Hamstring Strain

Common to participants in sports with a sprinting or jumping element, the tearing of a hamstring muscle on the back of the thigh results in hamstring strain (also know as a pulled hamstring).

Symptoms

A stabbing pain at the back of your thigh that strikes suddenly while training. This often occurs during the running cycle or a rapid increase in acceleration. Pain will then be present when trying to stretch or contract the muscle, making flexing the knee difficult. The degree to which you are unable to contract the hamstring may give an indication as to the severity of the injury. Due to the small tears in the muscle there is regularly accompanying bruising on the rear of the thigh, which can spread all the way down the leg. The thigh is prone to swelling up and you may experience muscle spasms.

Grades of Injury

The injury's severity can be graded from 1 to 3. Grade 1 is typified by minor tears, with the sufferer able to walk with pain and minimal swelling. Contracting the muscle against resistance should also not cause excessive pain. With Grade 2 injuries the tears are larger, affecting movement more seriously and possibly making straightening the leg unbearable. Grade 3 might necessitate the use of crutches due to a total rupture of the muscle. Swelling is immediately apparent and pain will be intense.

Causes

The hamstring often works hardest during sprinting. Muscle disparity between the quadriceps and hamstring is thought to lead to a significant amount of hamstring injuries. With very strong quads extending your leg but comparatively weak hamstring muscles slowing down knee extension, the hamstring becomes overworked and full of extreme tension. Fatigued or weak muscles, lack of strength or flexibility in the hamstring are other common factors resulting in injury.

Treatment

You should begin self-treatment immediately, resting and icing the muscles and using a compression bandage or similar technique in order to place significant pressure on the injury and diminish bleeding within the muscles. Stretch and strengthen the muscles as much as possible without pain, beginning the rehabilitation process and lessening any surrounding swelling.

Medical Attention

You should consult a medical professional to determine the severity of the condition. In some cases they may take scans and you might require walking aids, with particularly severe injuries also sometimes entailing surgery. Your doctor may recommend a specialist in sports medicine to assist with your recovery, or otherwise help with organising a fitting recovery program. Suitable massage and advice on appropriate methods to exercise the healing muscle will be beneficial.

Prevention

Continuous strengthening and stretching of the hamstring muscles will help to keep hamstring injury at bay. This involves arranging a committed routine with varied stretches to increase flexibility and power. You may also wish to cut back on hamstring-straining sports for a trial period. Other factors include correctly warming up, taking regular breaks for rest, and always recognising when your muscles are fatigued and therefore unfit for strenuous activity.

For more details please contact:

Dr. Prateek Gupta (Senior Surgeon)

Arthroscopy Surgery Clinic

C2/5 Safdarjung Development Area (SDA),

Aurobindo Marg, New Delhi - 110016

INDIA

Telephones: +91 9810852876, +91 11 26517776

24 x 7 Helpline & Appointment: +91 9810633876

Email: sportsmedicinedelhi@yahoo.com,

sportsmedicineclinics@gmail.com

Website: http://www.sportsmedicineclinicdelhi.com/arthroscopy.htm,

http://www.sportsmedicineclinicdelhi.com,

http://www.arthroscopysurgeryindia.com

Hamate Fracture

The hamate bone is a wedge shaped bone found below the little finger and near to the wrist. It protrudes in a 'hook' formation. Injuries to this bone are relatively rare but nevertheless have increased in prominence as participation soars in sports that use bats and racquets.

Symptoms

Aching or sharper pain around the area of the hamate bone, which may be worsened with wrist or hand movements, especially strenuous motions involved in most bat and racquet sports. Moving the ring finger and the little finger often proves particularly painful due to their proximity to and connection with the hamate bone (via the metatarsals). Grasping or clutching any bat or other instrument might also intensity the pain sensation. In some cases symptoms can be minimal, thus the injury can go untreated for a long time.

Causes of Hamate Fractures

Sports involving clubs, bats or racquets provide the most consistent cause of hamate fractures due to the way in which they encourage the hand to turn and twist at speed. It is thought that the most common of these causal injuries is arises as a result of repeated golfing swings (or hitting the ground during a swing), accounting for approximately one third of all hamate injuries. Repetitive motions like this in any such sport (e.g. tennis or hockey) can result in a stress fracture over time.

Another prominent cause is blunt trauma to the hamate bone, resulting from direct force to the area either from another participant, or from the base of a club, bat or racquet that is held on the hamate at the forceful moment of the swing. Falling injuries can indirectly cause a hamate fracture through the surrounding muscles or ligaments, especially when hyperextending the wrist by landing flat on the palm. Some other wrist complaints can also lead to the condition.

Complications of a Hamate Fracture

The ulnar nerve frequently becomes compressed as a result of hamate fractures. This is due to the location of the hamate at the Guyon canal, close to the motor section of the ulnar artery and nerve. Another possible complication is injury to the flexor tendons of the ring and small fingers, interfering with successful flexing because jagged edges of the fracture have ruptured them.

