Lateral Ligament Sprain

Lateral Ligament Sprain

The lateral collateral ligament is a strong collection of fibres that joins the top of the fibula to the thigh bone (or femur). It ensures that the knee joint’s outer surfaces do not open up or form a gap that can lead to instability and knee conditions.

Symptoms by Grade of Injury

The severity of the ligament sprain will usually fall under three grades of injury. These should correspond to the seriousness of your symptoms as follows:

GRADE 1

A grade 1 sprain will cause pain to be experienced while bending the knee approximately 30 degrees, especially with force placed on the inside of the knee. The likelihood of inflammation or tenderness in the area is minimal, and the joint should not feel loose or overly flexible when bent.

GRADE 2

Grade 2 will mimic the above symptoms but with additions. Tenderness will be prominent at a lateral ligament position on the outside of the knee. This is usually accompanied by inflammation. While bending or putting pressure on the knee, definite looseness will be felt. It may be difficult to fully turn the leg and knee out to the side.

GRADE 3

A grade 3 sprain involves a total ligament tear, though the pain symptoms can be deceptive: less pain is often felt than for a grade 2 injury. Pain symptoms will therefore depend on the individual, but when bending and placing stress on the knee there should be major looseness in the joint. A feeling of knee instability is a key factor.

Causes

A direct impact to the inner part of the knee joint is the most common way that the lateral ligament is sprained. This sort of collision can be expected in high speed contact sports that involve aggressive tackling, such as football or rugby. Sports that do not require or facilitate knee protection put you at greater risk. A hard blow to the outer surface of the knee joint is more likely to result in injury to the medial collateral ligament (see our article for further details).

Treatment

The first step is to cease any strenuous activities involving the knee, particularly the sport or activity that lead to the condition. Begin to rest, and ice the area approximately 3 times per day in the event of swelling. Consult your doctor, who can examine the injury and recommend the best course of action depending on the grade of injury. They might use a varus knee test to assess knee laxity, or take an x-ray in more severe cases. Most grade 1 and 2 sprains are treated conservatively with rest, suitable pain medication, massage, and rehabilitation techniques. More serious injuries (in the grade 2 and 3 range) can require measures such as a knee brace and heat retainer to support the knee and increase blood flow to the area. Surgery may also be necessary in order reduce the risk of injury recurrence or knee instability. If this is the case then full recovery can take up to a few months, whereas less serious sprains should be healed much sooner.

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

Ischiogluteal Bursitis

Ischiogluteal Bursitis

Ischiogluteal bursitis is a condition affecting the bursa sac of the lower buttock. Bursas are sacs of fluid around the body which help to provide necessary friction reduction between muscle (or tendon) and bone. The ischiogluteal bursa is situated at the bottom of the pelvis above the hamstring muscle. It is often inflamed due to repetitive motions associated with sports activities.

Symptoms

Pain will be present at the join between the pelvis, where the buttock ends, and the hamstring muscle. This may be worsened or most acute when attempting to stretch the hamstring or bending and straightening the knee. Any resistance (a weight, for example) used during these movements is likely to increase the pain, as is sitting for prolonged periods. Many activities can provoke a dull ache or rigidity in the joint; these include sprinting and walking, kicking, climbing and jumping. If the pain from such activities is very sharp then this may indicate that the injury has significantly progressed. Other possible symptoms include weakness or fatigue in the affected leg, and a feeling of tenderness or pain upon touching the ischiogluteal bursa area.

Causes

The condition is generally caused by extensive or repetitive pressure on the bursa. This can occur as a result of significant repeated kicking, running or jumping, which are all strenuous and potentially damaging to the bursa and hamstring areas. The likelihood of causing injury through these activities is increased with the amount of time you partake in them, especially with weakened muscles, or without taking breaks or warming up sufficiently. Sitting down on hard surfaces for long or unnecessary periods can also contribute to the condition. In some cases the bursitis is caused spontaneously by a hard fall onto the area, such as a cycling or horse riding accident.

