Link - Good Health Pharmacy

It’s that time of the year again when South Africa’s big marathons and cycle races are coming up. Athletes are busy with their training programmes and getting their bodies and minds ready for competition. The threat of injury looms large. We asked Gauteng-based sports physiotherapist, Gary Sobel about these injuries and how to treat them.

Q What is a sports injury?

A sports injury is sustained while practicing or competing in a sport, and generally stops the athlete from participating in the sport. There are two main types of injuries:

• Extrinsic injuries – caused by factors outside of the body and seen in sports such a soccer and rugby.
• Intrinsic injuries – caused by factors within the body. These are seen in sports such as cycling and running. Intrinsic injuries have two main causes – incorrect biomechanics (or body ‘wheel alignment’), or overuse injuries which occur when the athlete tries to do too much too soon.

Q What is the main avenue of treatment?

One needs to identify the cause of the injury and correct the problem to prevent a recurrence. Once this is done you can attend to the actual injury and assist in the healing process. The final stage would be to advise on a controlled return to sport.

If symptoms do not settle after these ‘self help’ methods, or if the grade of injury increases (see table opposite), professional treatment must be sought. The first step is to consult your doctor or physiotherapist who should be able to diagnose and treat the injury. He or she will refer you to an orthopaedic surgeon or podiatrist for orthotics (inserts in the running/cycling shoes), should that be necessary.

Q Can they be prevented?

Yes, there are two ways to prevent sports injuries in running and cycling. The first is to have a biomechanical assessment of the athlete completed to determine whether they have the correct ‘wheel alignment’. In runners, this would include correct shoes and in cyclists this would include a correct ‘setup’ on the bicycle, including saddle height and bike frame size. Secondly, the athlete’s training programme should be assessed to determine the correct programme so as not to overdo the training –
preventing the ‘doing too much too soon’ scenario.

Common Injuries

Achilles tendonitis

Achilles tendonitis is a painful inflammation of the Achilles tendon, the body’s strongest and largest tendon, that connects the muscles of the leg to the foot.

Pain may be gradual, worsening over a few days, or it may begin at the start of exercise and fade. This is an overuse injury and may be sparked by an increase in activity (distance, speed or hills) or a change in footwear.

The pain may decreases with rest and cold therapy. See your doctor or physiotherapist if things don’t improve over a few days. You may need some antiinflammatory medication from your doctor, or massage or ultrasound treatments from your physiotherapist to assist in the recovery.

Ankle sprains

Ankle sprains occur when the ankle twists downwards, causing damage to soft tissue and ligaments. It may also be caused by a biomechanical condition. The twisting motion can lead to small tears in the ligament which, as a result, becomes weak. Symptoms include mild to moderate pain, swelling and possible bruising.

Apply an ice pack to the ankle right away, then see your doctor. You may be sent for x-rays before any diagnosis is made. Your doctor will prescribe the necessary treatment, which may include rest, ice, compression and elevation. Recovery time will depend on the severity of the injury. You may be referred to a podiatrist for an ‘in-sole’ to prevent a recurrence of the injury.

Runners knee or Iliotibial band friction syndrome (ITBS)

Runners knee or Iliotibial band friction syndrome (ITBS) is an irritation of the IT band. This is a band of tough connective tissue that runs down the outside of the leg from the gluteal muscles (buttock) and the tensor fascia lata muscle and attaches to the shin below the knee. It acts as a stabilizer for the leg but may become irritated with overuse.

Pain usually presents on the outside of the knee with tightness on the IT band. It is usually aggravated by further exercise and can be particularly sore when the knee is flexed or extended.

Treatment consists of rest, cold packs and massages to the area. You should also see a sports injury specialist to address any biomechanical or training errors.

Shin splints

Shin splints refers to any pain in the front part of the lower leg, often along the front or inside of the shin bone. An exact cause isn’t known but it is thought to be an inflammation of the protective sheath that surrounds the tibia (shin bone, the bone that runs down the front of the lower leg). Symptoms include initial pain at the start of exercise that eases slightly as the work-out process, but later returns. Occasionally small lumps may be felt over the shin bone and there may be swelling and redness.

See your doctor or sports injury specialist who will diagnose the injury and treat the pain and inflammation. He or she will also determine training and biomechanical problems that may be related. Without this assessment the injury often returns once training resumes. A gradual return to training, under the guidance of a professional, is advised.

Stress fractures

Stress fractures are small cracks in a bone, usually occurring in the weight-bearing bones of the lower leg and foot, like the heel and the fibula. The repetitive motion of the foot striking hard ground may result in a stress fracture. Stress fractures are an overuse injury.

Muscles become tired and aren’t able to correctly reduce the shock of impact and the stress is transferred to the bone. Pain may be mild to severe and the area could present with swelling and bruising. If you suspect a stress fracture, see your doctor for further treatment. These tiny cracks are difficult to see on x-ray, so you may be sent for a MRI or bone scan to detect the fracture. Rest is essential for recovery.

By Gina Hartoog. Information sourced from: Gary Sobel, physiotherapist, Tel: (011) 647-3570 , E-mail: .(JavaScript must be enabled to view this email address), www.sportsinjuryclinic.net, www.orthoinfo. aaos.org

Sports First Aid Kit

A well-stocked first aid kit is essential. You may not be able to take it on your run or cycle race, but it should be easily accessible. If you do run or cycle for long distances on your own, especially during training, consider a runner’s utility belt for a few basic supplies. A kit for cyclist is essential and easy to take with you on the bike.

Use this as a shopping list when creating or restocking your first aid kit.

• Sunblock
• Adhesive tape
• Plasters
• Adhesive bandages
• Cotton
• Roll of gauze
• Gauze pads
• Antibiotic ointment
• Antihistamine ointment
• Scissors
• Thermometer
• Tweezers
• Appropriate pain killers (paracetamol, ibuprofen, aspirin)
• Latex gloves
• Burn pads
• Instant chemical ice pack

Extras for the runner:

• Vaseline for chafing

Extras for the cyclist:

• Constricting bandage
• Heating pad or hot water bottle
• Triangular bandage (for a sling)