Medical Treatment for Hamate Fractures

It is important to refrain from all stressful physical activities using the hand. Your doctor will examine the injury in order to determine that it is indeed a hamate fracture and the severity of the fracture. Medical treatment varies greatly depending on the individual injury and the recommendations of a specific doctor. Many hamate injuries in the past have been treated through a program of immobilisation for 6 to 8 weeks, implementing a cast to avoid damaging movements and allowing union of the bone. This may not always be suitable because of blood supply deficiencies, a late diagnosis, or the fact that ring and little fingers can still move inside the cast and may therefore worsen the injury despite immobilisation.

The preferred method is often for a professional hand surgeon to consider a suitable operation. The most common of the available surgeries involves excision of the hamate hook itself, while another procedure attempts internal fixation of the bone.

For more details please contact:

Dr. Prateek Gupta (Senior Surgeon)

Arthroscopy Surgery Clinic

C2/5 Safdarjung Development Area (SDA),

Aurobindo Marg, New Delhi - 110016

INDIA

Telephones: +91 9810852876, +91 11 26517776

24 x 7 Helpline & Appointment: +91 9810633876

Email: sportsmedicinedelhi@yahoo.com,

sportsmedicineclinics@gmail.com

Website: http://www.sportsmedicineclinicdelhi.com/arthroscopy.htm,

http://www.sportsmedicineclinicdelhi.com,

http://www.arthroscopysurgeryindia.com

Hallux Valgus (Bunion)

Hallux valgus is the technical name for the big toe deformity caused by a bunion. A bunion is a lump arising at the big toe joint, and this causes the joint to inflame to an unnatural size, with the result of the big toe pointing outwards at the four other toes (hallux valgus). This can lead to pain and swelling, interfering with regular and sporting activities.

Symptoms

The most obvious symptom is the bunion itself, which is a fairly large bump extending outwards from the base of the big toe. It will feel bony to the touch. Its presence can push the big toe sideways towards the other toes. Pain will be present around the big toe joint and the bunion, which can become debilitating to the extent that it prevents successful walking. The pain is often accompanied by inflammation where the toe meets the foot. Skin around the bunion might become reddened or sore, and sometimes seems thicker than usual. Infection is a possibility. The problem may cause difficulty with wearing shoes, as the front of the foot can become considerably wider than most footwear is designed to accommodate.

Warning signs to look out for before the appearance of a bunion or hallux valgus include irritation, redness or swelling around the big toe joint. The area may become covered by calloused skin.

Causes

The causes of bunions and hallux valgus may vary, with a hereditary element regularly put forward as a contributing factor. Other pre-existing joint conditions have been related to the injury, especially rheumatoid arthritis and osteoarthritis, due to progressive weakening of the joint. This weakening is also present in people who wear inappropriate shoes; such people are prone to hallux valgus. In particular, ill-fitting or overly tight shoes can put you at risk, such as women's high heels or certain tense and rigid sports shoes. Shoes with narrow front ends are also damaging. All of the aforementioned shoes can lead to friction and strain on the big toe. The injury is also more prominent in people with biomechanical problems in their feet (such as flat feet).

Treatment

A doctor will perform a physical examination and may use an x-ray to diagnose the condition or assess the extent of the damage. If the injury is particularly severe then medical intervention may be necessary. Bunionectomy surgery aims to remove a section of the bone in order to straighten the big toe, or use another method to correct the problem. However this is often considered most seriously if the condition is especially painful or debilitating. Non-surgical steps will be focused on using spacious shoes that provide sufficient comfort, and placing a healing device on the foot to amend the hallux valgus deformity. A relief pad might also be implemented. The doctor can prescribe anti-inflammatory medication to reduce pain and swelling. In cases of biomechanical foot errors, shoe orthotics may be required.

Long-Term Effects

The non-surgical treatment is used only to relieve symptoms, and surgery may be necessary to remove the bunion for good. A doctor can discuss the merits and negatives of this course of action. Many people do not have surgery because their symptoms are sufficiently diminished without it.

For more details please contact:

Dr. Prateek Gupta (Senior Surgeon)

Arthroscopy Surgery Clinic

C2/5 Safdarjung Development Area (SDA),

Aurobindo Marg, New Delhi - 110016

INDIA

Telephones: +91 9810852876, +91 11 26517776

24 x 7 Helpline & Appointment: +91 9810633876

Email: sportsmedicinedelhi@yahoo.com,

sportsmedicineclinics@gmail.com

Website: http://www.sportsmedicineclinicdelhi.com/arthroscopy.htm,

http://www.sportsmedicineclinicdelhi.com,

http://www.arthroscopysurgeryindia.com

Hallux Limitus

Hallux limitus is an injury involving stiffening, decreased movement and pain in the big toe joint (bunion joint). It can be a relatively minor or severe condition depending on the underlying cause. The condition gets progressively worse over time and often affects athletes suffering from another injury to the area.

