23 June 2009
The most common sports injuries are sprains and strains. A sprain is a tear in a ligament (a tough fibrous cord that connects a bone to another bone) caused by sudden, forceful twisting of a joint. Meanwhile, a strain occurs when a muscle or tendon (a sinewy tissue that connects muscle to bone) is overstretched or torn.
These injuries can cause varying degrees of pain and swelling. If a sprain is not allowed to heal properly, the injury may recur or worsen. On the other hand, if a strain is not allowed to heal properly, or if scar tissue forms, the affected muscle or tendon can remain weak or painful.
Ankle joint and knee injuries
The ankle is an important joint involved in weight bearing lower limb activities. Interestingly, this joint can transmit forces up to five times the body weight. However, accidents can often occur due to a lack of joint stability as the ankle joint lacks support.
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| Ankle: mild sprains occur when ligaments are stretched or slightly torn. |
Ankle: moderate sprains occur when ligaments are partially torn. |
Ankle: severe sprains occur when ligaments are completely torn. |
The most common ankle sprain is the Lateral Ligament Sprain – the sole of the foot turns downwards and inwards, injuring the ligaments in the outer part of the ankle resulting in a painful swelling. Neglect of the injury may lead to weakening of adjacent muscles and instability, which predisposes to recurrence and chronic instability.
The Anterior Cruciate Ligament (ACL) is an important structure that holds the bones of the knee and provides stability. Often, rupture of the ACL can occur due to sudden change in direction while running. A sudden forceful loading of the joint with twisting may result in a painful large swollen knee due to bleeding in the joint from the ruptured ACL. This injury requires prompt medical attention by a doctor and a possible referral for surgery.
With proper care (R.I.C.E.D, medication, rehabilitation exercises and bracing), most ankle and knee sprains and strains heal completely without problems after completion of a course of rehabilitation exercises.
Hamstring and calf muscle strains
Muscles and tendons have an inherent elasticity and strength that allows them to be stretched while giving rise to powerful movement. However, if they are subjected to unaccustomed and sudden forceful loading, they overstretch and undergo partial or complete tears (strain).
Without adequate warm-up and proper training, the hamstring and calf muscles in the back of the leg may be strained during sprints or jumps. This result in pain, swelling, bruising and possible accumulation of blood in the muscle.
Apply R.I.C.E.D treatment and seek medical attention immediately to assess the extent of injury, and whether further treatment is needed. A course of supervised exercise therapy is usually required before resuming normal activities. Inadequate treatment may result in stiffening and weakening of musculature, and persistent pain.
Elbow Pain
Tennis elbow refers to the degenerative changes of the tendons and muscles attached to the bony knob (lateral epicondyle) on the outer side of the elbow joint. These muscles and tendons assist in wrist extension, hand gripping, and turning your palm upwards.
 Playing a racket sport, or performing repetitive tasks that involves extending your wrist or rotating your forearm (eg, twisting a screwdriver, lifting heavy objects with your palm down, scrubbing) can cause tennis elbow.
The golfer's elbow occurs when the tendons and muscles attached to the bony knob of the inner part of the elbow joint (medial epicondyle) undergoes degenerative changes.
 Any movement that flexes the wrist can cause this problem (eg, in a golf swing, bowling, throwing).
| First-aid treatment* - "R.I.C.E.D" |
| Rest |
Stop the activity that's causing you pain. |
| Ice |
Apply crushed ice or ice cubes wrapped in a damp towel to the injury for 15-20 minutes immediately after the injury. Repeat once every 4 hours over the next 2 days. Cold reduces the pain, bleeding and swelling of injury site. |
| Compression |
A firmly applied elastic bandage will also reduce pain, bleeding and swelling, as well as provide support to the injured part. If there is any numbness or tingling in the fingers or toes, loosen the bandage. |
| Elevation |
Raise the injured body part by resting it on a chair or a cushion. This will help reduce bleeding and drain the swelling. |
| Diagnosis |
Consult your doctor if there is severe pain, swelling or deformity (suspect fracture) or if symptoms worsen or are unchanged after 2 days. In addition to the sprain/strain treatment and exercise rehabilitation, further evaluation may be necessary to rule out fracture or a more severe injury. |
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*Not for open wounds
Pain relief and rehabilitation
Prompt and appropriate action should be taken to protect the injury and promote recovery. Avoid heat, alcohol, running (or any exercise) and massage for the first 72 hours.
Over-the-counter medication can be used to treat mild to moderate pain. Your doctor may also prescribe stronger analgesics or anti-inflammatory drugs for more severe pain and swelling. Be aware that some of these medications may not be suitable if you are suffering from gastric pains, high blood pressure, heart disease and allergies.
Once your pain and swelling has subsided, rehabilitation guided by a doctor or physiotherapist may be needed to gain full recovery. This may include exercises:
- To restore normal movement and flexibility
- To improve strength and power
- To restore coordination and control
- To maintain overall fitness/healthy body weight
- To learn sports specific skills and movements
It is important to ensure you are assessed physically and fully recovered before resuming sporting activities.
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