1. ERINDANLE COLLEGE
SPORTS INJURIES TALK
• DAVE BERG, PHYSIO
• BERG PHYSIOTHERAPY AND SPORTS
INJURY CENTRE AT ERINDALE
MEDICAL CENTRE
• 6231 1155

2. Sport should be fun

3. ROLE OF PHYSIOTHERAPIST
• MANAGEMENT OF
MUSCULOSKELTAL INURIES IN
PRACTICE
• ON FIELD MANAGEMENT AND
ASSESSMENT OF INJURIES
• SCREENING FOR THE PREVENTION
OF INJURIES

4. MUSCULOSKELETAL
INJURIES
• BONE
– BREAKS, SPINAL INJURIES
• MUSCLE STRAINS
– TEARS, CORKS
• TENDONS
– IRRITATIONS, TEARS
• LIGAMENTS
– TEARS, SPRAINS

5. Musculoskeletal Injuries Cont
• JOINT
– MENISCAL, OSTEOCHONDRAL
– DISLOCATIONS
• OTHER SOFT TISSUE INJURIES

6. “OTHER”

7. “OTHER CONT”

8. BONE INJURIES

9. Bone Injuries
• Usually high energy injuries
• Immediate pain, usually associated with an
audible crack
• Deformity, Swelling, Pain to palpate, Pain
to axially load.
• Types of breaks
– stress fracture, spiral fracture, transverse break

10. Stress Fractures
• Begin as pain with
activity
• Progress to pain with
activity and constant
pain
• Most commonly
affected areas are the
foot, shin and low
back

11. Fracture Management
• Fingers. Sign if not obvious is to press
through length of bone.
• Xray is gold standard test.
• Surgery if displaced or rotated
• four to six weeks if no surgery
• Other breaks follow similar principles.
Immobilisation or surgery depending on
displacement.

12. Traumatic breaks

13. Muscle Injuries
• Muscle Injuries are direct (corks), or
indirect (tears).
• Muscle tears are known as strains, and are
classed one to three
• Most commonly injured muscles are
hamstring, calf, and quadriceps.
• Muscle Tears have a very high recurrence
rate.

14. Muscle Tears
• Grade One Tear: 7-10 days
• Grade Two Tear: 4-7 weeks
• Grade Three Tears: >six weeks
• Rehab of the muscle tear very important.
Regaining strength, length and power.
• Pain is not the guide. Tensile strength
(ability to contract under load) does not
recover till several weeks

15. Muscle Corks
• Impact injuries
• Usually poorly
managed.
• Immediate
management should be
ice with full stretch.
• Definitely should not
consume alcohol.

16. Ligament Injuries
• Can be contact or non
contact injuries.
• Involve the joint being
moved in a direction it
does not want to go.
• Pain is immediate
• Ligament in ankle and
knee are most
commonly torn

17. Ligament Injuries Cont.
• Injuries are graded one
to three
• Grade three injuries
are full thickness tears
and usually require
surgery.
• Grade two tears can
generally be managed
conservatively. >four
weeks

18. Ankle Ligaments
• Most commonly torn
are the Lateral
ligament and the
syndesmosis)
• Mechanism is usually
rolling over the ankle,
twisting on a fixed
foot (syndesmosis), or
falling over the heel
usually from a height

19. Management of Ankle Injuries
• Brace for four weeks if laxity present
• Strength training to improve peroneal and
gastroc muscle strength
• Stretching to restore range of movement,
particularly dorsiflexion
• Balance or proprioception retraining.

20. Knee Ligaments
• Most Commonly torn are the ACL and
Medial Ligament.
• ACL requires surgery. Is a non contact
injury. Happens when stepping or cutting.
• Medial ligament is usually a contact injury.
Managed conservatively with a brace for
four to six weeks.
• Posterior Cruciate Ligament rarer. Hardly
ever managed surgically even if fully torn.

21. Head Injuries

22. Head Injuries
• Usually involve head contacting something
solid eg another head or knee
• If player is knocked out they should
definitely not continue to play.
• Aggression, twitching, vomiting, severe
headache, amnesia, and blurred vision are
all bad signs
• Mandatory three weeks out if knocked out

23. Head Injuries
• Three concussion episodes in one year
should sit out the whole year.
• Two impacts in rapid succession can result
in death.
• Should not consume alcohol, risk death
• If knocked out should not drive home,
should be monitored and should not sleep
till that night.

24. Eye Injuries
• Involves foreign
object into eye socket.
• Can result in loss of
vision or eye.
• Immediate hospital
referral.

26. Joint Dislocations
• Occurs when a joint is
taken out its socket
• Most commonly
affected are the fingers
shoulder, AC joint,
and patella femoral
joint. Ankles are
uncommon
• Knee and hip
dislocations are rare
and VERY serious

27. DISLOCATIONS CONT

28. Shoulder disclocations

29. SHOULDERS CONT

30. Shoulder dislocations
• Mechanism outstretched arm forced
backwards
• In someone under 25 years, greater than 90
percent chance of doing it again
• Once dislocated three times need surgery
• Surgery follows six to nine month rehab
period

31. Shoulder dislocations
• Conservative approach after first dislocation
MIGHT prevent subsequent episodes and
therefore surgery.
• Four to eight weeks off.
• Strengthening of back and rotator cuff
muscles.
• Improved proprioception in shoulder.
• Improved thoracic movement.

32. Other dislocations
• Knee and hip dislocations require
immediate hospital review. Person can lose
their limb
• Patellofemoral and AC dislocations are not
surgical. Tend to respond very well to
conservative treatment.
• Finger dislocations can be surgical
depending on direction of dislocation

33. Finger dislocations

34. Hip dislocation

35. Other joint injuries
• Other intra articular structures can be
damaged.
These include bone cartilage interface,
called osteochondral injuries, meniscus
injuries.
• Osteochondral injuries require prolonged
rest or surgery.
• Meniscal tears can settle with rest but often
need surgery, especially if knee is locking

36. Tendon Injuries
• Usually occur in older athletes when blood
supply starts to lessen.
• Can occur in younger athletes in high
energy injuries.
• Tendons most commonly torn are rotator
cuff, achillies, patella.
• These are usually surgical injuries.

37. Groin injuries.

38. Tendon Injuries Cont.
• More common than tears are inflammations
• Tendonitis starts as pain with activity and
progresses to pain after activity.
• Very difficult to manage once established
due to the poor blood supply of tendons.
• Best managed early with rest, anti inflams,
and stretching and strengthening.

39. Back injuries

40. Back Injuries
• Can be traumatic or due to overuse.
• Stress Fractures can occur in sports where
athletes bend backward a lot (gymnastics)
• Any number of structures can be damaged,
and exact diagnosis is much more difficult.
• Back and neck injuries that occur on a
football field or with high energy
mechanism need to be taken very seriously

41. Many injuries can be prevented,
but sometimes its just plain
luck...

42. But don’t worry too much. After
all, sport shouldn’t be taken too
seriously, have fun!

43. AND BESIDES, INJURIES
CAN HAPPEN ANYWHERE,
ANYTIME.