Symptoms

Due to the restriction in motion that hallux limitus causes, with the big toe less able to move upwards without causing pain, everyday and sporting activities such as sprinting, walking uphill and walking can all ultimately cause pain. The amount of pain may increase as the injury worsens, as can the number of less strenuous movements (i.e. walking) that are affected by pain. Often this is accompanied by swelling around the joint. You might be able to feel a collection of bone spurs near the site of the injury where the toe joint is colliding with the first metatarsal. The pain of the injury regularly leads to secondary symptoms including the sufferer walking with their weight distributed to the side of their foot, and calluses accumulating.

Causes

The causes are varied, but any existing toe injury can be a significant factor. Conditions particularly affecting the big toe joint, such as fractures or breakages, can provoke hallux limitus, as can an infection. Serious prior conditions that often cause the injury include osteoarthritis and gout. Frequent injury to the area increases the risks due to the possibility of gradual degeneration of important cartilage. Hallux limitus can also be caused by a single instance (or repeated instances) of hard impact to the foot from a severe kick or blow, or a heavy object. This is especially relevant to sportspeople who are liable to such injuries. Another factor is age, as the joint weakens as we get older. Men typically sustain the injury more often than women.

Treatment

Talk to a doctor who will then perform a physical exam and diagnose the condition. This can require the use of an x-ray to assess the extent of the damage, which will allow the doctor to recommend suitable treatment. Milder forms of the injury can often be treated medically with injections, while more severe injuries may necessitate surgery to remove the problem. The most major injuries can demand serious surgery like joint replacement or fusion.

During the treatment and recovery process it is necessary to rest the joint appropriately so as not to exacerbate the injury and to allow it time to heal. Discuss gradual return to activity with a doctor or physical therapist, and to maintain fitness in the meantime try to replace foot exercise with upper body training.

Prevention

As previously mentioned, the injury has many causes. However you can decrease your risks of suffering from impacts to the big toe joint by wearing protective footwear for certain sports, such as football boots, or wearing safety boots if your job involves heavy items.

For more details please contact:

Dr. Prateek Gupta (Senior Surgeon)

Arthroscopy Surgery Clinic

C2/5 Safdarjung Development Area (SDA),

Aurobindo Marg, New Delhi - 110016

INDIA

Telephones: +91 9810852876, +91 11 26517776

24 x 7 Helpline & Appointment: +91 9810633876

Email: sportsmedicinedelhi@yahoo.com,

sportsmedicineclinics@gmail.com

Website: http://www.sportsmedicineclinicdelhi.com/arthroscopy.htm,

http://www.sportsmedicineclinicdelhi.com,

http://www.arthroscopysurgeryindia.com

Groin Strain

Groin strain is a common condition involving damage to an adductor muscle in the pelvis or thigh area.

Grades of Injury

A doctor is likely to grade the injury from 1 to 3 in terms of severity. Grade 1 is a relatively minor tear in a muscle, while Grade 2 injuries are considered to be moderate. Grade 2 comprises a wide spectrum of rips, including injuries with almost full tearing of the muscle in addition to those that are only slightly too severe for Grade 1. If a muscle suffers a partial or total rupture, this is a Grade 3 condition.

Symptoms

The injury is immediately characterised by an unexpected sharp pain around the groin, usually during activity and impeding your progress. It will feel similar to pulling any muscle in that the pain will be aggravated by movement and the area may be tender. A little later the muscle will probably become inflamed, and this can sometimes extend further along the leg. Your leg may exhibit an unnatural colour, and both running and regular walking might be severely painful and inhibited.

In the case of Grade 1 tears, your walking is likely to remain bearable. Additional symptoms indicating a Grade 2 injury include rigidity and tightness in the affected area within 24 hours, bruising, and an inability to stretch your muscle without pain or irritation. For Grade 3 ruptures you will experience significant difficulty performing exercise related to the adductors, intense bruising or inflammation, and may find it impossible to bring the legs together.

Causes

Due to the nature of muscle strains they are often provoked by a sudden movement such as jumping, changing direction or commencing a run. These motions place greater pressure on the adductor muscles and can overpower them. A lack of rest during extended periods of strenuous activity can cause overuse, as the muscles may become weakened or fatigued and thus unfit for support. This can also occur if you begin an ambitious training program after a period of inactivity. Failure to warm up correctly leaves the muscles at risk of being torn.

Treatment

Rest the injury and elevate your leg. Apply ice to the area approximately 3 times per day to reduce pain and swelling. Stay away from walking, running or jumping activities until the pain greatly subsides. Massage therapy may be beneficial; you should consult a doctor about this. Also ask for a doctor's advice if considering anti-inflammatory pain medication like ibuprofen. Seeing a medical professional to ascertain the grade of injury will be helpful in gaining an indication of the length of time you may have to rest. Strains can generally last from one week to two months depending on severity.

