Articles on knee injuries

Knee Sports Injuries

Dr. Rajat Jangir, Orthopedist
Problems in the knee are extremely common. These injuries range from sprains and anterior knee pain, to meniscus and ligament tears, to arthritis. With the current increase in activity that we are seeing in today’s population, knee injuries will only become more common. Fortunately, as knee injuries become more common our understanding of these injuries and ability to treat them successfully continues to improve. From improved understanding of how musculoskeletal dynamics affect knee injury, risk, and prevention; to using the latest minimally invasive techniques to treat surgical knee problems; our knowledge and techniques for treatment of the knee continues to evolve and improve.ACL InjuriesThe anterior cruciate ligament (ACL) is one of the four major ligaments of the knee. Ligaments are strong, dense structures made of connective tissues that help stabilize a joint. In this case, the ACL connects the femur to the tibia and helps provide stability to the knee and minimize stress across the knee joint. Twisting or pivoting movements can often cause the ACL to strain or tear.ACL tears occur in athletes participating in cutting and pivoting sports such as basketball, football, soccer, and skiing. At the time of an ACL injury the athlete typically feels a “pop” or a tearing sensation. This is followed by swelling within the first six hours of the injury. The most common injury associated with ACL tears is a meniscus tear.It is well recognized that ACL injuries are much more common in females. There are multiple reasons for this including bone anatomy, hormonal differences, muscular balance, and the way they perform certain sports. Of these factors, the ones we can potentially change are muscular balance and the way sporting moves are completed. Females tend to cut and jump with their knees only slightly bent, which can predispose them to ACL injury. The hamstring to quadriceps strength ratio is also different from males. Studies have shown that strengthening exercises and plyometric programs aimed at changing these factors can prevent ACL injuries.ACL strains can sometimes be treated with physical therapy and muscle strengthening. However, most complete tears require surgery in active patients. Modern ACL surgery involves completely removing the torn ligament and reconstructing the torn ACL. The most common grafts used to reconstruct a torn ACL are the patella tendon, hamstring tendons, or cadaver tissue (allograft). Each graft offers specific advantages and disadvantages, so it is important to understand the differences.Meniscus InjuriesThe meniscus is a pad of specialized cartilage that is located between the femur and tibia bones in the knee joint. There are two menisci in the knee – one on the inside of the knee (medial meniscus) and one on the outside of the knee (lateral meniscus). The meniscus has several functions including: acting as a shock absorber or cushion, distributing load across the knee, decreasing friction, and adding to stability of the knee.Meniscus tears typically occur as a result of twisting injuries to the knee. They can be caused by traumatic injury, often seen in athletes, or they can be degenerative in nature, tearing from minor trauma as the meniscus becomes more brittle with age. The symptoms of a meniscus tear include pain, swelling, locking, and inability to completely straighten the knee joint. An MRI is frequently obtained to diagnose a meniscus tear.Treatment of meniscal tears depends on several factors including the type of tear, the location of the tear, and the activity level of the patient. Some patients can be treated nonoperatively. If surgery is necessary, minimally invasive arthroscopic techniques are used to either trim out the torn portion of the meniscus (partial meniscectomy) or to repair the meniscus.The PCL InjuriesThe posterior cruciate ligament (PCL) is one of the four major ligaments of the knee. The PCL, along with the ACL, is located in the center of knee. Its primary function is to prevent posterior translation of the tibia on the femur. The PCL also plays a role in the side-to-side stability of the knee.The PCL is injured less commonly than the ACL. The most common mechanism of injury involves a blow to the front of the tibia (shin bone) when the knee is bent. PCL tears can occur as isolated injuries or can be associated with other knee injuries.The symptoms of a PCL injury are usually less dramatic than those of an ACL tear. Swelling is often only mild. The pain from a PCL injury is usually resolved within 2-4 weeks. However, a sense of instability may persist, especially when changing directions.Treatment for isolated PCL