SPORT MEDICINE

Sports medicine application of scientific and medical knowledge to aspects of exercise and sports. Sports medicine aims to optimize health, fitness and performance of the athletes. It also helps in the prevention, treatment and rehabilitation of their injures.

Sports medicine Team

The primary individuals of the Sports Medicine team comprises of

• Team doctors
• Physiotherapists
• Masseurs
• Nutritionists
• Sports Psychologists
• Conditioning Specialists

Scope of Sports Medicine

The scope of Sports Medicine includes:

• Promotion of lifelong fitness and wellness
• Illness and injury prevention
• Diagnosis and treatment of injuries
• Rehabilitation of the injured athlete
• Optimization of performance of the athlete
• Ensuring safety of athletes

INJURY PREVENTION

One of the overriding tragedies of sports and recreation is that many of the injuries sustained by sportsmen and sportswomen are preventable. The responsibility for the prevention of injury should lie primarily with the athlete himself. However coaches and other officials also share this responsibility.

Prevention of injury should be the major goal of all those involved in sports. A practical approach to prevention will decrease the incidence and severity of injuries sustained. Prevention principally is dependent on two issues, i.e. ensuring that the athlete is fit for the sport, and that the sport is fit for the athlete.

Be Fit For Your Sport

Individuals need to possess the appropriate health attributes and abilities that facilitate safe participation in sports. This requires the following to be given due attention:

Per-Participation Health Examination (PPHE)

• Questionnaires
• Medical check up
• Dental check up

Personal Care and Hygiene

• Cleanliness – bathing, clothing
• Nutrition – diet, hydration
• Infection control – food, drink, skin, immunizations

Attire and Personal Protective Equipment (PPE)

• Fit for the athlete
• Fit for the sport
• Appropriate for the environment

Foot Care

• Foot wear – type, size and appropriateness for sport
• Nail care
• Corns, calluses, blisters

Warm Up

• Purpose – increase flexibility, increase muscle temperature to optimize performance and reduce occurrence of muscle cramps.

Cool Down

• Purpose – facilitate muscle recovery, reduce muscle cramps and soreness.

Training programs

• Observe the FITT principle
• Do not over train
• Caution when ill/injured – absolute rest or relative rest.

Make Sure The Sport Is Fit For You

Sports have their own individual performance demands and the failure to address these appropriately predisposes to problems and injuries. It is important that these are assessed and addressed prior to participation.

Health, Fitness and Performance Requirements of the Sports

Health and Fitness and Performance Requirements:

• Strength
• Flexibility
• Endurance – muscular and cardio-respiratory
• Suitability – body weight, age, sex, biomechanical demands.

Performance Requirements

• Power
• Speed
• Agility
• Skill
• Reaction time

Rules and Regulations

• Ensure these are available for safe and fair sports.

Playing Areas and Facilities

• Must facilitate safety and conduct of the sport.

Environmental Conditions

• Comply with safety and health recommendations
• Adaptable for the individual athlete

Travel Requirements

• The athlete must be able to cope with the challenges of meeting the needs of adequate rest/sleep, food and personal medications. Attention needs to be given regarding Doping Regulations.

SOFT TISSUE INJURIES

These are injuries to the tissues of the body other than bones. Examples of soft tissues are skeletal muscle, tendon, ligament, joints and fascia.

Types of Injuries

• Acute injuries  occur from a known incident and have a rapid onset of symptoms and signs.
• Chronic injuries are one that has occurred over a period of time. The symptoms and signs develop slowly and are often not noticed initially.
•  Acute on Chronic Injuries are new injuries occurring on an existing chronic one.
•  Overuse injuries are due to continual repetitive movements of the sports which has caused repeated stress and micro-trauma, leading to inflammation and pain in the area. There is usually a biomechanical reason for this occurrence.

Mechanisms of Sports Trauma

Intrinsic mechanisms refers to how factors pertaining to the individual athlete lead to trauma. Similarly, extrinsic mechanisms refer to mechanisms involving external factors.

