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Justin Shaginaw, MPT, ATC, Aria 3B Orthopaedic Institute, Athletic Trainer - US Soccer Federation
POSTED: MONDAY, JANUARY 27, 2014, 9:41 AM A 2009 study by Wolf et al in the American Journal of Sports Medicine looked at injury rates for the men’s and women’s swim teams at the University of Iowa from 2002-2007. There were 90 injuries sustained by 32 of 44 male swimmers (72.7%), while 76 injuries occurred in 35 of 50 female swimmers (70.0%). The average number of exposures per year was estimated at 4526 for men and 4651 for women with an injury rate of 4.00 per 1000 athletic exposures (AE) for men and 3.78 per 1000 AE for women. There was no significant difference in injury risk between male and female swimmers and the proportion of injuries that resulted in missed time also was similar between genders. The shoulder and upper arm accounted for 31% of male swimmer injuries and 36% for female swimmers. Back and neck injuries were the second most injured area. There was no statistically significant relationship between body part injured and the likelihood of missing time. Freshman athletes suffered the highest number of total injuries and highest average number of injuries per athlete for both women’s and men’s teams. The risk of injury was not significantly different between sprinters and distance swimmers. Non-freestyle swimmers showed a 33% greater risk of injury than swimmers primarily specializing in freestyle. There was no significant association between stroke specialty and time missed and no clear association between stroke specialty and body region injured. Practice represented 55.6 and 60.5 percent, respectively, of men’s and women’s injuries with strength training showing the second highest rate of injury.
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 Philly Sports Doc
Justin Shaginaw, MPT, ATC, Aria 3B Orthopaedic Institute, Athletic Trainer - US Soccer Federation POSTED: MONDAY, JANUARY 27, 2014, 9:40 AM My last blog was about basketball injuries. Let’s dive into the pool and talk about common swimming injuries. Swimming Mechanics Poor swimming mechanics may be a contributing factor in many swimming injuries. But assessing these mechanics is beyond the expertise of most sports medicine. Your swimming stroke should be assessed by your coach, taking into account your specific injury, in order to eliminate an underlying biomechanical cause. A team approach should be taken with swimming injuries incorporating these stroke changes along with a specific rehabilitation program from your athletic trainer or sports medicine provider. Shoulder/Upper Arm Shoulder/upper arm injuries are the most common body area injured in swimming. These injuries can generally be categorized into two causes: flexibility and strength issues. From a flexibility stand point, shoulder injuries are usually from being too loose (hypermobile) or too tight (hypomobile). Hypermobility allows the shoulder ball to subtly move around in socket where hypomobility stresses shoulder structures due to lack of flexibility. Strength issues are usually seen as problems with scapular (shoulder blade) positioning and stability. Shoulder injuries should be thoroughly evaluated by your team’s athletic trainer or a sports medicine specialist to assess the underlying cause of the problem and develop an appropriate treatment plan which may include time out of the pool, rehabilitation, medications, injection, and even surgery when indicated. Common diagnoses include rotator cuff tendonitis/impingement, biceps tendonitis, rotator cuff tear, and labral tear. Spine Neck and back injuries are the second most common behind the shoulder. Swimming puts significant stress on the spine, specifically rotational stress on the cervical and thoracic spine. Common diagnoses include sprain/strain, spondylolysis, and disc derangement (bulge, herniation, etc). As with the shoulder, these injuries should be evaluated thoroughly by your team’s athletic trainer or a sports medicine specialist to assess the problem and develop an appropriate treatment plan which usually includes time out of the pool, rehabilitation, and medication. Lower Extremity Hip pain is an uncommon problem in swimming and is more frequently associated with the breast stroke due to the rotational motion of the kick. Some common diagnoses for hip pain in swimmers include sprain/strain, femoral acetabular impingement, and labral injuries. As with the shoulder, these injuries can generally be categorized into two causes: flexibility (hyper or hypomobility) and strength issues. Your team’s athletic trainer should assess the injury and either provide an appropriate rehabilitation program or refer the athlete to a