Prevention

Return to activity involving the groin muscles only when pain is significantly reduced. You should wait longer if sharp changes of direction still cause pain. Stretch and strengthen your adductor muscles regularly to add greater support to the area and prevent the injury from returning. Try adding rest to your training routine, and consider cutting down on activities that pressure the area.

For more details please contact:

Dr. Prateek Gupta (Senior Surgeon)

Arthroscopy Surgery Clinic

C2/5 Safdarjung Development Area (SDA),

Aurobindo Marg, New Delhi - 110016

INDIA

Telephones: +91 9810852876, +91 11 26517776

24 x 7 Helpline & Appointment: +91 9810633876

Email: sportsmedicinedelhi@yahoo.com,

sportsmedicineclinics@gmail.com

Website: http://www.sportsmedicineclinicdelhi.com/arthroscopy.htm,

http://www.sportsmedicineclinicdelhi.com,

http://www.arthroscopysurgeryindia.com

Frozen Shoulder

Adhesive capsulitis is commonly known as frozen shoulder syndrome, which is characterised by a reduction of movement in the shoulder. The condition feels as if an adhesive is involved, with the shoulder joint seeming glued in one position. It can be triggered by an impact in a sports activity, though it is rarely encountered in people below the age of 40.

Symptoms

Initial symptoms include inflammation and aching of the shoulder joint with the area gradually stiffening, in what is often described as the painful or freezing phase. Usually only one shoulder is affected, and pain may be exacerbated when lying on the injured side. The symptoms might worsen over time. This is followed by the stiffening or frozen phase, when the shoulder feels firmly stuck in place while the pain remains the same. This greatly impedes your ability to carry out everyday tasks and activities. The attendant muscles may be noticeably weakened at this stage due to difficulty using the arm.

The final thawing phase is a steady process of recovery. Movement should increase and pains diminish as the shoulder becomes 'unstuck'. Sometimes the pain temporarily spikes again as the rigidity in the shoulder lessens. Each phase of the injury lasts approximately 4 months, though this varies from case to case and in rare instances these phases can last for up to a year each.

Causes

In sport a frozen shoulder can arise as the result of an impact to the area. Sports with the potential to cause the injury include contact sports such as rugby or hockey, and activities with a risk of falling accidents like cycling or horse riding. Repetitive bad posture can also contribute to the condition over time, affecting a ligament in the shoulder. If you are recovering from a previous injury such as a shoulder fracture, and have been immobile for a long period, this may lead to a frozen shoulder.

The injury regularly occurs without an identifiable cause. There is however a link between diabetes and frozen shoulders, and women are also more likely to suffer from the injury than men.

Medical Treatment

See a doctor as soon as possible for the best chance of a speedy recovery. However, the initial 'freezing' phase proves difficult to treat and may need to be endured with pain relief before treatment can begin. A doctor will advise on a suitable program of rehabilitation, which may involve cutting down on certain activities while not allowing the shoulder to become dangerously immobile. To this end you should attempt to exercise the joint as long as this does not cause excessive pain. Anti-inflammatory medication may be prescribed to relieve pain and swelling symptoms. It can be helpful to begin physical therapy and regularly ice the area. Steroid injections are sometimes administered, and nerve blocks are effective. Surgery can be required in instances when treatment is unsuccessful.

Recovery Time

Recovery can be slow and depends on the injury, which may last from 1 to 3 years. Rehabilitation therefore requires patience and updates with your doctor.

For more details please contact:

Dr. Prateek Gupta (Senior Surgeon)

Arthroscopy Surgery Clinic

C2/5 Safdarjung Development Area (SDA),

Aurobindo Marg, New Delhi - 110016

INDIA

Telephones: +91 9810852876, +91 11 26517776

24 x 7 Helpline & Appointment: +91 9810633876

Email: sportsmedicinedelhi@yahoo.com,

sportsmedicineclinics@gmail.com

Website: http://www.sportsmedicineclinicdelhi.com/arthroscopy.htm,

http://www.sportsmedicineclinicdelhi.com,

http://www.arthroscopysurgeryindia.com

Fractured Clavicle

A fracture to the clavicle (or collarbone) is a very common injury to the shoulder. It is prominent in children, and also common to people who partake in contact sports.

Symptoms of a Fractured Clavicle

Sharp pain in the clavicle area near the top of the shoulder, which is exacerbated with any movement of the arm. Pain often spreads to the surrounding areas and muscles. Tenderness may also be present, and inflammation is likely. The injury will regularly exhibit visible signs such as bruising or an unnatural lump in the skin. In some cases arm movement can be fully impaired. Other symptoms include nausea and seeing spots in the field of vision.

Causes of Fractured Clavicle

A fractured clavicle is most commonly caused by a nasty fall onto the shoulder. In sports this can occur while cycling, horse riding or during similar activities with a risk of falling. The injury can also be provoked by a direct strike to the area in contact sports such as rugby, basketball or hockey. A smaller fall onto an outstretched arm can also lead to this fracture. High incidence has additionally been noted in winter sports. Children are more prone to this fracture, and babies often sustain the injury as a result of a problematic delivery.