injuries initially focuses on rehabilitation and strengthening after the pain and swelling subside. Partial tears of the PCL do not usually require surgical treatment; even isolated complete tears of the PCL do not always need surgical treatment.If symptoms of instability persist after rehabilitation, surgical reconstruction of the PCL is recommended. Modern PCL surgery involves completely removing the torn ligament and reconstructing the torn PCL using a minimally invasive arthroscopic technique. The new PCL is made using a tendon graft, obtained from either the patient or cadaver (allograft). Furthermore, PCL reconstruction surgery is typically performed as an outpatient procedure.Cartilage InjuriesCartilage is a type of specialized connective tissue. There are three main types of cartilage: hyaline (articular) cartilage, fibrocartilage, and elastic cartilage. Hyaline (articular) cartilage provides a smooth, white, glistening layer covering the femur, tibia, and undersurface of the patella. The main functions of the hyaline cartilage is to provide shock-absorbing properties and allow for a frictionless smooth surface. Articular cartilage lacks blood supply and therefore has a limited capacity for healing. It can be injured by trauma or repetitive injury.Cartilage injuries may cause pain, swelling, and/or locking if the fragment has separated into the joint. The surgical treatment options for cartilage damage are: debridement (cleanup), microfracture, cartilage (osteochondral) transplant, allograft, and chondrocyte transplantation. These cartilage restoration procedures can be done using minimally invasive arthroscopic techniques.MicrofractureThe microfracture technique is used for full thickness cartilage defects with exposed bone. Articular cartilage has a limited capacity to regenerate itself due to its lack of blood supply. Therefore, the microfracture technique was designed to stimulate a biologic repair for this type of cartilage. A minimally invasive arthroscopic technique is used to place microfracture holes into the exposed bone, which allows the release of blood and bone marrow contents into the cartilage defect. This activates a healing response and stimulates the production of the fibrocartilage layer, which forms over the exposed bone. This technique is very effective for cartilage restoration.Transplant (OATS)Osteochondral (cartilage) transplantation (OATS) procedures are designed for full thickness chondral defects. Small chondral defects are treated by removing an osteochondral cylinder (plug) from a specific area within the knee joint that does not require cartilage to function properly. This osteochondral cylinder (plug) is then transplanted to the affected area in order to repair the chondral defect.Large chondral defects can be treated using an allograft (cadaver) osteochondral graft. The typical patient considered for this procedure is a young, active individual with a traumatic isolated chondral injury. The advantage of this procedure is that it allows placement of hyaline (articular) cartilage into the chondral defect. This technique is performed through a minimally invasive arthroscopic procedure, or through an open technique depending on the size and location of the lesion.AllograftSome cartilage lesions are too large for microfracture or autograft OATS to work successfully. Thus, an allograft OATS surgery may be required in some of these cases. In this surgery a cylindrical area of bone is removed where the cartilage lesion is located. A similar sized bone plug with overlying articular cartilage is then removed from a matched cadaver. This cylindrical area of bone is then placed in the defected area in order to repair the cartilage lesion.Chondrocyte TransplantationChondrocyte transplantation is used for relatively large cartilage defects in the knee, where the underlying bone is normal. This procedure is usually done in one of two ways. Cartilage cells can be harvested from the patient, sent to a lab, grown, and then later implanted into the patient via a second surgery. The other option is to use fetal chondrocyte cells, which requires only one surgery. In either case the lesion is cleaned of any residual cartilage. A tissue patch is then sewn into the lesion and cartilage cells are injected into the area. These cells then grow into hyaline (articular) cartilage.SummaryMicrosoft PowerPoint - IOC Diploma presentation [Compatibility Mode]Knee injury extremely commonHistory will direct the examination and helpwith diagnosisPhysical examination directed to the history– Keep in mind the rules of thumbTreat based on the injury and also the patientMost knee injuries can be treated withoutsurgery– Need to rehabilitate the athlete

