Sports Injuries

Sports injuries result from acute trauma or repetitive stress associated with athletic activities. Sports injuries can affect bones or soft tissue (ligaments, muscles, tendons).

Description

Adults are less likely to suffer sports injuries than do children, whose vulnerability is heightened by:

• immature reflexes
• inability to recognize and evaluate risks
• underdeveloped coordination

Each year, about 3.2 million children between the ages of five and 14 are injured while participating in athletic activities, and account for 40% of all sports injuries. As many as 20% of children who play sports get hurt, and about 25% of their injuries are classified as serious. More than 775,000 boys and girls under age 14 are treated in hospital emergency rooms for sports-related injuries.

Injury rates are highest for athletes who participate in contact sports, but the most serious injuries are associated with individual activities. Between one-half and two-thirds of childhood sports injuries occur during practice, or in the course of unorganized athletic activity.

Chauncy Billups, a guard for the Denver Nuggets, grimaces after spraining his ankle during a game. (AP/Wide World Photos. Reproduced by permission.)

Types of 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. A sprain is a partial or complete tear of a ligament, a strong band of tissue that connects bones to one another and stabilizes joints.

A strain is a partial or complete tear of:

• muscle (tissue composed of cells that enable the body to move)
• tendon (strong connective tissue that links muscles to bones)

Inflammation of a tendon (tendinitis) and inflammation of one of the fluid-filled sacs that allow tendons to move easily over bones (bursitis) usually result from minor stresses that repeatedly aggravate the same part of the body. These conditions often occur at the same time.

SKELETAL INJURIES. Fractures account for 5–6% of all sports injuries. The bones of the arms and legs are most apt to be broken. Sports activities rarely involve fractures of the spine or skull. The bones of the legs and feet are most susceptible to stress fractures, which occur when muscle strains or contractions make bones bend. Stress fractures are especially common in ballet dancers, long-distance runners, and in people whose bones are thin.

Shin splints are characterized by soreness and slight swelling of the front, inside, and back of the lower leg, and by sharp pain that develops while exercising and gradually intensifies. Shin splints are caused by overuse or by stress fractures that result from the repeated foot pounding associated with activities like aerobics, long-distance running, basketball, and volleyball.

A compartment syndrome is a potentially debilitating condition in which the muscles of the lower leg grow too large to be contained within membranes that enclose them. This condition is characterized by numbness and tingling. Untreated compartment syndrome can result in long-term loss of function.

BRAIN INJURIES. Brain injury is the primary cause of fatal sports-related injuries. Concussion can result from even minor blows to the head. A concussion can cause loss of consciousness and may affect:

• balance
• comprehension
• coordination
• hearing
• memory
• vision

Causes and symptoms

Common causes of sports injuries include:

• athletic equipment that malfunctions or is used incorrectly
• falls
• forceful high-speed collisions between players
• wear and tear on areas of the body that are continually subjected to stress

Symptoms include:

• instability or obvious dislocation of a joint
• pain
• swelling
• weakness

Diagnosis

Symptoms that persist, intensify, or reduce the athlete's ability to play without pain should be evaluated by an orthopedic surgeon. Prompt diagnosis can often prevent minor injuries from becoming major problems, or causing long-term or lasting damage.

An orthopedic surgeon should examine anyone:

• who is prevented from playing by severe pain associated with acute injury,
• whose ability to play has declined due to chronic or long-term consequences of an injury,
• whose injury has caused visible deformities in an arm or leg.

The physician will perform a physical examination, ask how the injury occurred, and what symptoms the patient has experienced. X rays and other imaging studies of bones and soft tissues may be ordered.

Anyone who has suffered a blow to the head should be examined immediately, and at five-minute intervals until normal comprehension has returned. The initial examination measures the athlete's:

• awareness
• concentration
• short-term memory

Subsequent evaluations of concussion assess:

• dizziness
• headache
• nausea
• visual disturbances

Treatment

Treatment for minor soft tissue injuries generally consists of:

• compressing the injured area with an elastic bandage
• elevation
• ice
• rest

Anti-inflammatories, taken by mouth or injected into the swelling, may be used to treat bursitis. Anti-inflammatory medications and exercises to correct muscle imbalances are usually used to treat tendinitis. If the athlete keeps stressing inflamed tendons, they may rupture, and casting or surgery is sometimes necessary to correct this condition.

Orthopedic surgery may be required to repair serious sprains and strains.

Controlling inflammation as well as restoring normal use and mobility are the goals of treatment for overuse injuries.

Athletes who have been injured are usually advised to limit their activities until their injuries are healed. The physician may suggest special exercises or behavior modifications for athletes who have had several injuries. Athletes who have been severely injured may be advised to stop playing altogether.

Prevention

Every child who plans to participate in organized athletic activity should have a pre-season sports physical.

This special examination is performed by a pediatrician or family physician who:

• carefully evaluates the site of any previous injury
• may recommend special stretching and strengthening exercises to help growing athletes create and preserve proper muscle and joint interaction
• pays special attention to the cardiovascular and skeletal systems

Telling the physician which sport the athlete plays will help that physician to determine which parts of the body will be subjected to the most stress. The physician will then be able to suggest to the athlete steps to take to minimize the chance of getting hurt.

Other injury-reducing game plans include:

• being in shape
• knowing and obeying the rules that regulate the activity
• not playing when tired, ill, or in pain
• not using steroids, which can improve athletic performance but cause life-threatening problems
• taking good care of athletic equipment and using it properly
• wearing appropriate protective equipment