sports medicine physician for further evaluation and treatment options. Patellofemoral pain is another uncommon problem in swimming. It is also known as anterior knee pain or chondromalacia and its main symptom is pain behind the knee cap. More common in females than males, patellofemoral pain is usually the result of overuse from the kicking motion involved in swimming. The first line of treatment is an evaluation by your team’s athletic trainer to put together an appropriate rehabilitation program including lower extremity stretching and strengthening. It may also require some time out of the water to allow the symptoms to subside. Patellofemoral pain from swimming is of a different etiology than weight-bearing sports where the underlying problem is a biomechanical/kinetic chain dysfunction. Elbow/Wrist/Hand Hand and wrist injuries are relatively uncommon in swimming. They include finger sprains/fractures from contact with the wall and overuse injuries of the elbow and wrist such as sprains/strains and tendonitis. Finger injuries should be evaluated by your athletic trainer and referred to a sports medicine physician if a fracture is suspected. Overuse injuries are usually the result of overtraining or poor swimming mechanics. These injuries should also be evaluated by your athletic trainer. Treatment may include time out of the pool, rehabilitation, and referral to a sports medicine specialist if indicated. As you can see, upper extremity injuries account for the majority of swimming injuries. Many of these are minor and can be managed conservatively with a quick return to sports. The above treatment recommendations are just a guideline and any injury should be evaluated by your team’s athletic trainer or a sports medicine physician to accurately diagnose the injury and provide appropriate care. Swimming injury prevention brochure from the STOP (Sports Trauma and Overuse Prevention) Sports Injuries program: Philly.com Sports Doc
Justin Shaginaw, MPT, ATC, Aria 3B Orthopaedic Institute, Athletic Trainer - US Soccer Federation Robert Senior, Sports Doc blog Editor POSTED: MONDAY, JANUARY 13, 2014, 6:00 AM A 2008 study by Borowski et al in the American Journal of Sports Medicine looked at high school basketball injury rates using the online reporting from 100 high schools for the 2005-06 and 2006-07 seasons. They found that high school basketball players sustained 1.94 injuries per 1,000 athlete exposures (AE). Injuries were more common in games versus practices (3.27 game injuries vs. 1.40 practice injuries). Most Common Injuries (percentages are the respective portion of all injuries observed):
Girls sustained more injuries (2.08 per 1,000 AE) versus boys (1.83 per 1,000 AE). Girls accounted for more concussions and knee injuries, while boys sustained more fractures and contusions. For college basketball, two articles published in the Journal of Athletic Training in 2007 (Agel et al and Dick et al) looked at the NCAA injury data from the 1988-89 through 2003-04 seasons. Lower extremity injuries accounted for more than half of all game and practice injuries with rates two times higher in games than practice. Male injuries were 9.9 per 1000 AE during games and 4.3 per 1,000 AE during practice vs. 6.75 and 2.84 for females. Regarding ACL injuries in college basketball, women showed a 3.5 times greater incidence than men. Common Game Injuries:
 Philly.com Sports Doc
Justin Shaginaw, MPT, ATC, Aria 3B Orthopaedic Institute, Athletic Trainer - US Soccer Federation Robert Senior, Sports Doc blog Editor Posted: Monday, January 13, 2014, 6:00 AM The winter sports season is in full swing. In gyms everywhere the squeak of basketball shoes on the court can be heard. Along with the layups and 3 pointers, there are common injuries that occur. Let’s talk about some of these common basketball injuries and the appropriate treatment. Ankle Sprains This is the most common injury in basketball, accounting for 24.6 percent of women’s game injuries and 26.2 percent for men. It occurs when the foot rolls inward spraining the ligaments on the outside of the ankle. Swelling and bruising often occur with the severity of the injury dictating the athlete’s ability to return to play. Mild ankle sprains can return fairly quickly, sometimes even in the same game with taping or a brace. More serve injuries can take weeks to months to recover. Immediate treatment involves immobilization and ice followed by range of motion, strengthening, and balance/proprioceptive exercises. For athletes that cannot bear weight on their foot, they should be put on crutches and see a physician to rule out a fracture as well as assess the extent of the injury. For prevention, taping and bracing has been shown to reduce the