Medical Treatment for Fractured Clavicle

A doctor can usually diagnose a fractured clavicle with a simple physical exam due to the visibility of such an injury. They may examine the lungs in order to check for complications arising from the damaged collarbone. Sometimes an x-ray might be necessary to sufficiently view the extent of the fracture.

The injured arm will be placed in a sling to limit further pain and possible damage caused by excessive movement, and to set the arm in a suitable position for recovery. Pain medication (often paracetamol) is generally prescribed to reduce symptoms while the bone heals. An operation is rarely necessary, with 9 out of 10 cases healing without surgical intervention. If treated is recommended then the doctor will explain the reasons for this, which often include an inability for the arm to heal itself after a number of months.

Physical Therapy and Rehabilitation from a Fractured Clavicle

The doctor will also assist with providing physical therapy and advising suitable stretching and strengthening exercises to keep the shoulder and elbow from complete immobility. This will vary from case to case, but regularly the patient is permitted to remove their sling during the initial month period for gentle and specific exercises. Gradually the physical therapy will become more active as the shoulder heals more effectively, with full bone recovery often expected within 3 to 4 months and full mobility and strength generally recovered within 6 to 12 months.

Prevention of a Fractured Clavicle

Unfortunately it can be difficult to foresee damaging falls, but always wearing the

For more details please contact:

Dr. Prateek Gupta (Senior Surgeon)

Arthroscopy Surgery Clinic

C2/5 Safdarjung Development Area (SDA),

Aurobindo Marg, New Delhi - 110016

INDIA

Telephones: +91 9810852876, +91 11 26517776

24 x 7 Helpline & Appointment: +91 9810633876

Email: sportsmedicinedelhi@yahoo.com,

sportsmedicineclinics@gmail.com

Website: http://www.sportsmedicineclinicdelhi.com/arthroscopy.htm,

http://www.sportsmedicineclinicdelhi.com,

http://www.arthroscopysurgeryindia.com

Foot Blisters

Foot blisters are a common injury among athletes, runners and walkers, especially those partaking in marathons. They mostly form due to the adverse effects of friction on the foot, which has usually been worsened by faulty footwear, socks, or dampness in the shoes.

Pre-empting Blisters

Be aware of the risk factors for developing blisters. These are generally the combination of surface friction with heat, moisture or dirt. You must therefore ensure that your footwear is suitable for your activities and that the shoes do not rub against your feet due to smallness or tightness. With brand new shoes, use them casually before wearing them for strenuous training. When it comes to socks, layering can combat friction and athletic socks can help to dispel wetness. Cotton socks are known to be coarser than normal and should be discarded. You should also never use socks with holes.

Before exercise, you can heighten the dryness of your feet by using talcum powder or equivalents. This will assist in reducing friction, as can using a suitable lubricant. If you know where you are most vulnerable to blisters, you can decrease their likelihood by wrapping tape or bandages over these areas. It may also be beneficial to try walking barefoot in harmless and appropriate places, in order to harden and strengthen the skin.

If you feel a blister forming

Rest immediately if possible, removing the relevant footwear both to inspect the area and to reduce heat and moisture. The skin around the area will be reddening if a blister is imminent. Before continuing any activity wrap the area with tape or bandages, and if feasible take any of the other aforementioned steps to tackle excessive friction.

Self-Treatment

For a fully formed blister, dress around the area with soap and water to remove any dirt and help prevent infection. It is your choice whether to drain the fluid or leave the injury to heal, but if it does not cause pain to walk on then it is generally best to leave it to repair. If draining the fluid you should always be cautious and use a sterilised tool if it is necessary to make a minor hole. When removing the fluid be careful not to damage the skin, as this assists protecting the foot from infection. Gently wash the injury with a suitable wipe. Cover the blister using a special blister plaster which should stick and perform better than ordinary tape or plasters, and use additional cover if needed to reduce pain. However, you should allow air to the blister in order to help it heal.

When to see a Doctor

Most blisters require no professional medical attention, but if you have a smelly blister, if it is full of blood or extreme quantities of pus, it is likely to be infected and you should consult a doctor. Note also that you should not drain blood from a blister.

For more details please contact:

Dr. Prateek Gupta (Senior Surgeon)

Arthroscopy Surgery Clinic

C2/5 Safdarjung Development Area (SDA),

Aurobindo Marg, New Delhi - 110016

INDIA

Telephones: +91 9810852876, +91 11 26517776

24 x 7 Helpline & Appointment: +91 9810633876

Email: sportsmedicinedelhi@yahoo.com,

sportsmedicineclinics@gmail.com

Website: http://www.sportsmedicineclinicdelhi.com/arthroscopy.htm,

http://www.sportsmedicineclinicdelhi.com,

http://www.arthroscopysurgeryindia.com

Foot Arch Pain or Strain

Pain or strain in your foot arches is a common sports injury and often linked to inflammation of the plantar fascia, the shock absorption ligament along the bottom of each foot. The pain can also highlight underlying issues to do with the structure of your arches.