Why You Should Not Ignore a Knee Injury

Dr. Anurag Awasthi, Orthopedist
Sports injuries leading to knee pain and swelling are very common scenario among the young, active population. Most of such incidents happen while playing Soccer (Football), Tennis, Badminton, Dancing and even skating.We commonly see patients with twisting injuries presenting with sharp severe pain in the Knee, swelling of the knee, and difficulty in walking.First & foremost, we must never consider a knee injury as trivial one. Knee joint has multiple soft structures like meniscus and ligaments which get damaged due to injury. The most important aspect in the recovery is an early assessment by an Orthopedic doctor leading to diagnosis and early treatment.As a commoner, the first thing we need to do in case of a knee injury is to apply cold packs. There is a common myth to use hot packs even in case of injury, often leading to more pain and inflammation.Second important thing to do is to apply splintage. Knee immobilizer which block all knee movements are commonly available.Third, as soon as the patient stabilizes, take him/ her to an Orthopedic surgeon who deals with sports injury. An X ray may be required if a bony injury is suspected. But, in most cases, a normal x ray result leads to a conclusion for a normal knee; this error must be avoided at all costs. A comprehensive evaluation by an Orthopedic doctor will help him to assess for injury to meniscus or ligaments.We come across statements such as the x ray was clear, so we didn't take the injury seriously.Please understand that cases of ligament injuries or meniscus injuries cause much more problem at times, simply because they were overlooked or improperly diagnosed.MRI remains the gold standard test for diagnosis, and it should always be requested for if the doctor feels that there could be a ligament/ meniscus tear.Treatment for meniscus and ligament injuries can be done using minimally invasive techniques like Arthroscopy or key hole surgery; and results are excellent if treated within the right time frame.

6 Ways to Avoid Sports Injuries

Mr. Kaleem Mohammed, Physiotherapist
Most of us like to play some or the other sports. As long as we are injury free, it is always great fun, but sometimes sports injuries may take place, which can be a bummer!Sports injuries are commonly classified into trauma/acute injuries and overuse/stress injuries. The difference between the two is simple. Trauma injuries are due to a sudden twist or pull, or any other impact. Stress or overuse injuries occur when a part of our body is over-exercised without enough rest in between.Many lists describe the most common sports injuries in men. These lists have minor disagreements, but in general, they agree that the most frequent sports injuries are sprains (tearing of ligaments) and strains (over-stretching or tearing of muscles or tendons). Bruises or contusions are also a common result of trauma, but bruises rarely cause serious complications.Most common sports injuries include:BruisesKnee joint injuries: Pain, swelling, and stiffness ligaments or tendons injuriesAnkle sprain: Sprain, strains, fractures.Cuts and abrasionsDehydration: Excessive fluid loss causes heat exhaustion and heat stroke.Groin pull/strain: Symptoms include pain and swelling.Hamstring strain: Symptoms are a pain, swelling and bruising.Stress fractures: The impact of repeated jumps or running on hard surfaces can stress and break bones.Playing sports is much fun. Getting hurt is not.Follow these 6 steps to prevent injuries so you can stay in the game:1. Warm UpIt is not a good concept to just bolt on to the field and start playing. You should not even start stretching until you are a little warmed up. So take a light jog to get loosened up and ready to play. Increasing the heart rate and circulation; this loosens the joints and increases blood circulation to the muscles. Full-Body Stretch helps muscles to prepare them for physical activity and prevents injuries.2. Wear Protective GearProtective gears are anything you wear that helps keep you from injuries. The gear you use depends on the type of sports.The helmet is a most frequently used protective shield. It keeps you safe from head injuries when you are playing football, cricket, ice hockey, or baseball. Make sure you are wearing the right and comfortable helmet for your sport. Other sports require eye protection, mouth guards, pads, wrist, elbow, and knee guards, and a protective cup (for boys only). Moreover, don't forget your feet. Shin-guards are a must have gear for preventing trauma induced fractures in sports such as soccer and hockey.3. Proper healthy nutritionHealthy nutrition can enhance sporting performance because protein rich diet should provide enough protein to promote muscle mass growth and injury repair. Water is an excellent choice of fluid for athletes to help performance and prevent dehydration. Foods rich in unrefined carbohydrates, like whole grain bread and cereals, should form the basis of the diet.4. Early intervention and restMost of the sports injuries such as painful pulled muscle or sprains and strains are treated immediately with R.I.C.E. (rest, ice, compression, and elevation) protocol.Many sports physical therapists and athletes remember this short-form to help with sports injuries.Rest (minimizes motion and pressure over of the injured joint)Icing (apply an ice pack) to reduce pain and swelling and decrease blood flow to injured areaCompression (light pressure wrap to stop bleeding and swelling)Elevation (to drain the fluids from injured area to prevent swelling)5. Slow-fast-slow RhythmDuring physical activities, adding interval (slow-fast-slow) training into your exercise routine helps to improve your heart’s ability to beat at a high rate for prolonged periods. That is a real plus for your aerobic fitness. Moreover, oxygen is circulated in your body at a slower rate, so it increases your ability for a longer stay during workouts. The simple rule is that always warm up before any sports or exercise, and always cool down at the end by gently stretching your muscles and breathing out slowly.Further, when starting any weight bearing exercise after a while, always take precaution that you do not start off with a heavyweight, but a much lighter one that you can easily exercise with. Don’t worry if anyone is looking!If you manage to follow these simple five rules, you can easily avoid most types of sports injuries and continue to enjoy the sports you like.6. Do not over-stretch yourselfIt is critical to take part in physical activities, to listen to your body and know your physical limits. When you begin a new sport, begin steadily and slowly to avoid muscle pull. If you have not undertaken a strenuous exercise for some time, it is especially crucial to building up your endurance and strength gradually to avoid injury. It is essential when taking part in physical activities, to listen to your body and know your physical limits.

