Sports related injuries are of two types. Macrotrauma occurs as an acute,
perhaps dramatic event, like a concussion or spinal cord injury, or a
fracture or dislocation. Microtrauma occurs as a repeated injury, usually
not noticed initially because the injury is microscopic in magnitude,
but where the cumulative trauma leads to pain and in some cases, significant
disability. Stress fractures and the
so-called overuse syndromes are examples of microtrauma.
Any injury can be caused by any sport, but there are injuries that are
recognized to be peculiar for a specific sport in a specific age group.
The following are some injuries peculiar to certain sports, with suggestions
for prevention and treatment.
Elbow injuries occur frequently in pitchers. The valgus stress placed
on the elbow during pitching causes distraction of the medial side
of the elbow and compression of the lateral side. In the child, this
leads to inflammation of the medial epicondyle with microtears of
the flexor tendons (Little League elbow).
In the adolescent, with increasing strength, there may be avulsion
fractures through the epiphysis or growth plate. On the lateral side,
osteochondritis dissecans can occur, where
a fragment of bone from the capitellum loses its blood supply, loosens,
and becomes a loose body in the joint. Surgery is often needed to
correct the problem. The best way to prevent this is to learn proper
pitching technique, as well as limiting the number of pitches allowed
in Little League baseball. Studies suggest that a young pitcher should
not exceed 350 throws a week.
Pitcher’s shoulder (or Little League shoulder)
is from repeated stress on the head of the humerus in young pitchers,
causing a stress fracture of the
proximal humeral epiphysis. When diagnosed, rest is essential for
healing and to prevent further damage. Another form of Little league
shoulder is due to impingement syndrome,
from overuse of the rotator cuff tendons leading to stretching and
proximal migration of the humeral head and impingement against the
acromion and coracoacromial ligament.
Shoulder Separation (or AC separation)
can occur with falls, especially head-first slides. Impact on the
shoulder causes injury to the acromio-clavicular joint, sometimes
with disruption to the ligaments of the joint, hence the term separation.
Foot and ankle injuries can happen with sliding injuries, when the
foot or ankle gets caught while trying to slide into base. This causes
a twisting injury, resulting in an ankle
sprain or fracture of the foot.
Hand injuries are common. Mallet finger
occurs when the tip of the finger is truck by the ball. Gamekeeper's
thumb occurs when the thumb is forced outwards by the ball or
a fall. Finger fractures and dislocations are common. The key to prevention
is learning proper catching technique that uses the whole hand, rather
than the fingers.
Jumper's knee (or patellar tendonitis)
is common with frequent jumping, as is ankle
sprain when landing wrong. The best prevention for these injuries
is proper conditioning and warmups before sports.
Head injury is the main cause of disabling injuries in bicyclists,
and is often fatal. Helmets are therefore strongly recommended for
Prolonged sitting on the saddle can cause pressure on the nerves
and plood supply ot he penis. This may sometimes cause priapism (persistent
erection) or impotence, usually temporary.
Carpal Tunnel Syndrome occurs due to constant
pressure of the palm of the hands on the handlebars.
Quadriceps or patellar tendonitis, and anterior knee pain (chondromalacia
patellae) are quite common in cyclists, who put a lot of strain
on their knees.
Head injury is after all, the intent and object of this sport, and
it is therefore not surprising that boxing carries a high risk of
head and brain injury.
Boxers who are near sighted are prone to detached retina when the
eye is hit. Consult a physician before deciding if it is worth the
risk to take up boxing.
Snapping hip occurs in the young dancer.
The hip "snaps" due to the iliotibial band rubbing against
the greater trochanter, or less commonly, due to the iliopsoas tendon
rubbing against the neck of the femur. In both cases, rest is important
as well as physical therapy to stretch and strengthen the trunk muscles,
the iliopsoas and external rotators of the hip.
Stress fractures of the metatarsals
of the foot is not infrequent, especially during periods of hard training.
Ankle sprain occurs when the dancer
lands on the outside of her foot.
Spinal cord injury occurs, usually due to diving in shallow water
or hitting an object. Prevention includes public education and posting
warnings in public places.
High velocity dives may cause wrist or shoulder injuries from impact
when the body hits the water.
Springboard exercises may cause knee problems like Osgood-Schlatter
disease, or Jumper's knee.
Head and neck injuries include intracranial hemorrhage, cervical
spine fractures and dislocations and quadriplegia. These injuries
are now less common due to improve helmet design and the 1976 ban
on spearing - using the helmet to deliberately ram an oppponent.
Lumbar spondylolysis and spondylolisthesis
occurs due to pars interarticularis injury occurs. This is often a
form of stress fracture.
Shoulder separation is common with falls
on the shoulder.
Finger fractures and dislocations are common.
Back pain is common with golf. The best way to prevent this is to
learn proper swing atechnique and to have proper conditioning and
warmup before a game.