Symptoms

The primary symptom is pain or aching in the arch area. This can be accompanied by inflammation and tenderness. If the pain is caused by the plantar fascia, it is likely to be considerably more severe in the mornings due to the muscles being unused.

Causes

Plantar fasciitis, another sports injury detailed on this website, is regularly the cause of foot arch pain or strain. This can arise due to faulty biomechanics in your feet, which alone can also provoke foot arch pains. The most prominent biomechanical difficulties are flat feet and high arches. With flat feet (or overpronation) the arches appear to be almost flattened, causing unevenness by forcing the feet roll inwards in order to maintain balance and support the body's weight. This places inordinate pressure on the plantar fascia and arches. If by contrast you have high arches (instep), the ankle can roll outwards, again causing undue strain on the arches. Too much of this strain can lead to stretching of the plantar fascia and pain in the arches.

Other causes include overstretching or otherwise pressuring the arches, for example by exercising with fatigued leg muscles which leave the feet with excessive work to do. You are also particularly at risk if in your 40s or 50s and commencing an intense program of training after a long period of inactivity.

Treatment

Consult a doctor to diagnose the condition and determine the cause. If revealed to be plantar fasciitis, please refer to our article on that injury for further information. Generally arch pain is easy to treat, with the most effective method of treatment being the placement of arch supports in the shoes. This counteracts the strain placed on the arches by biomechanical errors, causing them to cease stretching excessively. A specialist can recommend the inserts suitable to your needs, which will depend on the shape of your arches. These supports should lessen your symptoms within days.

If pain is severe you should refrain from running activities until it subsides to avoid risking an aggravation of the injury. To maintain fitness, alter your training program temporarily to be focused on low-impact sports like swimming. Applying ice to the affected area should assist in reducing pain and swelling.

Prevention

Stretch and strengthen important muscles in your feet, ankles and legs in order to guard against future strain. Make sure to acquire suitable arch supports and inserts if necessary, and that your shoes are shock absorbent and in good condition. Wearing tattered shoes provides no protection, and runners should replace their footwear before exceeding 500 miles of usage. Athletes new to arch supports should gradually build their training routine, allowing their feet to become accustomed to a new stance.

For more details please contact:

Dr. Prateek Gupta (Senior Surgeon)

Arthroscopy Surgery Clinic

C2/5 Safdarjung Development Area (SDA),

Aurobindo Marg, New Delhi - 110016

INDIA

Telephones: +91 9810852876, +91 11 26517776

24 x 7 Helpline & Appointment: +91 9810633876

Email: sportsmedicinedelhi@yahoo.com,

sportsmedicineclinics@gmail.com

Website: http://www.sportsmedicineclinicdelhi.com/arthroscopy.htm,

http://www.sportsmedicineclinicdelhi.com,

http://www.arthroscopysurgeryindia.com

Fibula Stress Fracture

The fibula is the calf bone, connected at the top and bottom to the much larger tibia. Fracturing the fibula is not as widespread an injury as tibia fractures because the bone is smaller and is therefore not pressurised in the same way, i.e. weight bearing during many activities such as running and jumping. Yet stress fractures can occur, causing a hairline break in the bone.

Symptoms

Sharp or aching pain will arise at a location on the fibula. This is likely to be increased with physical activity, particularly those involving a degree of weight bearing on the leg; however this may not always be immediately noticeable. The most painful point on the affected fibula might feel tender to the touch.

Causes

Usually the cause of a fibula stress fracture is an excessive twisting or pulling force on the bone. This can occur when the associated leg muscles are not functioning at full capacity and so they place intense pressure on the fibula during movement. Such injuries may be caused due to a single incident or stress over time. Overuse factors can contribute, such as a failure to sufficiently stretch or strengthen important muscles, or exercising when the muscles become fatigued. This leads to great pressure being placed on the bone. Worn or inappropriate footwear can also increase the risks, as can relying on irregular or sloped surfaces for training. A biomechanical foot error called pronation – the foot rolling inwards – can put excessive stress on the muscles.

Treatment

You must rest from any strenuous activities until you are pain free and any other symptoms have diminished. See a doctor for a specific, accurate time scale and to rule out any complications or associated injuries. They may prescribe anti-inflammatory pain medication to help relieve the symptoms. Within the first few days it can be beneficial to keep the leg elevated and to ice the area frequently. The doctor might also recommend wearing a leg support or heat retainer to assist blood flow into the injured area and thus aid the recovery process. Any other factor must also be treated, such as correcting pronation with shoe orthotics.

Rehabilitation

As important as resting is, maintaining movement in the legs is also essential. When the doctor approves and the pain is not as severe, you should commence suitable exercises to avoid inflexibility and hardening in the leg muscles. These should not cause you pain but rather aid gradual healing. When the time is right, a physical therapist can assist with building up stretches and other training. This process aims to recuperate muscle strength and ensure a successful return to activity. Most fibula stress fractures treated in this way heal fully within 2 to 3 months.