14 Tips for Avoiding Overuse Strain Injuries

Dr. Vishwas Virmani, Physiotherapist
Here are 14 tips for avoiding overuse strain injuries.Up to 50% of industrial injuries are thought to be attributed to cumulative trauma or overuse injury. These can range from troublesome annoyances, to severe debilitation. For office, building and site managers, there are a number of steps you can take to minimise repetitive strain injury within your workforce.1. Identify and correct postural problems The aim is to eliminate fixed positions which impose static loads on the muscles of the back, neck, shoulders and arms. Poor or improperly-adjusted equipment, furniture or layout is often to blame.2. Identify and eliminate forceful movements The worst are those which involve fingers, hands and wrists, especially with bending or twisting. Check tools, knobs, processes, postures. Do things fit? Is maintenance happening?3. Identify and break up periods of repetitive work The aim is physical variety; use rest pauses and alternated tasks. Consult staff before introducing job rotation.4. Ensure that any tell-tale early-warning signs are noticed and acted upon Supervisors and staff alike will require (a) Training Induction trainingProduction of training videosStrain prevention: training seminars5. Educate supervisors in the recognition and correction of faulty workplace set-out and procedures They should then be accountable for managing this.6. Train staff to recognise and adjust their own workstations properly The benefits of “ergonomic” furniture may otherwise be lost. Be sure to include thorough instruction for all new staff.7. Identify and control work peaks These can be daily, weekly or even annually; individual work loads need monitoring.8. Know which staff are most vulnerable to overuse strain New staff (how thorough is your induction?); those returning from leave; jerky or tense workers; staff using hands and fingers a lot.9. Identify and control sources of individual pressures These may be related to work output requirements, to ‘pacing’ by workmates, to supervisors’ attitudes – or even personal problems. Financial need may push vulnerable staff into harmful overtime. Bonus systems are bad.10. Educate managers, engineers and designers in preventive measures Once they know about ergonomics, they should be able to apply it quickly.11. Carefully-selected tasks matched to individual needs (eg., as specified by a treating doctor) are essential. Close supervision is necessary.13. Keep close to people who are off work sick Letting people know you care about their welfare and recovery will help them a great deal. Weekly phone contact at least; have people come in to collect their pay, and keep them close to their workgroup.14. Keep close to treating doctors Let them know you’re keen to help. Ask them to give specific advice to assist even a partial return-to-work. Invite them to visit you.

