Dr Jennifer Brown column

Injuries in sports fall in two categories, acute and chronic (or overuse injuries).

Acute injuries are the result of a sudden stress on the body.

Chronic or overuse injuries are caused by overtraining, insufficient recovery, poor technique, and badly designed footwear or equipment.

Injuries are classified as soft-tissue injuries, hard-tissue injuries; and there are others referred to as dangerous condition.

Soft-tissue injuries

These include damage to muscles, ligaments, tendons, and cartilage. These injuries are identified as follows:

Sprains: This happens when ligament at the joint gets overstretched and torn. For example: twisting your ankle when running can cause it to sprain. In a severe sprain, the ligament is badly torn and the injury looks like a fracture. The symptoms are pain and tenderness around the joint that are made worse by movement. Swelling occurs, followed by bruising.

Strains or pull: This happens when a muscle or tendon is torn due to violent overstretching. The hamstrings and calf muscles are at special risk if warm-up is not done properly (the Achilles tendon of the calf muscles can tear completely). The symptoms are a sudden sharp pain at the tear, then swelling, stiffening and sometimes cramps. A torn Achilles tendon prevents the casualty from getting up.

Torn knee cartilage: There are two curved pads of cartilage at the knee joint. These may tear if the knee is twisted violently. Symptoms are pain on one side of the knee. The joint may 'lock' and not straighten fully for a time and may swell later.

Tennis or golfer's elbow: This happens when the muscles in the lower arm are over used; the area around the elbow is inflamed, tender and sore.

Abrasions or grazes: This is where skin is scraped off the body. For example, during a sliding tackle in football on a hard pitch.

Cuts: This is where the skin and the blood vessels get damaged, so blood flows out of the body. Bleeding must be stopped as quickly as possible.

Bruises: These are signs that blood is leaking from damaged blood vessels under the skin and are caused by impact. The skin changes colour (blue/black), the area is painful and can swell.

Blisters: Repeated friction in the skin causes the layers to separate and fill with fluid, creating a small swelling. This is best avoided by wearing correct size and type of footwear.

Hard-tissue injuries

These are injuries to the bone and include fractures and dislocation.

Fractures: A fracture is a break in the bone. There are two types: Simple (closed) fracture, where the bone is cracked but the skin is not damaged; and open or compound fracture, where the skin is damaged and the bone may stick out. Bones contain nerves and blood vessels, so a fracture means pain and bleeding. This leads to swelling and bruising when blood leaks in surrounding tissue.

Signs and symptoms: The casualty may have heard or felt a snap; pain and tenderness around the injury; the part cannot be moved normally; swelling and bruising develops; and the limb may look deformed and twisted.

Stress fractures

These are small cracks in the bone. They are often an overuse injury caused by too much running on hard surfaces. The signs of stress fracture are steadily increasing pain in a particular area of the limb, swelling and tenderness. An example of this injury is the shin splint in the leg.

Dislocations

A dislocation means that a bone at a joint is forced out of its normal position, usually by violent twisting. The ligaments around the joint may also be damaged. This usually happens at the shoulder, elbow, finger, and thumb.

The signs and symptoms are severe pain at or near the joint, the joint appears deformed and the casualty can't move it. Swelling and bruising occurs around the joint.

NEXT WEEK: Procedures for treating sport-related injuries.