Golf elbow and tennis
elbow occur frequently in golfers who have not developed a smooth
and balanced swing, grip the club too hard, or hit the ground frequently.
Spondylolysis occurs frequently in female
gymnasts, due to the hyperextended position required in gymnastic
routines, e.g. back walk-overs. It may represent a form of stress
fracture. Prevention includes abdominal and spinal muscle strengthening.
Elbow injury from excessive weight-bearing with the elbow in an exaggerated
valgus position (since this sport is often performed by young females)
can lead to problems similar to Little League elbow.
Wrist pain is frequent in young gymnasts, due to constant stress
on the lower radial epiphysis or growth plate at the wrist. If ignored,
it can cause premature closure of the growth plate, leading to a Madelung
Knee pain is very frequent in young gymnasts, especially Osgood-Schlatter
disease, Patellar tendonitis, and Patello-femoral syndrome.
Head and neck injuries occur with collision against the board or
another player. Severe injuries can be caused by a direct blow with
the stick (spearing), which is illegal. Prevention includes use of
protective equipment and strict enforcement of rules.
- Horseback Riding
The most serious injuries occur with falls involcing the head or
neck. Riding helmets are important.
Falls on the shoulder can cause shoulder
separation, or injuries to the knee including fractures.
- Ice Skating
Stress fracture of distal fibula occurs with eversion stress to the
ankle, exaggerated by the blade of the skate raising the foot off
Fractures of the lower radius and scaphoid are common with falls.
Ill-fitting boots can cause
Skater's heel or pump-bump, due
to irritation of the back of the heel. There is normally a bursa that
protects the heelbone, which gets inflamed and tender. A "bump" occurs
that can be quite painful. Treament consists of ice, rest, anti-inflammatory
medication, and making adjustments to your boots. Rarely is surgery
Stress fracture of tibia and metatarsal occurs especially at the
beginning of track season, when too much demand was placed on the
body too soon. According to the principle of bone conditioning, muscle
strength builds up much faster than bone strength. During the third
week, when muscle strength has developed much more than bone strength,
it would be wise to limit training in the third and fourth week to
allow bone strength to catch up, to prevent stress fracture. Another
factor concerns the use of proper running shoes and choice of running
Shin splints and anterior leg pain are
common with runners.
Planter fascitis occurs frequently in runners. Proper shoe wear and
running surfaces are important considerations in preventing this problem.
Head injury may occur with collision. But repeated heading of the
ball has been known to cause chronic encelopathy (brain damage). It
is recommended that children before high school age should be discouraged
Overstretching sideways can cause hip abductor strain, and overstretching
forwards with the leg to kick the ball can cause a hamstring strain.
Shin injuries from idrect kicks can cause a fracture of the tibia.
Shin guards are important to prevent this injury.
Knee sprains and ankle sprains are very
common soccer injuries.
Swimmer’s shoulder occurs when there
is chronic overload (microtrauma) of the rotator cuff tendons, leading
the weakness and proximal migration of the head of the humerus. This
causes impingement syndrome and
pain with the upstroke due to the rotator cuff being impinged by the
acromion and coraco-acromial ligament. Treatment consists of rest,
ice and antiinflammatory medications. Prevention includes learning
proper technique, or learning an alternative swimming style.
Breast-stroker's knee is due to the whipkick
that puts excessive strain on the medial collateral ligament of the
knee. By reducing the width of the kick, this problem can be avoided.
Back pain can occur with the butterfly stroke, and is due to strain
on the back. Reduction of training and alternating swimming styles
while training may help.
Tennis elbow, or lateral epicondylitis
occurs with repeated stress on the lateral aspect of the elbow with
backhand shots. Causes include an oversized racket, overtight grip,
and not hitting the ball squarely with the racket. Two-hand backhand
shots may be preferable for young players to unload some of the stress
on the dominant hand.
Elbow injuries not unlike those of a pitcher's elbow are often seen.
Head and spinal cord injury occurs, even in experienced gymnasts.
It is discouraged as a form of sports or exercise.
Low back pain occurs with improper lifting techniques, and chronic
Osteolysis of the distal clavicle
has been reported in weightlifters, where the bone in the distal part
of the clavicle gets absorbed, due to an inflammatory response from
overuse. There is usually a dull pain over the AC joint, and over
time, X-rays will show the distal clavicle being absorbed. Activity
modification is recommended, avoiding bench presses, dips, flies,
pushups and any lifts that cause pain. It is thought that bench-pressing
with the hands held closer together causes less stress to the acromio-clavicular
joint, thus preventing this from happening, or allowing the athlete
to continue exercising. Rest and nonsteroidal antiinflammatory medications
usually reverse the problem, although in the more intractable case,
resection of the distal clavicle may be necessary.
Biceps strain and shoulder separations
can occur with bench presses.
Spinal cord injury usually occurs when the participant is thrown
and lands on his head. When the head is forcibly flexed to one side,
the brachial plexus may be stretched, causing tingling and numbness
to the arm and hand.