"Winners never quit and quitters

never win."
SPORTS INJURIES

Presenter:
Dr. Shumaila Naz-PT
(Senior Physiotherapist)
KMSMCS
 LEARNING OBJECTIVES
 Classify sports injuries and their prevention.
 Describe common sports injuries in upper and lower limbs.
 Discuss pathophysiology of muscle strains and ligament
sprains.
 Explain Biomechanics of gait and malalignment injuries.
 Outline injury prevention strategies in sports.
 Analyze rehabilitation processes for sports injuries.
 Discuss uses of assistive devices in rehabilitation.
 Explain psychological impact of sports injuries.
 Discuss nutritional roles in recovery from sports injuries.
 Understand surgical intervention in severe sports injuries.
 Promote multidisciplinary approach in managing sports
injuries.
 WHAT IS SPORT?
Sport should be considered in the broadest
context when answering the question of “What?”
According to the Merriam Webster Dictionary
(2010):
 Sport is a physical or recreational activity,
usually engaged in for pleasure, that an
individual is involved in either as a single
athlete or participant, or in a group or team
format.
CLASSIFY SPORTS INJURIES AND
THEIR PREVENTION
 WHAT IS SPORTS INJURY
A sports injury involves damage to your body
parts due to sports, exercise, or any athletic Acute:
activities. Sudden
stress like
collision
Two types of sports injuries occur :
 sudden (acute)
 and those which occur over a period of time
(chronic).

These can also be caused by an accident, or

inadequate warm-up before exercise, using
inappropriate techniques, or pushing yourself too
hard during workouts. Chronic:
Mostly affected body parts during these sports Continuous
injuries are muscles, bones, joints, ligaments stress e.g poor
(bone-bone connections), or tendons (bone-muscle
footwear,bad
connections).
technique
TIPS FOR PREVENTION OF SPORTS INJURIES
Maintaining an active lifestyle offers a number of benefits for your
physical and mental health.
Following are some tips to help you remain injury-free:
Warm Up: Always take time to warm up and stretch before a workout.
A warm-up gets your body ready for exercise by gradually increasing
your heart rate and loosening your muscles and joints. Warm up by
walking, cycling or jogging for 5 to 10 minutes. Once your body is
warm, do some stretching to increase flexibility.
Increase your range gradually: A key to preventing injuries is to
gradually build the intensity, duration and frequency of your workouts.
Avoid pushing yourself too hard, too fast. Follow the 10 percent rule to
increase activity in increments of 10 percent per week.
Exercise consistently: Avoid the “weekend warrior” syndrome that
compresses exercise into two days for the entire week. Try to get at
least 30 minutes of moderate physical activity every day.
TIPS FOR PREVENTION OF SPORTS INJURIES

Vary your workouts: Follow a balanced fitness program that

incorporates cardiovascular exercise, strength training and
flexibility. This will help decrease your chance of injury. Avoid
overusing one set of muscles — repeating the same muscle
movements frequently can lead to overuse injuries like shin
splints or tendonitis.
Listen to your body: Adjust your activities if your body is
showing signs of too much stress. The “no pain, no gain”
mentality can have damaging effects. Pain in your muscles or
joints is a sign that you should cut back.
Cool Down: When ending your exercise, remember to cool
down with slow, gentle stretching. Hold each stretch for 30
seconds
 TREATMENT
• Minor injuries such as mild sprains and strains can be
treated at home using PRICE (Protection, Rest, Ice,
Compression, Elevation) therapy which involves:
• Protecting the affected area from further damage.
• Resting / reducing exercise to avoid further strain on
the injured joints.
• Ice pack on the affected area for 15-20 minutes every
2-3 hours.
• Compression bandages (elastic) to be used to limit
swelling
• Elevate the injured body part above the level of your
heart whenever possible.
 TREATMENT
• To relieve pain and swelling you may take Non-steroidal
painkillers such as paracetamol or ibuprofen.
• In cases of severe and continuous swelling of joints due to
injury, corticosteroid injections are recommended based
on the judgment of your healthcare professional.
• In case of severe injuries, surgeries such as knee ligament
surgery are performed for a sports person followed by a
period of rest to recover from the damage due to the injury.
• The most common treatment after a severe sports injury or
accident is physiotherapy which involves techniques such
as exercises, to improve motion, blood flow and strengthen
muscles around the injury and return to normalcy.
COMMON SPORTS INJURIES IN UPPER
AND LOWER LIMBS
COMMON SPORTS INJURIES IN UPPER LIMB
COMMON SPORTS INJURIES IN UPPER LIMBS
Wheelchair athletes, rock climbers and cyclists are at increased risk of developing
carpal tunnel syndrome due to the demands of their sport.
Sports that have a high incidence of carpal tunnel syndrome include most
racket sports, handball, swimming, body building, rowing, golf, archery, and rock ...

