Sports Injuries and Trauma

Ankle fractures are common in contact sports, when a severe twisting motion occurs in the ankle to break the bones along with jumping or landing incorrectly. Instant pain is felt from the fracture and significant swelling and bruising occurs almost instantly.

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The ankle joint is supported by many ligaments on both sides that attach the foot and ankle to the leg. The cause of an ankle sprain is usually from a twisting motion or incorrect placement of the foot when playing sports, e.g. running or jumping. The ankle rolls either inward or outwardly and the ligaments supporting the ankle are stretched and/or torn.

Symptoms include immediate pain, inability to weight bear and a popping or tearing sensation. In some severe cases, small pieces of bone can be torn off with the ligament or bones are dislocated and fractured. Some patients are at risk of having an unstable ankle joint from repetitive sprains.

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Stress Fractures are small cracks in the bone of the foot or ankle and are usually caused by overuse. Women are more at risk then men due to contributing factors such as osteoporosis or low oestrogen production which aids bone heeling. Risk factors contributing to stress fracture are;

• Increase in training
• High impact sports which are performed on hard surfaces e.g. tennis, football, running.
• Incorrect footwear or poor foot positioning when performing the sport.
• Osteoporosis or hormone imbalance that contributes to poor bone strengthening.

Most bones in the foot and ankle can be affected and symptoms are usually pain in the affected area when training or playing sports.

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The Knee has many supporting ligaments surrounding the joint that is important for movement and is at risk of injury when playing sports. Injuries can occur to the many ligaments including:

• Anterior Cruciate Ligament (ACL)
• Posterior Cruciate Ligament (PCL)
• Medial Collateral Ligament (MCL)
• Lateral Collateral Ligament (LCL)
• Multiple Ligament Injury

Twisting, jumping, leg rotation using poor techniques or where contact is made can cause partial or full thickness tears in the surrounding ligaments. Depending on the movement when the injury occurred will signify the location of the ligament injury.

Symptoms range from a noise heard from the knee when injured, pain, inability to weight bear and instability in the joint, swelling and bruising. Consultation, X-rays and MRI will also be needed for a diagnosis.

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The Meniscus is a cartilage layer like shock absorber in the middle of the knee joint between the heads of the femur and tibia. Tears can occur during sport where a jumping action or sudden change of direction, knee twists. The older generation can also suffer from Meniscal Tears due to degeneration of the cartilage and an accident or fall can contribute to further injury.

Symptoms include immediate pain from injury, swelling and the knee may lock due to the torn meniscus blocking flexion of the joint. Diagnosis includes consultation and MRI scan.

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A Disc Herniation (Slipped  Disc) occurs when the inner part of the disc herniates through a split in the outer surface. Most disc herniations occur in the lumbar area, the lower part of the back.

The cause of a slipped disc can be from a lifting or twisting injury, high impact sports or degenerative disease. Because the disc is herniating out of its outer layer and puts pressure on spinal nerve(s), the symptoms include pain in the area, nerve pain that continues through the buttocks and down the leg and in some cases leg weakness. This pain is referred to as lumbar nerve root pain (sciatica). Diagnosis includes consultation, medical examination, x-ray and/or MRI or CT.

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Fractures of the spine can unfortunately occur from a sporting injury or accident such as falling from a height or vehicle accident.   The cause is usually from direct impact and/or be related to degenerative disease e.g. Osteoporosis. Fractures can range between the front/back and either side of the spine and occur in any area from the neck down.

Symptoms include pain at the site of the fracture, swelling and inability to weight bear or move the spine. Swelling around the site can cause pressure on the spinal cord and therefore fractures are needed to be diagnosed and treated urgently. Diagnosis includes medical examination, x-rays, CT/MRI.

The tendons surrounding the elbow are susceptible to inflammatory conditions or what is known as elbow tendinopathy. Tennis elbow and golfers elbow are conditions relating to the tendons on the outside(tennis) and inside (golf) of the elbow. Flexor Tendonitis relates to the tendon in the forearm that continues down the arm through to the hand. The cause for all conditions is due to repetitive stress on the tendons surrounding the elbow and/or arthritis in the elbow joint.

Symptoms include pain, tenderness on examination and the progression to weakness in grip strength of racquet or club. Diagnosis involves medical examination, x-ray and/or MRI.

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Fractures occur in the collar bone (clavicle), upper arm (proximal humerus) and shoulder blade (scapula). The cause and location of the fracture would depend on the injury, whether relating to a sport e.g. cycling, rugby or high impact e.g. a vehicle accident.

Symptoms include immediate pain over the fracture site, swelling, bruising and limited movement in the arm. Diagnosis includes physical examination, x-rays.

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The Labrum is tissue surrounding the socket part of the shoulder joint (Glenoid). A tear is caused by an injury such as dislocation, impact during sport/accident to an outstretched arm or repetitive shoulder movement in sports.

Symptoms include pain when the arm is stretched over the head, catching or instability when the shoulder moves or an increase in immobility of the joint. Diagnosis includes consultation, x-ray and MRI.

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The Rotator Cuff refers to the tendons and muscles that holds the shoulder joint in place with the upper arm and shoulder blade. Other structures affect the rotator cuff and these include a bursa which is a sac that lubricates the rotator cuff and is positioned under the end of the shoulder blade (acromion).

Inflammation of the tendons and bursa can occur, additionally the acromion can rub on the rotator cuff due to the narrowing caused by the inflammation of the surrounding tissues, bony lumps that may have formed or caused by degenerative disease.  The rotator cuff tendons due to wear and tear and repetitive stress can be torn either partially or completely ruptured.  Sports such as tennis and rowing, degeneration of the joint and age are contributing factors of these conditions.

Symptoms include pain, weakness in the arm, difficulty with full range of movement of the arm. Diagnosis includes consultation by an experienced shoulder consultant with extensive physical examination. Diagnostic tests such as x-ray, ultrasound and MRI may also be needed.

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The shoulder is the most commonly dislocated joint in the body. The cause of the ball and socket joint being dislocated is usually from an accident or sports injury when impact has occurred. The dislocation can additionally cause stretching and damage to the ligaments, tendons and muscles that stabilise the joint.

Previous dislocation of the shoulder may cause ongoing instability of the shoulder joint due to damage to the surrounding tissues. Diagnosis includes consultation, physical examination, X-ray, MRI.

Find out more about Shoulder Dislocation and Treatments.