For more details please contact:

Dr. Prateek Gupta (Senior Surgeon)

Arthroscopy Surgery Clinic

C2/5 Safdarjung Development Area (SDA),

Aurobindo Marg, New Delhi - 110016

INDIA

Telephones: +91 9810852876, +91 11 26517776

24 x 7 Helpline & Appointment: +91 9810633876

Email: sportsmedicinedelhi@yahoo.com,

sportsmedicineclinics@gmail.com

Website: http://www.sportsmedicineclinicdelhi.com/arthroscopy.htm,

http://www.sportsmedicineclinicdelhi.com,

http://www.arthroscopysurgeryindia.com

FHL Tenosynovitis

Located in the tarsal tunnel, the flexor hallucis longus (FHL) is a tendon associated with the ankle and runs into the big toe (specifically the distal phalanx). It helps with flexing the big toe, plus pointing the toes and feet downwards, and also with elevation of the arch beneath the foot.

Symptoms of FHL Tenosynovitis

Spreading pain primarily found in the rear of the ankle, behind the bone, but not necessarily restricted to that area. The pain can be worsened during walking, sprinting or climbing activities and the ache felt throughout the ankle. Pushing off (such as in a race) is an especially painful motion. Some movements of the big toe or ankle might result in sharp pain and a clicking sensation. The area around the back of the ankle may feel slightly tender to the touch, though this is not universal due to the deepness of the tendon within the ankle. The ankle can become inflamed. Regular upward pointing of the big toe can prove difficult. Flexing the affected foot against weight or other resistance should replicate the pain of the condition. Symptoms generally improve during rest.

Causes of FHL Tenosynovitis

The causes of the injury can be complex but FHL tenosynovitis often arises in ballet dancers, who are required to perform intricate and intense foot movements over long periods. Other extreme repetition can also contribute to the injury, such as overuse from extending and flexing the foot or big toe over a long period of time or without the necessary stretches and warm ups to maintain such exertion. This can occur in many high impact sports if the athlete is not careful. Repeated trauma, such as direct blows to the rear of the ankle or the big toe in a contact sport, can also lead to deterioration in the FHL tendon.

Medical Treatment for FHL Tenosynovitis

Consult a doctor as soon as you experience symptoms similar to those listed above, and cease any stressful activities involving the feet. It is likely that the doctor will have to perform x-rays or other tests in order to properly diagnose the condition. This is essential because the injury is often confused with others because of similarities with conditions including tarsal tunnel syndrome, Achilles tendonitis and tibialis posterior tendonitis. They will also wish to investigate the possibility of a more serious tear to the tendon. Treatment depends on the severity of the injury, but anti-inflammatory painkillers are commonly prescribed along with a course of immobilisation for the affected foot. A cast may be used for this, and crutches can be necessary for a short time. In major cases an operation might be required to fully repair the FHL tendon.

For more details please contact:

Dr. Prateek Gupta (Senior Surgeon)

Arthroscopy Surgery Clinic

C2/5 Safdarjung Development Area (SDA),

Aurobindo Marg, New Delhi - 110016

INDIA

Telephones: +91 9810852876, +91 11 26517776

24 x 7 Helpline & Appointment: +91 9810633876

Email: sportsmedicinedelhi@yahoo.com,

sportsmedicineclinics@gmail.com

Website: http://www.sportsmedicineclinicdelhi.com/arthroscopy.htm,

http://www.sportsmedicineclinicdelhi.com,

http://www.arthroscopysurgeryindia.com

Fat Pad Contusion

The fat pad of the heel provides a protective layer over the heel bone. This pad can become damaged or moved to a less useful area due to a single injury or long term wear and tear. When the fat pad is weakened like this, the heel becomes more prone to bruising. Fat pad contusions are common among athletes whose activities carry the risk or necessity of repetitively bumping the heel.

Symptoms

Pain to the heel area which may be exacerbated if the heel is moved against weight or pressure. Other possible symptoms include tenderness, irritation of the skin and excessive heat. These symptoms are particularly likely to be associated with a bruised heel if they follow on from sharp, sudden foot movements, a fall or a similar abrupt change in body position.

Causes

A direct impact to the heel, either due to landing forcefully or from the strike of a projectile, often causes a fat pad contusion. Heavy landings can occur as an accident (such as while cycling) and are also regularly encountered in contact sports like football, rugby or basketball. Another frequent cause is prolonged strain or strikes to the heel over time or in one session, for example a runner or jumper pressing hard against a surface. Such blows can dislodge and injure the protective fat pad, leaving the heel open to contusions. Sudden changes in body or foot position – such as rapidly turning – can also contribute to the injury.

In some cases the heel injury might be linked to overuse; insufficient warm ups, overexertion or training with fatigued muscles can all lead to overuse injuries. One of these injuries is plantar fasciitis; if you suspect this condition, please see our corresponding article.