Know More About Various Knee Problems and Injuries

VAISHU
Most people have had a minor knee problem at one time or another. Most of the time our body movements do not cause problems, but it's not surprising that symptoms develop from everyday wear and tear, overuse, or injury. Knee problems and injuries most often occur during sports or recreational activities, work-related tasks, or home projects.Injuries:Anterior Cruciate Ligament (ACL) InjuriesThe anterior cruciate ligament is often injured during sports activities. Athletes who participate in high demand sports like soccer, football, and basketball are more likely to injure their anterior cruciate ligaments. Changing direction rapidly or landing from a jump incorrectly can tear the ACL. About half of all injuries to the anterior cruciate ligament occur along with damage to other structures in the knee, such as articular cartilage, meniscus, or other ligaments.Posterior Cruciate Ligament InjuriesThe posterior cruciate ligament is often injured from a blow to the front of the knee while the knee is bent. This often occurs in motor vehicle crashes and sports-related contact. Posterior cruciate ligament tears tend to be partial tears with the potential to heal on their own.Collateral Ligament InjuriesInjuries to the collateral ligaments are usually caused by a force that pushes the knee sideways. These are often contact injuries. Injuries to the MCL are usually caused by a direct blow to the outside of the knee, and are often sports-related. Blows to the inside of the knee that push the knee outwards may injure the lateral collateral ligament. Lateral collateral ligament tears occur less frequently than other knee injuries.Meniscal TearsSudden meniscal tears often happen during sports. Tears in the meniscus can occur when twisting, cutting, pivoting, or being tackled. Meniscal tears may also occur as a result of arthritis or ageing. Just an awkward twist when getting up from a chair may be enough to cause a tear, if the menisci have weakened with age.Tendon Tears(Tendonitis)The quadriceps and patella tendons can be stretched and torn. Although anyone can injure these tendons, tears are more common among middle-aged people who play running or jumping sports. Falls, direct force to the front of the knee, and landing awkwardly from a jump are common causes of knee tendon injuries.FracturesThe most common bone broken around the knee is the patella. The ends of the femur and tibia where they meet to form the knee joint can also be fractured. Many fractures around the knee are caused by high energy trauma, such as falls from significant heights and motor vehicle collisions.DislocationA dislocation occurs when the bones of the knee are out of place, either completely or partially. For example, the femur and tibia can be forced out of alignment, and the patella can also slip out of place. Dislocations can be caused by an abnormality in the structure of a person's knee. In people who have normal knee structure, dislocations are most often caused by high energy trauma, such as falls, motor vehicle crashes, and sports-related contact.Overuse Injuries includes:Inflammation of the small sacs of fluid that cushion and lubricate the knee (bursitis).Thickening or folding of the knee ligaments (plica syndrome).Pain in the front of the knee from overuse, injury, excess weight, or problems in the kneecap (patellofemoral pain syndrome).Irritation and inflammation of the band of fibrous tissue that runs down the outside of the thigh (iliotibial band syndrome).Osteoarthritis (degenerative joint disease) may cause knee pain that is worse in the morning and improves during the day. It often develops at the site of a previous injury.Osgood-Schlatter disease causes pain, swelling, and tenderness in the front of the knee below the kneecap. It is especially common in boys ages 11 to 15.A popliteal (or Baker's) cyst causes swelling in the back of the knee.       Infection in the skin (cellulitis), joint (infectious arthritis), bone (osteomyelitis), or bursa (septic bursitis) can cause pain and decreased knee movement.A problem elsewhere in the body, such as a pinched nerve or a problem in the hip, can sometimes cause knee pain.Osteochondritis dissecans causes pain and decreased movement when a piece of bone or cartilage or both inside the knee joint loses blood supply and dies.Treatments:-When you are first injured, the RICE method (rest, ice, gentle compression and elevation) can help speed your recovery. Treatment depends on the location, type, and severity of the injury as well as your age, health condition, and activity level.Nonsurgical TreatmentMany knee injuries can be treated with simple measures, such as:Immobilization. Your doctor may recommend a brace to prevent your knee from moving. If you have fractured a bone, a cast or brace may hold the bones in place while they heal. To further protect your knee, you may be given crutches to keep you from putting weight on your leg.Physical therapy. Specific exercises will restore function to your knee and strengthen the leg muscles that support it. (Cryotherapy, Ultrasound, IFT and knee exercises) * Taping if requiredNon-steroidal anti-inflammatory medicines. Drugs like aspirin and ibuprofen reduce pain and swelling.Surgical TreatmentMany fractures and injuries around the knee require surgery to fully restore function to your leg. In some cases - such as many ACL tears surgery can be done arthroscopically using miniature instruments and small incisions. Many injuries require open surgery with a larger incision that provides your surgeon with a more direct view and easier access to the injured structures.

