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Sport Injuries In the Martial Arts Treatment and Prevention Ihsan Antoine Azzam , MD, MPH June 24, 2005 Today's Topics What are Martial Arts (Sports) Injuries? What is the Difference Between Acute and Chronic Injuries?

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Ihsan Antoine Azzam , MD, MPH June 24, 2005

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Sport InjuriesIn the Martial ArtsTreatment and Prevention

Ihsan Antoine Azzam , MD, MPH June 24, 2005


Today's Topics

  • What are Martial Arts (Sports) Injuries?

  • What is the Difference Between Acute and Chronic Injuries?

  • What Should We Do in Case of Injury?

  • How are These Injuries Treated?

  • Individuals/Groups at High Risk

  • How Can We Prevent These Injuries?

  • Recent Advances


Statistical Facts

  • Most sports injuries can be treated

    effectively

  • Most people who suffer injuries can return to a satisfying level of physical activity

    after an injury

  • Many sports injuries can be prevented if people take the proper precautions


“Injuries that most commonly occur during sports or exercise.”

Sports Injuries - Definition

What Are Sports Injuries?

Could be due to:

  • Unintentional accidents

  • Poor training practices

  • Improper equipment

  • Lack of conditioning

  • Insufficient or inadequate warm-up and stretching

  • Could Involve:

  • Muscles

  • Bones

  • Associated tissues:

    • Ligaments

    • Tendons

    • Cartilage

  • Any part of the body


Sprains and Strains

  • Joint Sprain:Stretch or tear of a ligament (the band of tough soft tissues that connects bones to bones)

  • Caused by trauma

  • Most vulnerable to sprains are:

  • Ankles

  • Knees

  • Wrists Signs include:

  • Tenderness or pain

  • Bruising

  • Inflammation

  • Swelling

  • inability to move a limb or joint

  • joint looseness, laxity, or instability

  • Joint Strain:twist, pull, or tear of a muscle or tendon(the band of tough soft tissue that connects muscles to bones)

  • Could be None-contact injury

  • May result from over-stretching or

    over-contraction

  • Most vulnerable to sprains are:

  • Ankles

  • Knees

  • Wrists

  • Signs include:

  • Pain

  • Muscle Spasm

  • Loss of Muscle Strength

  • Swelling


Knee Injuries

  • knee is the most commonly injured joint

  • Each year > 5.5 million Individuals visit orthopedic clinics for knee problems.

  • Ranges from mild to severe

  • Functionally limiting

  • Pain or tenderness


Causes of Knee Injuries

  • Running too Hard too Much

  • Training without Warm- up

  • Blow, Kick or Punch

  • Twist

  • Improper Landing


Compartment Syndrome

Ongoing overuse (chronic)or one-timetraumatic

injury (acute compartment syndrome),such as:

  • Fractured bone

  • Hard blow to the thigh (or repeated hard blows)

    Occurswhen muscles become swollen, and filled

    the compartment to capacity, causing damage to the

    muscles and interference with:

  • Nerves

  • Blood vessels.


Achilles Tendon Injuries

  • Stretch, tear, or irritation

  • Tendonitis

  • degenerative caused by

    aging*or overuse

  • Rupture.

Lateral View of the Ankle

* Healthy and active lifestyle may delay soft tissues degeneration


Shin Splints

Definition: Leg pain along the tibia associated with exercise

  • Running and Overtraining

  • Jumping on hard surfaces

  • Running in shoes that don't have enough support

  • Overuse or incorrect use of the lower leg

  • Improper stretching, warm-up, or exercise technique

  • Flat (over-pronated) feet


Additional Images of the Knee Joint


Common Types of Sports Injuries

  • Muscle sprains and strains

  • Tears of the ligaments that hold joints together

  • Tears of the tendons that support joints and

    allow them to move

  • Dislocated joints

  • Fractured bones, including vertebrae

  • Hernias


Fractures

Broken bones

  • Quick, Acute or one-time injury

  • Repeated stress

  • Simple and Clean break

  • Compound

  • Most acute fractures are emergencies

  • Symptoms:

    • Pain

    • Tenderness

    • Swelling

Broken Arm

Humerus Fracture


Dislocations

  • When bones that form a joint become separated

  • Due to excessive force, stretching or

    falling

  • Emergency situation


Fractures and Dislocations


Acute Versus Chronic Injuries

  • Signs of an acute injury include

  • the following:

  • Sudden, severe pain

  • Swelling

  • Inability to place weight on a lower limb

  • Extreme tenderness in an upper limb

  • Inability to move a joint through its full range of motion

  • Extreme limb weakness

  • Visible dislocation or break of a bone

Acute Injuries such

as:

  • sprained ankle,

  • strained back

  • fractured hand

    Chronic Injuries

    Result from Overuse

What's the Difference Between Acute and Chronic Injuries?