Causes of injury

Intrinsic Causes eg.

• Inadequate warming up
• Incorrect stretching
• Lack of flexibility
• Medical condition
• Poor nutrition

Extrinsic causes eg.

• Not wearing proper attire
• Uneven surface
• Bad weather
• Hot or warm climate

COMMON INJURIES IN SPORTS

Generally, trauma that causes soft tissue injuries result in pain, discoloration, swelling and limitation on movement. These are the cardinal signs of inflammation.

Amongst the common soft tissue injures in sports are:

Abrasions / Lacerations

An abrasions is a break in the skin integrity that causes pain and bleeding. A laceration is a deeper break that involves the full skin thickness.

Muscle Cramps

A sustained involuntary contraction of the muscle that causes pain or discomfort. The individual is unable to voluntarily relax this muscle. It may be due to heat, dehydration or electrolyte imbalances.

Muscle Contusion

An injury which occurs from a sudden traumatic blow to the muscle that causes bleeding and bruising within the muscle. It can cause swelling discomfort or pain due to tissue damage that occurs.

Muscle Strain

A strain is a tear in the muscle. It is produced by an abnormal muscular contraction or an excessive stretch of the muscle.

Ligament Sprain

A sprain is an over stretching of the ligament leading to a tear. It can result in bleeding. Brusing, discomfort, pain and limitation of movement of the joint.

Muscle Soreness

This muscular pain due to overexertion or strenuous muscular activity that one is unaccustomed to.

Tendonitis

Tendonitis is an inflammation of the tendon. This may cause pain, tenderness, redness, swelling and limitation of movement involving the affected muscle of that tendon.

MANAGEMENT OF SOFT TISSUES INJURES

Decision Making

The principle in management of soft tissue injuries involves the following

Recognition

TOTAPS

(Talk, Observe, Touch, Active movement, Passive movement, Skill performance)

Pain, limitation of movement, swelling, deformity

Problem Identification

By the appropriate person.

Preventing aggravation or further injury

Stop cause

Protect affected part/individual

Instituting appropriate care

First Aid

Bleeding/open wounds

Inspect and apply direct pressure

Clean and dress wound

Definitive care

RICE

The acute phase is defined as the first 48 to 72 hours following the injury. The goal during the first stage is to reduce swelling and pain. At this stage, doctor usually advise patients to follow a formula of rest, ice, compression and elevation (RICE) for the 24 to 72 hours after the injury. If the swelling and inflammation can be controlled initially, the recovery process is enhanced.

REST

Rest refer to the immobilization of the injured part of the body. It reduces the bleeding and prevents further damage to the injured tissues.

ICE (cold applications)

The initial treatment of acute injuries use cold. Ice is used for conditions involving strain, sprain and contusion. It will decrease pain and bleeding by promoting local constriction of the blood vessels. Ice is applied on the injured part for 15 minutes every two hours by placing the ice in a cloth or plastic bag to avoid direct contact with the skin. Take care to not cause an ice burn.

Contraindication of ice therapy include:

• Allergy to ice
• Diabetes patient
• Circulatory problems
• Open wounds
• Elderly patient

COMPRESSION

Place external pressure on an injury assists in decreasing hemorrhage and hematoma formation by occluding the blood vessels.

ELEVATION

Elevation assists the veins to return blood and fluid from the injured part to the central circulatory system. Along with cold and compression, elevation reduces internal bleeding. In ankle sprain for example, the leg should be placed so that the ankle is at least above the level of the heart.

HEALTHY LIFE STYLE

Society today is largely focused on physical performance and the conditioning of one’s body. If an athlete aims to get and stay in shape, he or she would include strenuous exercise and athletic participation in his training module. It is also important for athletes to practice healthy life style in order to achieve the highest level of health and fitness.

Components of healthy life style include:

• Regular physical activity
• Maintaining appropriate body weight, BMI and fat composition
• Cope with stress well
• Avoiding drugs and alcohol
• Smoking cessation
• Well balanced diet
• Good rest and adequate sleep of at least 8 hours.