Treatment

Take immediate rest from all activity involving pressure to the heel. Ice the area appropriately for a few minutes at least 3 times per day to help relieve pain and any swelling. In the first day following the injury, try not to put any weight on the heel. After 3 days apply heat treatment, such as heating pads, warm water or showers. When beginning to walk on the heel again, seek out a suitable pad or cup to fit inside your shoe; this will assist with shock absorption and should help to keep the pain at bay while moving. Return to sports activity gradually, being careful not to continue training if you feel pain or other symptoms. It may not be necessary to see a doctor but people experiencing debilitating pain or suspecting a related injury should consult a professional. Also talk to a doctor if you feel you would benefit from taping the heel.

Recovery

A bruised heel can recover within a few days if you notice the symptoms and take them seriously, whereas continuing to train on the injured heel can lead to a prolonged period of treatment and inactivity. Therefore it is essential to take appropriate rest from all activities which could potentially damage or strain the heel in any way. It is also important to inspect your footwear and replace any inefficient or worn shoes. Running shoes should be replaced after 400-500 miles of running. You should begin to wear shock absorbent shoes when feasible in order to further protect the heel and fat pad.

For more details please contact:

Dr. Prateek Gupta (Senior Surgeon)

Arthroscopy Surgery Clinic

C2/5 Safdarjung Development Area (SDA),

Aurobindo Marg, New Delhi - 110016

INDIA

Telephones: +91 9810852876, +91 11 26517776

24 x 7 Helpline & Appointment: +91 9810633876

Email: sportsmedicinedelhi@yahoo.com,

sportsmedicineclinics@gmail.com

Website: http://www.sportsmedicineclinicdelhi.com/arthroscopy.htm,

http://www.sportsmedicineclinicdelhi.com,

http://www.arthroscopysurgeryindia.com

Elbow Fractures

Three bones feed into the elbow: the humerus from the upper arm, the large ulna bone from the lower arm, and the smaller radius. Trauma to the elbow during sports activity can cause a fracture in one of these bones.

Symptoms of Elbow Fractures

Intense and ongoing pain at the site of injury, especially following a major strike to the elbow. The area may swell up and can become bruised or discoloured. It might also feel tender when touched. Numbness can arise at any point below the elbow: in the fingers, the hand or forearm. You may find your arm much harder to move, particularly without causing pain, and the elbow often moves far less than usual. In some cases there is a noticeable bump or other abnormal protuberance where the fracture was sustained.

Causes of Elbow Fractures

Direct trauma to any or all of the elbow bones can result in a fracture. The most common causes of elbow trauma are direct blows to the elbow (such as from a competitor or a projectile in a high speed sport), excessively twisting the elbow beyond its range of motion, and falling accidents, either onto an outstretched arm or the elbow itself. Fast paced contact sports such as football, rugby, wrestling or hockey can increase the risk of sustaining a fracture. Those involving intricate and stressful arm movements such as gymnastics are also commonly associated with the injury.

Athletes at a greater age can have more chance of fracturing the elbow, as can those with bone problems like osteoporosis. Underdeveloped muscles are a further warning sign.

Treatment for Elbow Fractures

See your doctor, who will examine the injury and ask about its cause and your specific symptoms. They may take an x-ray or other suitable test to assess the damage. The treatment they recommend depends on the fracture's severity. The conservative approach to relatively minor fractures is immobilising the elbow (and possibly lower arm) for a period long enough to facilitate successful bone healing. This utilises a splint or cast.

The goal of surgical methods is similar. In severe cases some screws and a metal plate are positioned within the elbow during an operation. Another option, depending on the injury, is fixing pieces of the bone into the correct positions either with surgery or a procedure with you placed under anaesthesia.

During the recovery process the doctor might prescribe certain pain medication to help relieve symptoms. On average a fractured elbow heals within 8 to 10 weeks, and with the doctor's approval you can begin physical therapy which involves strengthening your arm and increasing motion in the elbow. This gradual process leads you to a stage at which it is safe to return to full activity.

Prevention of Elbow Fractures

Try to limit your exposure to elbow trauma; this can mean wearing elbow pads or suitable padding where appropriate. Maintaining healthy levels of vitamin D and calcium in your diet can improve bone strength. Regular stretching and strengthening of your muscles can help to increase balance and thus reduce the risk of falling.

For more details please contact:

Dr. Prateek Gupta (Senior Surgeon)

Arthroscopy Surgery Clinic

C2/5 Safdarjung Development Area (SDA),

Aurobindo Marg, New Delhi - 110016

INDIA

Telephones: +91 9810852876, +91 11 26517776

24 x 7 Helpline & Appointment: +91 9810633876

Email: sportsmedicinedelhi@yahoo.com,

sportsmedicineclinics@gmail.com

Website: http://www.sportsmedicineclinicdelhi.com/arthroscopy.htm,

http://www.sportsmedicineclinicdelhi.com,

http://www.arthroscopysurgeryindia.com