Sports injuries can be fatal

Early treatment can hasten healing process :

by Carol Aloysius

School children worldwide have become increasingly vulnerable to sports-related injuries. Some are serious enough to send them to the Intensive Care Unit (ICU) in a hospital. A study in the US in 2013 found that 1.3 million children were rushed to emergency wards after sustaining an injury at school during a sporting event.

In Sri Lanka just recently, a promising young cricketer Kaushal Silva at a practice match was knocked unconscious from a leather ball and had to be rushed to the ICU. In Australia, cricketer Phil Hughes died when he was hit by a ball while batting.

Apart from these injuries, of course there is the occasional bump or bruise on the knee, a twisted ankle or fractured hand that is expected in every school child while playing, which are often neglected till it is too late.

“It could lead to permanent disability which precludes future sports activities for the child”, says a leading physiotherapist.

With the upcoming sports meets and the new year festivities still continuing with sporting events and marathon races, he says, “If your child is injured during a sporting event, get him examined immediately by a qualified doctor and if he requires further help, our therapists can help minimise complications”.

Here Chartered Physiotherapist, Dr Gopi Kitnasamy, Chairman Cerebral Palsy Foundation, fields some important questions on sports-related injuries among school children.

Excerpts…

Q. With the upcoming sports meets and Avurudu sporting events still continuing, what are the most common types of injuries that school children and adolescents likely to suffer from?

A. 40% of all youth (children, teenager and adolescent) injuries are sports-related. Types of school injuries in young athletes fall into two basic categories: overuse injuries and acute injuries. Both types include injuries to the soft tissues (muscles and ligaments) and bones.

Q. How do these injuries occur?

A. Acute Injuries are caused by a sudden trauma. Examples of trauma include collisions with obstacles on the field or between players. Common acute injuries among young athletes include contusions (bruises), sprains (a partial or complete tear of ligaments), strains (a partial or complete tear of a muscle or tendon), and fractures.

Overuse injuries occur gradually over time, when an athletic activity is repeated so often, parts of the body do not have enough time to heal between playing. It can affect muscles, ligaments, tendons, bones, and growth plates. For example, swimming is often associated with injuries to the shoulder. There are also more serious injuries like Catastrophic Sports Injuries. Many sports, especially contact sports, have inherent dangers that put young athletes at special risk for severe injuries. Even with rigorous training and proper safety equipment, children are at risk for severe injuries to the head and neck with damage to the brain or spinal cord..

Q. Are there specific injuries related to growth?

A. They are called Growth Plate Injuries. Growth plates are areas of developing cartilage tissue near the ends of long bones. When a child becomes full-grown, the growth plates harden into solid bone. Because growth plates are the last portion of bones to harden (ossify), they are vulnerable to fracture. They regulate and help determine the length and shape of adult bone, therefore, injuries to the growth plate can result in disturbances to bone growth and bone deformity.

Q. How do you treat them?

A. Any injury that involves obvious swelling, deformity, and/or loss of normal function (i.e. movement or strength) should be seen by a physician immediately. All other injuries that appear to be minor should resolve themselves within a few days. However, if it does not heal on its own, and your child is not back to full participation without pain, it is best to have him/her evaluated by a physician. Nagging injuries that go untreated can turn into chronic problems that require a much longer time away from the sport to allow the injury to heal properly.

Q. What is the best way of treating these sports injuries?

A. If your child does get injured while playing sports, the best treatment plan is R.I.C.E: That means:

Rest

Do not use the injured area until examination for further evaluation by a physician
If walking with a limp, have the athlete use crutches
Ice Apply ice to the injured area to help decrease pain and swelling

Use ice 10 - 15 minutes at a time

Crushed/cubed ice works best, avoid using chemical cold packs
Always ice for the first 48 - 72 hours after injury
Never sleep with ice on the injured area

Compression

Elastic wrap/compression sock should be used to reduce swelling
Apply wrap beginning below the injured area and wrapping upward
Always leave toes/fingers exposed
Watch for numbness, discoloration or temperature changes (loosen wrap if needed)
Do not sleep with wrap on the injured area

Elevation

Use gravity to control swelling
Prop injured area higher than the heart

Q. How can parents reduce risks of children being injured while doing sports?

A. Wear the right gear. Appropriate protective equipment may include pads, helmets, mouthpieces, face guards, protective cups, and eyewear.

Increase flexibility. Stretching exercises before and after games can help increase flexibility of muscles and tendons used in play.