Research suggests that about half of elite tennis players have symptoms of carpal
tunnel syndrome.
COMMON SPORTS INJURIES IN LOWER
LIMB
PATHOPHYSIOLOGY OF MUSCLE STRAINS
AND LIGAMENT SPRAINS.
 PATHOPHYSIOLOGY OF MUSCLE
STRAINS
There are a number of types of muscle injury that can occur:
laceration, contusion and strain(Garrett1996; Huard et al. 2002; Jarvinen et al.
2005).
• A laceration occurs when the muscle is cut by an external object, this
usually occurs during traumatic accidents such as road traffic or industrial
accidents.
• A contusion occurs when there is a compressive force to the muscle and
usually occurs in contact sports (Jarvinen et al. 2005), for example in
football when two players collide, knee to thigh in a tackle.
• Strain injuries occur when muscle fibres cannot withstand excessive
tensile forces placed on them and are therefore generally associated with
eccentric muscle action.
• Strains most commonly occur in muscles working across two joints e.g.
hamstrings, gastrocnemius (Jarvinen et al. 2005) during periods of rapid
acceleration and deceleration, by placing the muscle in a lengthened state
over two joints and contracting forcefully (Stanton 1989; Farber and
Buckwalter 2002).
PATHOPHYSIOLOGY OF LIGAMENT
INJURIES
Pathological changes in ligaments may occur due to structural and
functional failure. Any strain to a ligament may cause a long-term joint
instability.
There are agreed degrees of ligaments strain:
1st degree is mild, 2nd degree moderate and 3rd degree is a complete
tear (Chen et al. 2008).
Following a strain, ligaments do not heal by producing an identical
tissue; instead, a scar tissue is formed. The scar tissue presents with an
uneven matrix and weaker collagen crosslinking.
The blood circulation is also affected with a long term reduction in
blood circulation to the scar tissue.
Although scar tissue is formed relatively fast, there are still mechanical
and chemical changes months and years after the injury, though it never
has a normal appearance or function again, resulting in a high level of
reoccurrences (Frank et al. 1999).
Ankle sprains, for example, reoccur in 73% of all athletes.
BIOMECHANICS OF GAIT AND
MALALIGNMENT INJURIES.
• Gait biomechanics is defined as the
application of mechanical principles to
understand the movement of the human body
during locomotion.
Gait Cycle
 PHASES OF GAIT
Normal gait consists of two phases:
stance phase; swing phase.
These phases are further divided into a total of 8 sub-phases.
The gait cycle involves a combination of open- and closed-chain
activities.
Stance Phase
The stance phase occupies 60% of the total gait cycle, during
which some part of the foot is in contact with the ground. It is
further divided into five sub-phases:
• Initial contact (heel strike)
• Loading response (foot flat)
• Mid-stance
• Terminal stance (heel off)
• Pre-swing (toe off)
 PHASES OF GAIT
Swing Phase
The swing phase occupies 40% of the total
gait cycle , during which the foot is not in
contact with the ground and the bodyweight
is borne by the other leg and foot. It is
further divided into three sub-phases:
• Initial swing
• Mid-swing
• Late swing
 GAIT MALALIGNMENT