6 Ways to Strengthen Your Knee

Dr Hardik Patel, Physiotherapist
1) ANKLE BAND DISTRACTIONSOne of the main functions of the ankle is to hinge, enabling the knee and hip to synergistically work together in creating movement. Stiff, rigid ankles are common, which can lead to injury and discomfort. Band distractions serve to “floss” stubborn joints. They can enhance range of motion, get nutrients into cartilage and alleviate pain. How To Do It:Loop one end of a band around a sturdy base and the other around your ankle. Drop into staggered stance, with the banded leg in front of the non banded leg. Inch out until you feel tension and then drive the knee forward as far as you comfortably can. Keep the banded foot firmly on the ground (not up on your tippy toes) Feel free to rotate the ankle side to side as you drive the knee back and forth. Repeat on both sides for 45 seconds each.2) ROLL OUT YOUR SHINSFoam rolling is a tremendous tool for soft tissue work. Fitness enthusiasts use it for their hips, lower back and other trouble zones that can get irritated with frequent use. But there is an area that I rarely see being attacked in my day to day gym-goings- The shins. Perhaps it’s because it’s a tougher group to really hit, or just an oversight because it typically doesn’t feel horrendous. But don’t simply blindly chase pain. Even if that area doesn’t hurt, it could be a big factor contributing to knee issues. In my experience (not 100% mind you) people who suffer from some degree of anterior knee pain feel a great deal of discomfort while trying this movement.  How To Do ItGet into a pushup position with a roller at the base of your ankles. Turn your toe in towards the midline of your body in order to expose the muscles of the shin and address them. Press your shins firmly down on the roller and gradually inch up towards your knee. You completely control the pressure in this movement. For more intensity really lay your body weight into the foam, for less ease back on the throttle. I like trying to move my foot up and down during the rolling and search for hot spots. 45 seconds to a minute on each leg should suffice and free up those important lower leg muscles.3) WALL QUAD STRETCHThe wall based quad stretch is a tremendous bang for your buck move that can be done just about anywhere. Got a wall? Good you can do this exercise.  The beauty in this stretch is that it hits the front of the foot, ankles, shins, quads and knees.How To Do ItGet up against the wall (facing away from the wall) in the bottom of a lunge position. Flip your back foot up against the wall with your toes on the actual surface of the wall. Your back knee is the axis point and really determines how much of a stretch you will get during this exercise. The closer the back knee is to the wall the more of a stretch there will be through the foot, ankle and quads. If you are looking to get a little adventurous and want to stretch the hip flexors out, focus on pushing the hips forward.4) HAMSTRING FLOSSINGThe muscles in the hamstring group (semitendinous, bicep femoris and semi membranosus) all cross the knee joint. Issues in any of these muscles can cause knee pain in the posterior (rear) portion of the knee and leg.How To Do ItGet a hold of a tennis or lacrosse ball and a sturdy box or ledge of about mid thigh height. Sit on the box and place the ball underneath the leg, firmly on the hamstrings. Extend and bend the knee while applying pressure to the muscle. Let the ball go up and down the back of the leg while you continue flexing and straightening the leg. One minute on each leg should have your hamstrings and knees feeling like gold.5) BAND TKEA classic rehab exercise, the Terminal Knee Extension serves as a great low impact quad activator. It can get blood flowing to the knee and quad to prepare your lower body for training.How To Do ItTake a exercise band and loop it around a sturdy base. Step into the band with one leg and place it just above the top of the knee. Walk out and get some tension in the band. From there bend and extend the knee, really focusing on straightening the knee completely and contracting the quad as hard as you can. Perform for 25 reps on each side and get ready to feel a ton of blood rush to that area.6) TFL DISTRACTIONThe TFL (Tensor Fasciae Latae) is a small muscle located at the side of your hip just below the crest of your pelvis. When tight and bound up this nasty little bugger can affect the knee by pulling through the IT band and causing pain on the outside of the knee.How To Do ItAgain, we will make use of the versatile exercise band. Loop one end to a stationary object and loop the other end right underneath your butt. Get into a kneeling position with the banded leg in the back and the other leg in front of you (envision a kneeling lunge). Keep your torso tall and turn the banded leg out (internally rotating the hip). When you rotate the leg out you are really able to appropriately address the TFL as it’s a difficult area to stretch.  Squeeze the glute on the banded leg side to really stretch the heck out of the TFL.Knee pain is no laughing matter and can rob the fun out of rewarding physical activities. Getting a thorough examination from a doctor or physical therapist is always recommended. But, if time or financial issues are a consideration then hopefully these exercises and stretches can serve as a way to alleviate some of the pain and get you squatting and lunging like a pro.

