Ass. dr sci med Vladan Stevanović – orthopedic specialist with traumatology appeared on TV Zdravlje on “Bolje sprečiti” and the topic of discussion was sports injuries.
Sports injury statistics in sport traumatology
I have to admit sports injuries are more and more present. A large number of young people opt for sports activities at a very young age, which is very good in terms of their health and development. However, the demands of parents, coaches and the children are increasing and thus sports injuries are becoming more common. The popularity of professional sports brings an increasing number of activities, and in order to achieve this level, a great deal of commitment, and hard work are required, and this of course leads to a disproportionate number of injuries compared to previous period when sports activity was in schools only in physical education.
Risk factors that cause injuries
Risk factors are related to the type of sport, age, and the manner and intensity with which the exercises are performed. There are more and more contact sports in our area. An interesting occurrence is sports where we have MMA fighters, Crossfit, then a lot of extreme activities carried out by people of all ages. So the type of sports activity is number one as a risk factor. Elsewhere are the anatomical predispositions for some sports, the age at which sports activities are conducted, how educated is the one who conducts sports activities, in order to instruct our fellow citizens to properly conduct sports activities. Not just owning a sport equipment, gym or club is enough to carry out any sporting activity. Some education at all levels is required.
Everything is easily accessible today for young people, they can watch a series of clips on Youtube or in the newspaper for ideas and tips on how to perform exercises, what to do. Then most of them, when everything is easily accessible, decides to achieve some results on their own without the proper advice of experts and preparation. Now is the summer, many people want to make quick “adjustments” for their body which unfortunately causes serious injuries.
We do not have fast solutions, it is evident. We, who have been dealing with it, have been educated for decades to reach some level of consideration of the patient’s issues, prevention and treatment for such injuries. People who practice sports themselves, or anyone who wants to bring exercise to high level must do it the right way.
Everything is available to us today, and we also have a variety of sports, not only recreational but competitive and even some previously unknown sports that are Olympic sports today, which brings us a wide range of activities. Also, we have a great media influence on people. The impact of the media, however positive it may be, can also be negative in the broadcasts of these sports and extreme activities leading to more sports injuries.
Type of sport injuries
Sports injuries are related to practicing sport, but today we have a lot of seasonal injuries. There are more and more people who go skiing during the winter months and each year we have double the number of injuries that occur in winter sports. These injuries are not harmless and are most commonly include wrist, knee, hip and severe fractures that require surgical treatment and multiple immobilizations that result in absence from daily activities and work. During the summer and throughout the year, tennis is always present, which is good on the one hand because it is well accepted as a sport. On the other hand, we again have factors that influence injury, how much we are in training, in what way, what kind of tennis rackets, etc., which often results in injuries in the area of the wrist, elbow, shoulder, ankle. We also have football all year long, played by young people at school and recreationally in balloons on various grounds, resulting in various injuries. The second category is the elderly who after work go to recreation which results in injury to the Achilles tendon, knees with injuries of the ligaments as well as fractures of both upper and lower extremities.
Periodic exercise, when you go for a run on a hard surface with no continuity or precognition, is a common case of injury
Most of this happens when you go from car to activity, without a pre-program of warming up, entering training, training appropriately and on adequate surfaces, stretching. It is not easy in this fast life and work but there are many centers and experts you can always turn to.
Who has more gender-specific injuries?
There used to be a bit of a male predominance, however, today we have equally represented genders in sports. A lot of girls play football today, handball, volleyball, so there are a lot of ladies who end up in operating rooms. There are no more male dominated sports, I would say that the prevalence of gender injuries is 50-50.
What is the first aid when an injury occurs?
We use English terminology here: rais – as rest, rest, ice – set ice, see – as compression and set fixation bend and e-elevation and lifting extremities. This is something that can be done in the field with lower extremity injuries until you get to a medical facility. One such facility is Atlas Hospital, which adequately takes care all types of sports injuries, whether operationally or otherwise.
What is used in sports injury diagnostics?
