issue.

The importance of sport and exercise and the consequences of an injury must be emphasised by whoever provides treatment and advice. They must appreciate and understand but provide evidence-based advice. To tell a keen recreational tennis or golf player that they have to stop playing because of an injury must be thoroughly considered advice. There are very often a number of options for consideration during recovery from even a very serious injury. Complete rest is seldom motivating and may be ill-advised because of the detrimental effect rest has on tensile tissue strength and general fitness, and such rest’s potentially fatal consequences for some patients. An 80-year-old keen, regular golfer, suffering from a painful knee due to a meniscus tear, could die from the in activity caused by the injury. With arthroscopy, that knee could be operated on and fixed within fifteen minutes, allowing him to play golf a week or two later; it would be a shame and very wrong to tell him to stop playing golf.

For doctors, the keys to success are: consulting evidence-based criteria for the definition and diagnosis of an injury; using reliable examination techniques; considering the background and fitness level of the patient; and being prepared to admit to a lack of knowledge and to refer the patient to someone who may know more. They must recognise the changes and developments that are occurring in sports medicine and the cultural differences that exist in the management of these injuries. Doctors should not take the view that sports injuries are self- inflicted and tell their patients to ‘stop doing these silly things’. In societies threatened by obesity, osteoporosis and a general decline in fitness due to inactivity, exercise and sport are potent means of keeping the population fit and healthy.

Most sports injuries are specific to the sport and the level of participation: for example, 70 per cent of keen runners will be affected by a lower limb injury during their career, usually through over-use; soccer players have a high risk of traumatic ankle or knee injuries from tackles. The incidence of injury in soccer is between 15 and 20 injuries per thousand activity hours, with the highest risk during games. The figures are somewhat higher for rugby: between 20 and 40 injuries per thousand activity hours and with higher risks of upper limb injuries, in particular those of the shoulder joint. Golf is a low-risk sport but a knee or shoulder injury can affect performance and the ability to walk a five kilometre course. Within any particular sport, different positions and roles carry different risks. For example, in cricket a fast bowler may struggle to perform with a minor knee injury to his stance leg or a fielder may be hampered by a minor shoulder injury, while a batsman can perform well with both these injuries. We must all, athletes, administrators and medical personnel alike, educate ourselves about the principles of exercise on prescription and different training methods and improve our understanding of the demands and impact inflicted by different sports. Thus, injured athletes can have an individualised recovery programme, based on current concepts and based on evidence.

If you have a Sports related injury, especially one with persisting pain, it will be be advisable to come down to our clinic for a consultation with us so as to properly access your condition, so as to proceed with the appropriate treatment. You can call us at +65 6664 8135 (24 hrs) to make an appointment or for further queries. Thank you

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