Sports Injuries In Young Athletes - An Overview

Dr. Senthilvelan.R, Orthopedist
The prevalence of injuries in young athletes is on the rise as more and more young children take upon more intense sports training. There are multi factorial reasons which contribute to overuse injuries in young athletes. Targeted interventions are necessary in prevention of these injuries.Children have numerous benefits when they stay active and physically fit by participating in sports, however there is concern regarding safety of intense sports participation of young athletes. Almost 1/3rd to 50 percent of injuries in this age group is as a result of overuse.Chronic overuse injuries are generally defined as injuries that occur because of increased levels of physiological stress without sufficient recovery time. A number of prevention strategies are available to prevent which target the athlete's neuro-muscular control mechanisms to reduce the likelihood of injury.Numbers of extrinsic risk factors are often implicated in over use injuries. These can occur in a number of scenarios. In the first scenario the athlete may attempt to rapidly increase training load after period of inactivity and this could result in stress fractures. In this situation the body does not have enough time to adapt to higher level of stress and is not adequately prepared to dissipate repetitive forces.A second scenario is when an athlete attempts to participate at a level that exceeds individual’s skill level. There could be potential mismatch between skill and fitness level to that of imposed physical demand and can potentially lead to injury.Coaches or PT masters at school should understand the physical fitness levels of children at school and design training in a  way to provide appropriate progression of training.Ways to prevent Overuse injuries:1. A young athlete needs to be assessed in regards to readiness of running and his/hers relative risk of running related injury. Determining the fitness level before running, length of running and prior running injuries and previous sports needs to be documented.2. Modifying training volumes for athletes who have recently undergone growth spurts are recommended to reduce stress on growing bones.3. Provision of individualized training programs taking into account their fitness level, and injuries._______________________________________________________________________________________

