ACL Injury: A positive frame of mind

ACL Injury: A positive frame of mind, seems to aid recovery and return to sport, after a ACL reconstruction.

A recently published study from Australia, seems to indicate that those who returned to sport, after an ACL reconstruction had more positive psychological responses, reported better knee function in sport and recreational activities, perceived a higher knee-related quality of life and were more satisfied with their current knee function. The main reasons for not returning were not trusting the knee (28%), fear of a new injury (24%) and poor knee function (22%).

ACL injury prevention.

ACL injury, can have a major imapct on sports participation, apart from leading to further damage and injury to the knee, due to resultant instability. Females have a 7 fold increased risk of sustaining the injury than males. The following warm up exercises have been shown to reduce the incidence.

http://blogs.bmj.com/bjsm/files/2014/09/Jump-Leaflet-women.jpg

ECU (Extensor Carpi Ulnaris) tendon Injury at the wrist.

ECU tendon, is one of the tendons that crosses the wrist, at the little finger side of it.

It can get injured in sports like Tennis, Golf and Rugby League. The injury may range from Tendinosis (wear) to Instability (tendon slipping out of the grove) to frank rupture.

The injury may be avoided by attention to proper technique, avoiding at-risk strokes and appropriate conditioning.

Treatment usually involves, rest and strengthening, sometimes injection and very occasionally surgery to stabilise or repair a tendon.

Greater trochanteric pain syndrome (of the hip)

Greater trochanteric pain syndrome (of the hip)

Associated with Gluteus Medius Tendinopathy, Gluteus medius tendinopathy, Gluteus medius and minimus tears (Rotator cuff of the hip), Trochanteric Bursitis.

Gluteus Medius and Minimus  (muscles that attaches across the hip joint) Tendinopathy (wear) and tears can present as hip pain in the athlete or the non-athlete, causing pain on walking, running, climbing stairs etc. Clinically, the patient would have tenderness at the Greater Trochanter, where the muscles insert. Range of motion, may be painful and so is resisted abduction (movement at the hip, away from the mid-line). The diagnosis may or may not be confirmed by a MRI scan. But it can help to exclude other serious causes of hip pain. It can be associated with a Trochanteric bursitis - (Inflammation of a bursa)

Treatment initially involves stopping the aggravating activities, like sport. Stretching followed by strengthening and gradual return to sport. Sometimes a judicious use of an injection with a local anaesthetic and a corticosteroid, may help, if the above management is not successful.

Further reading
Radiology - http://www.radsource.us/clinic/0405

Dr Praveen Kumar KL
Sports Injuries and Ortho Clinic

Rehab for Acute Hamstring Injuries

A recent study done on the elite swedish footballers, has shown that, lengthening type of Hamstring exercises led to early rehabilitation, than conventional exercises, for Acute Hamstring Injuries.

ACL injury in Adolescent athletes

It is a known fact that there is an increased incidence of ACL (Anterior Cruciate Ligament) injury in female athletes. It has been shown that Nero Muscular training directed at preventing these injuries, initiated at Early Adolescence (mid teens), significantly reduced the incidence of these injuries, when compared to those who were initiated later.

Here is a link for these exercises. To be initiated by qualified personnel.

http://sportsmetrics.org/wp-content/uploads/2012/12/WIPP-Poster.pdf

Patellar tendinopathy (and Rafael Nadal)

Patellar tendinopathy (and Rafael Nadal)

http://www.huffingtonpost.com/2012/08/16/rafael-nadal-knee-tendini_n_1788561.html

Rafael Nadal pulls out and the news reports seem to suggest that it must be his patellar tendonitis.

Well, what is this anyway ? For starters the medical community  is moving away from calling this condition as tendonitis, as there is not much inflammation (itis), but more of degeneration, due to overuse. Commonly, this condition is also known as "jumper's knee", as it is more commonly seen in jumping sports like basketball and volley ball, though not exclusive to them, as we have seen in the case of Nadal.

The patellar tendon attaches, the knee cap (patella) to the shin bone and takes a lot of force with jumping activities and those that might need excessive knee bending. Over a period of time this may lead to severe pain, resulting in the player unable to participate in sports. But more often than not (80-90%), it can be treated with graduated, specialised exercises and re-habilitation, which allows the player to get back to sport. In the resistant cases, injections may be beneficial and very rarely, surgery !