A gait deviation is an abnormality in the gait

cycle that can affect the trunk, hip, knee, or ankle
joint. Gait deviations can stem from increased
age and/or certain pathologies. These pathologies
can be musculoskeletal or neurological in nature.
 MUSCULOSKELETAL
• Antalgic gait. Antalgic gait is due to pain in the lower extremities
that results in a limp that is associated with a shortened stance phase
relative to the swing phase. This gait deviation, asymmetry, can be
caused by issues that originate in the trunk, hip, knee, or ankle.
• Leg Length Discrepancies. Leg length discrepancies can either be
structural of functional. This can cause pelvic drop, decreased hip,
knee, and ankle plantarflexion. To compensate, the patient may use
vaulting or toe-walking.
• Trendelenburg Gait. Trendelenburg gait occurs when the gluteus
medius is weak. Gluteus medius weakness can be the result of
dysfunctions or diagnoses related to back pain or lumbopelvic pain,
chronic hip dysfunctions, or lumbopelvic surgery. The weakness of
the involved side causes a contralateral pelvic hip drop during swing
phase
 MUSCULOSKELETAL
• Posterior Lurch Gait. Posterior lurch gait is when the
trunk leans posteriorly with a hyperextended hip,
especially during the loading response due to a weak
gluteus [Link] it is also known as gluteus
maximus gait.
• Circumduction of the Hip. Circumduction of the hip
during swing phase occurs for several reasons including
weak hip flexors, contralateral hip dysfunction, or leg
length discrepancy. This is a combination of hip hiking,
forward rotation of the pelvis, and abduction of the hip.
Hip flexor weakness is caused by L2-L3 nerve
compression or possibly upper motor neuron lesion.
 NEUROLOGICAL
• Spastic hemiparetic gait. It is characterized by unilateral
leg extension and circumduction, in which the paretic leg
performs a lateral motion (circumduction ) during the swing
phase. This is also known as circumductory gait.
• Spastic diplegic gait (scissors gait). It is characterized by
bilateral leg extension and adduction, the legs appear to be
stiff. When spasticity in the adductors is marked it results in
a scissoring gait where the legs cross in the scissors-like
pattern.
• Steppage gait. In this gait, the patient must lift the leg
higher than usual and the patient is unable to stand or walk
on their heel. It is caused by weakness in the ankle
dorsiflexors. This gait is also known as a slapping gait.
• Waddling gait (myopathic gait). In waddling gait weakness in the
gluteus medius muscles leads the hip on the swinging side to drop
during gait, in an attempt to counteract, the patient bends the trunk
towards the other side, resulting in the gait to appear waddling.
• Parkinsonism gait. Parkinsonian Gait is described as a decrease in
stride length and arm swing which will result in a slow shuffling
pattern. There will also be an increased in hip flexion of the trunk
and knees with partially flexed elbows. An individual with
Parkinsonism will have difficulties initiating walking and may
freeze mid-strike. They may also present with festination meaning
involuntary acceleration.
• Cerebellar ataxic gait. The gait is broad based, insecure and lacks
coordination. Leg movements and step length are irregular and
variable.
• Sensory Ataxic gait. In this gait the patient’s proprioception is
disturbed resulting the gait to appear broad-based and insecure. The
patient uses visual control to compensate for the disturbed
proprioception.
• Hyperkinetic gait. this gait is seen in basal ganglia deviations
including chorea, dystonia and Wilson's disease.
INJURY PREVENTION STRATEGIES
IN SPORTS
The following are some basic steps to prevent a sports injury:

1. Develop a fitness plan that includes cardiovascular exercise, strength

training, and flexibility. This will help decrease your chance of injury.
2. Alternate exercising different muscle groups and exercise every other day.
3. Cooldown properly after exercise or sports. It should take 2 times as long
as your warm-ups.
4. Stay hydrated. Drink water to prevent dehydration, heat exhaustion, and
heatstroke.
5. Stretching exercises can improve the ability of muscles to contract and
perform, reducing the risk of injury. Each stretch should start slowly until
you reach a point of muscle tension. Stretching should not be painful.
Aim to hold each stretch for up to 20 seconds.
6. Use the right equipment or gear and wear shoes that provide support
and that may correct certain foot problems that can lead to injury.
7. Learn the right techniques to play your sport.
8. Rest when tired, Avoid exercise when you are tired or in pain.
9. Always take your time during strength training and go through the full
range of motion with each repetition.
10. If you do sustain a sports injury, make sure you participate in adequate
rehabilitation before resuming strenuous activity.
REHABILITATION PROCESSES FOR
SPORTS INJURIES.
• Rehabilitation is the restoration of optimal form
(anatomy) and function (physiology). It is a
method created to enhance functional capacity,
fitness, and performance while minimizing the loss
associated with acute injury or chronic disease.
The rehabilitation process should begin as soon
as possible after an accident, and it should be
integrated into a continuum with other therapeutic
interventions including the use of pharmaceutical
medications.
 BENEFITS OF SPORT SPECIFIC
REHABILITATION
Sport specific rehabilitation is the best course of action to restore and
enhance your original athletic abilities when you have suffered a
debilitating sports injury. There are many other benefits to sports PT
that will aid in your recovery, such as:
 Pain management
 Increased cellular metabolism to encourage healing of damaged
tissue
 Increased circulation in the injured area to encouraging healing
 Strengthening of weakened muscles
 Prevention of muscular atrophy
 Stimulation of joint receptors
 Restoration of range of motion and increased flexibility in tight
muscles
 Increased lymphatic drainage
 Increased extensibility of connective and supporting tissue structures
 Relief of muscular spasms
The most common sports injury rehabilitation techniques
are:

 Physical therapy: This is a core part of any sports injury rehab program. It
involves a variety of techniques, such as strength and flexibility exercises, balance
and coordination activities, and sport-specific training.
 Pain management: Techniques for managing pain can include medication,
massage, hot and cold therapy, electrical stimulation, acupuncture, and other non-
pharmacological methods.
 Manual therapy: This includes hands-on techniques such as joint mobilizations,
manipulations, and massage to improve mobility and decrease pain.
 Exercise therapy: Structured exercise programs designed to improve strength,
flexibility, endurance, balance, and coordination are often part of the rehab process.
 Hydrotherapy: The use of water in the treatment of different conditions is
especially effective for early-stage rehabilitation when weight-bearing exercise may
not be possible.
 Electrotherapy: This type of therapy utilizes electrical signals to interrupt pain
signals, promote healing, and stimulate muscles. Techniques can include
Transcutaneous Electrical Nerve Stimulation (TENS), ultrasound, and laser therapy.
 Proprioceptive training: This type of training is used to help athletes regain
control over their body movements and awareness. It’s particularly important after
joint injuries.
 Functional and sports-specific training: Once an athlete has regained basic
strength and mobility, they will need to relearn the specific skills associated with
their sport. This can include agility drills, plyometric exercises, and sport-specific
practice.
 Assistive devices are external devices that are
designed, made, or adapted to assist a
person to perform a particular task.