rate of ankle injuries in sports. Stress Injuries Stress injuries (shin splints, stress fracture, etc) are another common basketball injury, usually seen during preseason as athletes transition from softer outdoor fields in fall sports to the hard indoor courts. Initially, symptoms are only with activity. As the problem worsens, pain can occur with walking and even at rest. If not addressed early, it can lead to a stress fracture requiring the patient to stop sports for a prolonged period of time. The common locations of these injuries are the tibia, medial malleolus, fifth metatarsal, and navicular. Initial treatment involves decreasing impact activities until symptoms resolve and assessing the athlete’s feet for appropriate shoes and possibly supportive inserts. It’s also a good idea to progress practice intensity gradually to allow players to acclimate to the new playing surface. Players that do not respond to conservative measures should be seen by a sports medicine physician for further evaluation. ACL/Meniscus Knee injuries are the second most common injury in basketball, with ACL injuries being more common in female players. Both meniscal tears and ACL injuries are caused by deceleration and pivoting on a planted foot. The common signs of an internal knee injury include swelling and a feeling of a “pop” or “catching and locking.” Immediate treatment should include ice and crutches if the athlete cannot walk normally followed by a referral to a sports medicine doctor to diagnose the injury. Research has shown that ACL prevention programs have been effective in reducing the incidence of injury. Some well-known programs are the PEP program (http://smsmf.org/smsf-programs/pep-program), Sportsmetrics (http://sportsmetrics.org/), and the FIFA 11+ program (http://f-marc.com/11plus/home/) . Although some of these are sports specific, they can be easily modified for basketball. Patellar Tendinopathy Commonly known as patellar tendonitis or jumper’s knee, this injury presents as pain and tenderness of the patellar tendon. The mechanism of injury is believed to be due to repetitive strain to the tendon from jumping, cutting, and deceleration activities involved in basketball. Treatment includes limiting activity until symptoms improve, as well as ice, quad stretching, eccentric quadriceps exercises, and soft tissue treatments. Patellar tendon straps can also be beneficial. In more chronic cases, medications, injection therapies, and surgery are other options. In younger patients whose growth plates are not closed, usually under 15, Osgood-Schlatter syndrome is more common. This is an injury to the attachment of the patellar tendon to the tibia. The tendon actually pulls away from the bone causing a boney protuberance that can become painful and tender. The treatment for Osgood-Schlatter syndrome is rest and ice as it is almost always self-limiting. Hand Injuries Finger injuries are fairly common in basketball and occur when players “jam” their fingers on the ball. The injuries are usually simple sprains that can be treated symptomatically with ice and buddy taping. Occasionally these injuries can be more serious such a fracture and tendon rupture. If the player’s finger looks deformed or if they are unable to move it, they should be evaluated by a sports medicine physician to accurately diagnose the injury. Upper Extremity Shoulder injuries are relatively rare in basketball with the most common being dislocations and labral tears. These injuries usually occur when a player is blocked during a shot forcing the arm backwards. For a dislocation, urgent treatment should be sought from the team’s athletic trainer and a physician if necessary. Labral tears should be considered for players with chronic shoulder pain with overhead activities such as shooting, and an appointment with a sports medicine physician should be schedule to accurately diagnose the injury. The other upper extremity injury seen in basketball is a fracture. These usually occur from falling on an outstretched arm. As with dislocations, the player should be evaluated by the team’s athletic trainer and referred to a physician for urgent care. As you can see, lower extremity injuries account for the majority of basketball injuries. Many of these are minor and can be managed conservatively with a quick return to sports. With more serious injuries such as ligament/tendon ruptures and fractures, urgent care by a sports medicine physician is advised. The above treatment recommendations are just a guideline and any injury should be evaluated by your team’s athletic trainer or a sports medicine physician to accurately diagnose the injury and provide appropriate care. |
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