STOP IMMEDIATELY

When Injury Occurs

  • Severe pain, swelling,or numbness

  • Can't tolerate any weight on that area

  • Pain or dull ache of an old injury that is accompanied by increased:

    • swelling

    • joint abnormality

    • instability.

When to Seek Medical Attention?

What Should We Do in Case of an Injury?


Managing Injuries at Home

Follow “RICE” for 48 hours

  • Rest

  • Ice (for maximum 48 hours, no more than 10 times/day 20-30

    minutes each)

  • Compression (should be performed by skilled individuals

    only)

  • Elevation (slightly above the level of heart)

    If pain or other symptoms worsen

    check with your healthcare provider

How Are Sport Injuries Treated?


How Are Sport Injuries Treated?

  • Start with “RICE”

  • Immediate Immobilization

  • Surgery

  • None Steroidal Anti-Inflammatory Drugs (NSAIDs)

  • Rehabilitation:

    • Gradual Exercise

    • Early Mobilization

    • Avoid Pain

    • Avoid Re-injury

  • Other Therapies include:

    • Electrostimulation (reduces pain, swelling, functionality, and produce passive muscle contraction - not recommended in the first 72 hours)

    • Cryotherapy

    • Thermotherapy (enhances and speeds up the healing process not recommended in the first 72 hours)

    • Ultrasound (not recommended in the first 72 hours)

    • Massage (not recommended in the first 72 hours)


  • High Risk Individuals (Vulnerable Groups)

    • Children and Adolescents

      • Bones, Muscles Tendons and Ligaments still Growing

      • Neck, Spinal Cord and Growth Plates (contact Sports)

  • Middle Aged Martial Artists

    • Aging (physical activity and some medical and food supplements*

      may delay the progress of arthritis)

    • Moving too Quickly to Active Lifestyle

  • Women (High Prevalence of Osteoporosis among inactive women who are not on Calcium supplements)

    • Conditioning Levels

    • Structural Differences

    • Hormonal Levels

  • Individuals and Groups at High Risk for Sport Injuries

    * NSADs, Glucosamine and Chondroitin may play a role in slowing the progress of arthritis


    Preventing (Sports) Martial Arts Injuries

    • Do Warm-up Exercises.

    • Don't Overdo

    • Accept Your Body Limit

    • Modify Activities as Needed

    • Increase the Emphasis on Conditioning

    • Maintain “Normal” Body Weight (some cushion could be helpful)

    • Avoid Twisting Knees by keeping feet as flat as possible during stretches.

    • When Jumping, Land with your knees bent

    • Wear Protective Gear

    • Use Soft Exercise Surface

    • Increase Your Exercise Level Gradually

    • Avoid Excessive Activities

    • Strive for A Total Body Workout (Cardio, Strength and Flexibility)

    How Can We Prevent Sport Injuries?


    Hernias

    • Hernias of the abdominal wall must be considered in patients who present with abdominal or groin pain

    • Inguinal hernia pain can be confused with pain due to chronic muscular-skeletal conditions encountered in a variety of sporting activities, especially Martial Arts and Weight Lifting

    • Herniated (prolapsed) inter- vertebral discs is extremely common among over-achiever martial artists


    Recent Advances

    • Arthroscopy

      • Tiny Incisions (less trauma, swelling and scaring)

      • Diagnostic Tool

      • Treatment Tool (torn meniscus or ligament)

      • Better Healing

  • Tissue Engineering

    • Cartilage Transplanting

    • Improve Healing

  • Targeted Pain Relief

    • Patches

  • What Are Some Recent Advances in Treating Sports Injuries?


    Thank you

    Questions

    I/Azzam - 2004


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