Treatment

Consult a doctor who will diagnose the injury and its severity using a physical exam or tests such as an x-ray or MRI scan. They will emphasise the importance of refraining from any activity which causes pain to the area, and it is crucial to be strict about this in order to keep the condition from becoming chronic. It may be possible to replace this training with other routines that do not require the use of injured areas. Ice the area a few times per day in the first 3 days to combat pain and inflammation, and apply a compression bandage if feasible. Elevating the leg can also reduce swelling. Taking anti-inflammatory medication such as ibuprofen can improve recovery time.

Physical Therapy and Recovery

As the injury begins to recover it is important to maintain mobility and muscle strength. Talk to a doctor or physical therapist who will recommend suitable stretches and strengthening exercises, often building incrementally as the pain decreases. They can also advise on the correct time to begin a return to normal activity. With responsible treatment this can be within weeks, though in some cases can take months (if the condition is chronic or went undiagnosed for a long time).

Prevention

Adjust your training routine to incorporate breaks and suitable warm ups. Make sure that you are not overdoing certain exercises, as this will only be detrimental.

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

Iliotibial band syndrome

Iliotibial band syndrome is a thigh injury particularly common to runners, cyclists and certain types of weight-lifter. It causes instability of the knee during movement, resulting in intense knee pain while exercising.

Symptoms

Stinging pain above the outer side of the knee joint, and sometimes below the knee. Inflammation of the iliotibial tissue where the band chafes across the femoral condyle. There may be no immediate pain when you begin exercising but it will intensify as the routine progresses and may continue when you have finished training. You will almost certainly experience diminished balance on the injured leg.

Causes

The iliotibial band is a thick section of the tensor fasciae latae muscle extending down the thigh and meeting the knee. If it tightens then this can wrench the knee joint out of alignment causing inflammation and pain. A frequent cause of this tightening is weakness of the hip abductor muscles, as this overburdens the iliotibial band by greatly increasing the pressure placed upon it.

You should look for activities that have been placing an inordinate strain on the band, often due to a running or weight-training routine with an overuse of steep hills, hard or uneven ground. This can lead to asymmetrical muscle strength. Other imperfect training practices can also contribute to the condition, such as starting a demanding routine of sport or exercise immediately following a period of inactivity, or otherwise expanding your training too rapidly. Using worn out or inappropriate shoes is another risk factor.

Structural errors in your feet and legs may also set off the injury. Uneven leg length, bowlegs, or irregular foot arches can all lead to this sort of inflammation over time, as can overpronation in the foot so that the arch is abnormally flattened and the heel curved inwards.

Treatment

Avoid cycling, running and weight-lifting (especially squats and deadlifting) while injured. Contact sports like martial arts and wrestling should also be avoided, and court sports like basketball and tennis which involve high impact on your knee joints.

Rest the joint and ice it generously, using massage therapy if available. Stretch your side muscles and strengthen hip abductors suitably. A common method of undertaking the latter is to balance on one leg and then, keeping that leg straight, to gently tilt the hip upwards. To combat overpronation, a change in footwear will be beneficial.

Seeking Medical Advice

Your doctor will perform a physical examination to diagnose the injury, and might recommend that you see a physiotherapist or a chiropractor if the symptoms do not improve after 2 to 3 weeks of taking the above steps. They can also prescribe anti-inflammatory medication if necessary.

Prevention

Effective and appropriate stretching is one of the keys to preventing further injury of this sort, and results in an altogether improved and safer training program. Replace worn or faulty shoes with a kind catered to your type of foot, and consider using inexpensive, easy to find orthotic inserts to amend biomechanical problems of the foot like supination or pronation. Also pay careful attention to your training practices, varying how you exercise and limiting the amount of time spent on uneven surfaces and hills.

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

Iliolumbar Ligament Injury

Iliolumbar Ligament Injury

The iliolumbar ligaments are crucial in supporting the lower lumbar spine; they join the 4th and 5th lumbar vertebrae (L4 and L5) to the iliac bone crest at the back of the pelvis. Injury to this area, fairly common among certain athletes due to the amount of frantic spinal motion involved in many sports, can develop into sacroiliac joint pain and associated problems. The sacroiliac joint is located in the pelvis and helps to keep the spine stable.