Strengthen muscles. Conditioning exercises during practice and before games can help strengthen muscles used in play.

Use the proper technique throughout the season of play.

Take breaks. Rest periods are important during practice and games to reduce the risk of overuse injuries. During the year, a 2-month break from a specific sport is recommended to prevent overuse injuries.

Play safe. There should be strict rules against headfirst sliding (in baseball and softball), spearing (in football), and body checking (in ice hockey) to prevent serious head and spine injuries.

Stop the workout if there is pain.

Prevent heat injury or illness. Rules for safe exercise in the heat include the following:

Drink plenty of proper fluids before, during, and after exercise or play.

Allow athletes to gradually adjust to exercising in hot, humid weather by increasing activities slowly over the first 2 weeks of practice.

Decrease or stop practices or competitions during periods when the combination of excessive heat and humidity approaches dangerous levels.

Wear lightweight clothing.

Stop playing if lightning is detected within a 6-mile radius

Play on safe fields. Inspect fields before practices and games. Clear all debris and repair holes and uneven surfaces.

It’s also important to make sure your child has a complete physical exam by your paediatrician before participating in any sport to make sure they are in good health and can safely play the game.

Q. How does physiotherapy play a key role in correcting injuries?

A. Physiotherapy plays an integral part in the management of sports injuries. The aim of physiotherapy is to treat and fully rehabilitate the athlete post-injury, post-operatively, to prevent further injury and to return the athlete to sport in the shortest possible time.

Prompt assessment and diagnosis is vital in the successful treatment and rehabilitation of sports injuries. Injuries can only be successfully treated when the cause of the problem is fully assessed and corrected; therefore, a detailed assessment is mandatory and a complete posture, gait, and biomechanical assessment must be made. Careful history taking is of the utmost importance to ascertain the location, nature, behaviour and onset of symptoms, etc. This is followed by a physical examination where a methodological approach is adopted. It is not acceptable to treat symptoms without first establishing the underlying cause. Sports injuries commonly treated by physiotherapists, include muscle strains, ligament sprains, dislocations and fracture. The type of physiotherapy treatments will vary according to the injury and specific sports.

Q. How effective are they in the long term?

A. Prompt assessment and diagnosis is vital in the successful treatment and rehabilitation of sports injuries. Injuries can only be successfully treated when the cause of the problem is fully assessed and corrected; therefore, a detailed assessment is mandatory and a complete posture, gait, and biomechanical assessment must be made. Careful history taking is of the utmost importance to ascertain the location, nature, behaviour and onset of symptoms, etc. This is followed by a physical examination where a methodological approach is adopted. It is not acceptable to treat symptoms without first establishing the underlying cause. Goals of treatment and rehabilitation

1. Protect the injured tissues to allow healing and to control the early inflammatory phase.

2. Rehabilitate and improve flexibility, strength, proprioception (joint sensation), and muscle imbalance, and control physical activities with the aid of taping and splinting.

3. Sport-specific activities must be tested to ensure the child can return to sport safely.If proper rehabilitation is not undertaken, the athlete may be competing too soon, with residual instability, proprioceptive disturbance and muscle weakness and imbalances. Individual programs must be planned and implemented for each athlete. This would include sport-specific and tailored exercise program, adaptation to new postures to correct muscle imbalance, taping and strapping and a home exercise program.

Q. Your golden rules for parents

A. SPORTS SAFETY TIPS

Participation in sports offers tremendous social, emotional and physical benefits for children. One of the worst things for kids is being on the sidelines with an injury. As parents and coaches, there are simple things we can do to help reduce preventable injuries so that the kids can continue playing the games they love.

Prepare kids for the demands of playing a Sport

Before playing organised sports, make sure your child receives a proper physical and medical exam by his/her doctor.

In case of an emergency, provide your child’s coaches with important information (phone numbers, doctor information and allergy information).

Meet with the coaches before the first practice to inform them of history with asthma or other medical conditions that require special attention.

Warm up and stretch before games and practices

Sports specific stretching before practice and games can release muscle tension and help prevent sports-related injuries.

Remember to Hydrate

Be aware of the signs and symptoms of dehydration and other forms of heat illness.

Encourage them to stay well-hydrated by drinking plenty of water before, during and after play.

Wear appropriate sports gear

Use appropriate and properly-fitted sports gear to prevent or reduce the severity of injuries.

Make sure the kids use the correct equipment in order to participate in both practices and games. This may include helmets, shin guards, mouth guards, ankle braces, shoes with rubber cleats and sunscreen.

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