Head Injuries: Causes and Treatments

Dr. Apoorva Kumar, Spine Surgeon
Head injuries are dangerous. They can lead to permanent disability, mental impairment, and even death. To most people, head injuries are considered an acceptable risk when engaging in sports and other types of recreational activities. But there are steps you can take to lower the risk and protect yourself and your children.What Are Head Injuries?Head injuries are injuries to the scalp, skull, or brain caused by trauma. Concussions are the most common type of sports-related brain injury with an estimated 1.6 million to 3.8 million sports-related concussions a year. A concussion is a type of traumatic brain injury (TBI) that happens when the brain is jarred or shaken hard enough to bounce against the skull. This can happen when two athletes collide or when someone falls and hits his or her head. It can also result from being hit in the head with a piece of sporting equipment. In a sport such as soccer, even "heading" the ball can cause a concussion. A concussion causes an alteration of a person's mental status and can disrupt the normal functioning of the brain. Multiple concussions can have a long-lasting, cumulative life-changing effect.You don't have to be hit in the head to experience a concussion. An impact elsewhere on the body can create enough force to jar the brain. You also won't necessarily lose consciousness with a concussion. Concussions range from mild to severe. The effects may be apparent immediately, or they may not show up until hours or even days later.Other types of TBIs are a contusion, which is a bruise on the brain that can cause swelling, and a hematoma, which is bleeding in the brain that collects and forms a clot. A skull fracture is another type of head injury that can affect the brain. Sometimes with a fracture, pieces of bone can cut into the brain and cause bleeding and other types of injury.In 2008, the following activities resulted in the highest number of head injuries for all ages:CyclingFootballBasketballBaseball and softball,Riding powered recreational vehicles such as dune buggies, go-carts, and mini bikesAccording to the Brain Injury Association of America, the five leading activities responsible for concussions in children and adolescents aged 5 to 18 years of age are:CyclingFootballBasketballPlayground activitiesSoccerWhat Are the Signs and Symptoms of a Brain Injury?Signs of a TBI include:ConfusionDepressionDizziness or balance problemsDouble or fuzzy visionFeeling foggy or groggyFeeling sluggish or tiredHeadacheMemory lossNauseaSensitivity to light or noiseSleep disturbanceTrouble concentratingTrouble rememberingIndications that a head injury is more serious than a concussion and requires emergency treatment include:Changes in size of pupilsClear or bloody fluid draining from the nose, mouth, or earsConvulsionsDistorted facial featuresFacial bruisingFracture in the skull or faceImpaired hearing, smell, taste, or visionInability to move one or more limbsIrritabilityLightheadednessLoss of consciousnessLow breathing rateRestlessness, clumsiness, or lack of coordinationSevere headacheSlurred speech or blurred visionStiff neck or vomitingSudden worsening of symptoms after initial improvementSwelling at the site of the injuryPersistent vomitingOther important safety measures include:Wear light-reflecting clothes when riding a bike at night.Don't dive in water less than 12 feet deep or any body of water where you cannot see the bottom, murky water.Make sure that children's play areas and equipment are safe and in good repair.Don't let children play sports that are inappropriate for their age.Supervise and teach children how to properly use sports equipment.Don't wear clothing that interferes with vision.Follow all rules at water parks and swimming pools.Don't skateboard or cycle on uneven or unpaved surfaces.Don't play sports when you are tired or very ill.

5 Important Things to Prevent Sports Injuries

Dr. Shekhar Srivastav, Orthopedist
Sports is being taken up by more & more people especially young ones as hobby & profession. With Gyms & fitness centres mushrooming across the country, there is a rush among general population to train hard becoming physically fit. Being fit definitely increases the productivity & also makes the person feel good about themselves. But this has also seen a spurt in sports related injuries in these group of people. Most common cause of injuries are due to overuse. These can be avoided if certain simple rules are followed.You cannot become fit overnight by starting exercises and pushing your body beyond its limit to get quick results. Most athletes & sports persons have years of training & hard work behind them to reach this level. Increase the intensity & duration of your exercises gradually in a phased manner to get desired result.Warm-up- Proper warm-up before starting any sports is essential to prevent injury. Warm-up increases the blood flow to the muscles, stretches muscles, increases flexibility to prevent injuries.Strengthening- Strengthening of required muscles is essential for balance & power during the sporting activity. Weak muscles may increase the stress on other parts of the body leading to problems.Stretching- Stiff joints are more prone to injuries during sports. Stretching of ligaments & tendons & flexibility of joints can prevent that.Rest- Rest is very important to allow the tissues to repair & recover. One should always have a rest day in a week in your training schedule to allow your tissues to heal.