The way in which a patient was injured means a lot to us, a description of how a particular joint was injured in which sports activity, whether there was a steady foot, was there a change of direction, was there contact with another person, was there anything heard about the injury, when it began to swell ..Then we can already have an opinion on what the injury is. To adequately confirm this, we often include X ray imaging as more serious bone injuries need to be ruled out. Soft tissue injuries can also be analyzed by ultrasound, but after clinical examination we sometimes achieve complete diagnostics with magnetic resonance imagining.
Can there be an injury that can be seen clearly later, when everything cools down and then we see that it is necessary to see a doctor
The initial injury leads to certain defense mechanisms of the organism itself, with the production of more adrenaline and corticosteroids to protect the body itself and the pain receptors behave differently in such situations. Some injuries are also manifested in the later period, whether they are bone injuries or soft tissue injuries. Often, some fractures with minimal pain can be seen only after a few weeks and give characteristics that can be seen on the x-ray. Some fractures are also not immediately visible but can be diagnosed in the coming weeks. Until the stress factor and swelling go away, then we can only clinically diagnose certain injuries. Patients thus generally comes with injuries of the ankle, knee, elbow, or shoulder, where initially they generally believe that no major injury has occurred and it is later determined that the injury is serious and requires serious treatment.
How are injuries treated when surgery is required?
It is a multy-layered question and it also requires such an answer. Therefore, it is also good for patients to consult a professional at the time of the injury in order to receive an adequate response. There are a number of factors that influence whether an operation will be performed. Of course, certain injuries involving bone fractures and something that cannot be resolved otherwise will be surgically put into one group. Soft tissue injuries, a feeling of instability, and blockage in the joints resulting from injury to structures like the meniscus or ligaments in the joints are something that we, as professionals, and in agreement with the patient, need to have an agreement. What is the type of intervention they need, of course using magnetic resonance imaging as a diagnostic tool. If the problems are of such a degree that they limit life or work activities and it is confirmed that this is a soft tissue injury that cannot be resolved otherwise, then we treat it surgically. You often hear about cross ligament injuries in athletes, basketball players, handball players, soccer players and these are categories of patients who do not have too many choices because their careers depend on their joints and they are candidates for surgical treatment. These are most commonly candidates for ligament reconstruction, suture or meniscus removal, for resolution of shoulder or elbow instability by various techniques. Recreationalist are in a different category than athletes. With knee injuries that commonly affect meniscus or ligaments, we generally tell them that if they want to continue at the same pace, surgical treatment is considered if physical therapy has not helped them before.
How long does it take to repair injuries?
In meniscus injuries that require the repair, suturing, recovery takes up to three months. Cross ligament injuries with reconstruction require at least one six to nine months of different levels of rehabilitation. We are talking here about the date of return to the activity. Of course, patients are capable of many things very soon after surgery. With guided rehabilitation, a progressive increase in mobility, relief from crutches, or immobilization at the shoulders, but daily life activities take about a month. After all the upgrades, it takes three to nine months to return to the field, depending on the injury. Back to what activities they had before they got hurt.
Do you have to change your lifestyle, diet, rest, or have any other advice?
No, on the contrary, it is mainly towards improving the quality of life. After those first months that are more restrictive in any surgical option, each subsequent month brings them to behave as normally as possible, but of course without the activities and sports that led to that injury.
Is special caution advised for the injured part of body?
There is another factor here, one psychological fence after a previous injury. To be precise, knowing that what they went through after the injury, surgery, therapy and recovery, the patients themselves already implement certain restrictions when engaging in sports activities, despite being capable of engaging in those activities. It takes a long time for the patient, both mentally and psychologically, to return to the pre-traumatic state. There are also a number of commercial products, orthoses and corsets that can also help make patients feel better. Surely 70-80% of them return to a form identical to that which was before the injury both mentally and physically.
What is certainly important is that when it comes to sports activities we first of all need to be well informed, to be well warmed up, to perform training properly and to qualitatively stretch in the end of the training. We live at a fast pace, we would all have more to achieve in as little time as possible. The main advice is to be moderate in the type of activity and listen to your body. Each joint and muscle will limit to each person what is realistically possible for them if they listen to their body well. Moderate exercise and upgrading with training, and therefore it is easier for us to treat such injuries.