USES OF ASSISTIVE DEVICES IN

REHABILITATION
• Assistive devices play a crucial
role in sports rehabilitation
by enhancing recovery,
improving performance, and
enabling participation for
athletes with disabilities. These
devices range from simple
mobility aids like crutches and
braces to more sophisticated
technologies like robotic
exoskeletons and virtual reality
simulators.
• They help athletes regain lost
function, manage pain, and
increase their independence and
confidence during the
rehabilitation process.
 USES OF ASSISTIVE DEVICES IN SPORTS
REHABILITATION:
• Mobility and Support:
Devices like crutches, canes, walkers, and wheelchairs provide support and reduce
weight-bearing on injured limbs, allowing for controlled movement and exercise during
rehabilitation.
• Joint Protection and Stability:
Braces, splints, and supports help stabilize joints, prevent re-injury, and facilitate proper
alignment during rehabilitation exercises.
• Pain Management:
Assistive devices like TENS units, cryotherapy equipment, and compression wraps can
help manage pain and inflammation, allowing athletes to participate in rehabilitation
activities more comfortably.
• Gait Training and Balance:
Assistive devices like parallel bars, treadmills with unweighting systems (e.g., AlterG),
and balance boards can help athletes improve their gait, balance, and coordination.
• Muscle Strengthening and Endurance:
Resistance bands, weights, and specialized exercise equipment can be used to
strengthen specific muscle groups and improve overall endurance during rehabilitation.
• Neuromuscular Re-education:
Devices like electromyography (EMG) biofeedback and neuromuscular
electrical stimulation (NMES) help athletes relearn and improve muscle
control and coordination.
• Adaptive Sports Equipment:
For athletes with permanent disabilities, specially designed sports
equipment like adapted golf clubs, handcycles, and racing wheelchairs
allow for participation in adapted sports and continued physical
activity.
• Communication and Accessibility:
Assistive communication devices, such as speech-generating devices
and visual aids, enable athletes with communication impairments to
interact effectively with coaches and teammates.
• Virtual Reality and Augmented Reality:
These technologies can be used to create immersive training
environments, providing feedback on movement and posture, and
enhancing motivation during rehabilitation.
• Robotic Rehabilitation:
Robotic devices can assist with specific movements, provide resistance,
and guide athletes through rehabilitation exercises, particularly useful
for patients with neurological conditions or severe injuries.
SPORTS THAT USE ASSISTIVE TECHNOLOGY
MAY INCLUDE THE FOLLOWING
Accessible Fishing Adaptive Water
& Hunting. Sports. Wheelchair Racing
Accessible Sailing / Extreme and Field Sports.
Boating / Kayaking. Wheelchair Sports. Wheelchair
Adaptive Archery. Handcycling. Baseball.
Adaptive Bowling. Power Soccer. Wheelchair
Adaptive Flying. Quad Rugby. Softball.
Adaptive Golf. Sled, Floor & Wheelchair Table
Adaptive Power Hockey. Tennis.
Horseback Wheelchair Wheelchair Tennis.
Riding/Equestrian. Basketball. Wheelchair
Adaptive Scuba Wheelchair Volleyball.
Diving. Curling. Wheelchair
Adaptive Shooting. Wheelchair Weightlifting.
Adaptive Skiing & Fencing.
Snowboarding. Wheelchair
Adaptive Table Lacrosse.
Tennis. Wheelchair Pool
and Billiards.
PSYCHOLOGICAL IMPACT
OF SPORTS INJURIES
NUTRITIONAL ROLES IN RECOVERY
FROM SPORTS INJURIES
• Understandably, we want a fast recovery from injury to
be able to return to our daily activities and get back
onto our feet. In addition to our rehabilitation exercises
and proper sleep, nutrition is a crucial factor that can
contribute to enhancing your recovery.
• Throughout the recovery phase, our body requires
additional energy to ensure weight maintenance and
preservation of lean muscle mass. A combination of
ineffective training due to injury, and low energy intake
can accelerate muscle loss.
• The goal is to adhere to maintenance calories to
minimise both fat gain and muscle loss.
 PROTEIN
Protein plays a crucial role in recovery to help
reduce the risk of muscle and strength loss.
Current recommendations for adults during injury
recovery is 1.6-2.5g of protein/kg/day (2).
Examples of protein:
• Lean beef, chicken, turkey, eggs, fish, prawns
• Dairy products: natural yoghurt, milk, hard cheese
• Legumes: lentils, chickpeas, kidney beans, tofu,
beans
 ANTI-INFLAMMATORY FOODS
Anti-inflammatory foods assist in reducing inflammation
within the body, contributing to enhanced mobility at the site
of injury.
Examples of anti-inflammatory foods:
• Omega-3 (animal-based is more readily absorbed than
plant-based).
• Animal: 2-3x oily fish per week: salmon, sardines,
mackerel, or a fish oil tablet
• Plant: Chia seeds, walnuts, linseeds daily
• Wholegrains & legumes (our main sources of fibre).
• Oats, wholegrain bread, spelt pasta, brown rice, quinoa
• Lentils, chickpeas, kidney beans, black beans.
 ANTI-INFLAMMATORY FOODS
• Dark leafy greens (the darker in colour, the better)
• Kale, silverbeet, spinach, broccoli
• Bright red, blue, purple fruit & vegetables
• Berries, cherries, acai, red grapes
• Beetroot, red cabbage, purple flesh potato
• Spices (the stronger the flavour the more
antioxidants it contains)
• Ginger, garlic, cinnamon, cloves, turmeric (pair with
black pepper to activate the antioxidant properties)
• Green Tea
 SUPPLEMENTS

• Vitamin D and Calcium

Vitamin D and calcium are both crucial nutrients for our bone health,
and particularly for any bone related injuries, such as fractures. If you
are deficient in vitamin D, or if you do not consume many dairy
products, taking a vitamin D and calcium supplement may be
beneficial.
• Collagen and Gelatine
For any soft tissue injuries (such as ligaments or tendons), emerging
research suggests that collagen may help to enhance injury repair.
Choosing a collagen supplement over whey protein is based on the fact
that collagen contains specific amino acids, the building blocks of
proteins, which aid in the repair of soft tissue. In contrast, whey protein
is primarily utilised for muscle building.
Surgery is needed in some cases to repair torn
connective tissues or to realign fractured bones. The
majority of musculoskeletal sports injuries do not
require surgery.
Some of the most common orthopedic sports surgeries
include the following:
• 1. ACL reconstruction
An ACL reconstruction is a surgical procedure aimed at
repairing a torn or injured anterior cruciate ligament in
the knee.
2. Meniscus tear repair
A meniscus tear repair is a
surgical procedure to treat a torn
meniscus in the knee. The
meniscus is a wedge-shaped
cartilage in the knee joint that acts
as a cushion and provides
stability.
4. SHOULDER LABRUM REPAIR

• The shoulder labrum is a ring of

cartilage that surrounds the socket
of the shoulder joint, providing
stability and support to the
shoulder. Injuries to the labrum are
common, often resulting from
traumatic events, repetitive
shoulder motions, or dislocations.
• A shoulder labrum repair is used to
address injuries or tears in the
shoulder’s labrum.
• 5. Achilles tendon repair
Achilles tendon repair is a surgical
procedure to treat a torn or ruptured Achilles
tendon, which is the large tendon connecting
the calf muscles to the heel bone.
The Achilles tendon is crucial for activities
such as walking, running, and jumping, and
injuries to this tendon can significantly
impact mobility.
• 6. Tennis elbow surgery
Tennis elbow surgery, also known as lateral
epicondylitis surgery, is a procedure
designed to treat severe cases of tennis
elbow—a condition characterized by
inflammation and degeneration of the
tendons on the outer part of the elbow
• 7. Hip arthroscopy
• Hip arthroscopy is a minimally invasive surgical procedure
that allows surgeons to visualize, diagnose, and treat various
hip conditions through small incisions using an arthroscope.
Hip arthroscopy is commonly used to diagnose and treat
multiple sports-related injuries and conditions, such as:
• Hip impingement
• Labral tears
• Hip dysplasia
• Synovitis
• Hip cartilage injuries
• Loose bodies in the joints
• Hip bursitis

The procedure usually starts with a small incision, usually less

than 1 centimeter each, around the hip joint. These serve as
entry points for the arthroscope and surgical instruments.
• Injuries result from complex interactions between
a variety of internal and external risk factors.
• Due to the complex-systems nature of injuries it
is not possible to place responsibility for injury
risk management solely within a single domain of
professional practice.
• Instead, an interdisciplinary collaboration
between technical/tactical coaches, strength and
conditioning coaches, team doctors, physical
therapists and sport scientists is more likely to
have a meaningful impact on injury risk.