Symptoms

Pain is likely to arise in the lower lumbar spine and may be felt as occasional stabbing attacks. This can be exacerbated by physical activity involving the spine, e.g. twisting or bending, and long periods of sitting can also bring on the pain. The area can be tender to the touch and your back might feel weaker than usual. While these may be the primary symptoms if the injury is caught and treated early, iliolumbar ligament sprain or trauma can also lead to more serious conditions involving the 4th or 5th lumbar vertebrae. These areas can become weakened and prone to degenerative processes that can result either in persistent lower back pain, disc tearing, a herniated disc, or lower back nerve root compression (see our article for further details). Such conditions will cause harsher symptoms, such as burning pain in the back or legs, and motor problems.

Causes

Sports incorporating repeated spinal movements like bending and twisting often provoke iliolumbar injury, e.g. golf, tennis and many net sports. Direct trauma to the area can also cause the condition, such as a hard strike from a projectile or fellow athlete. Outside of sport, car accidents and other collisions can lead to these problems.

If the initial iliolumbar ligament injury is worsened, this is generally due to instability in the affected lumbar vertebrae that causes the 4th vertebra to slip and the 5th to move. This can lead to disc herniation.

Treatment

Your doctor will recommend suitable treatment based on their diagnosis; this will depend on the severity of the problem and whether the iliolumbar injury has developed into another condition. Conservative, non-invasive treatment is usually the first and most successful option, but depending on individual circumstances surgery may be required. In the meantime it is important, until the pain symptoms have desisted, to take a break from all activities that could put unneeded pressure on the spine. You can reduce pain and swelling by applying ice to the injured area at least 3 times per day to begin with, and by taking anti-inflammatory pain medication such as ibuprofen.

Rehabilitation

When you are pain free, consult your doctor or a physical therapist about an appropriate program of stretching and strengthening exercises for the buttocks and hips. This is crucial in building up strength and support for the lumbar spine in order to prevent similar future injuries, and for maintaining smooth movement in the injured areas. The doctor might also prescribe a course of medication for this purpose.

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

Hyphema

Hyphema

Blood in the anterior chamber (the front) of the eye is known as hyphema. It is associated with blunt trauma to the eye, and while pooling of blood may be clearly visible, the condition is sometimes only observable through using magnification.

Symptoms

You may be able to identify a pool of blood at the base of the iris, but the clearest indicator is diminished vision. Any amount of blood mixed with the clear fluid (aqueous humour) in the iris will cause a degree of vision loss, and if the amount of blood is great then the experience can be comparable to blindness, with only perception of light and movement remaining intact. In certain cases the intraocular pressure within the eye might be increased, which can be checked as part of a simple eye exam.

Causes

Hyphema is generally the consequence of a projectile or a physical force such as a punch that directly strikes the front of eye. This is usually prevented by the protecting structure of the orbital rim, making hyphema often the result of being hit by chance at a particularly bad angle or position. In sport anything from a variety of balls to a hockey puck can cause the damage. The condition can also be provoked during or after eye surgery.

Medical Examination

A medical professional will need to ascertain the cause of the injury. Detail about the event leading to the hyphema is therefore important. You will be given eye tests to measure the extent of the damage caused by the hyphema, thus helping the doctor to determine the correct course of treatment.

Grades of Injury

Your doctor will often use a grading system to assess the severity of the condition. These grades broadly correspond to the amount of blood and visual loss present in the eye. Grade 1 is when blood fills less than a third of the eye's anterior chamber; Grade 2 fills more than this but less than one half; Grade 3 can be anything above half that does not fill the entire chamber; and Grade 4 is complete coverage. A majority of hyphemas are Grade 1, with only a small minority reaching Grade 4.

Treatment

Initially an in-depth medical history will be taken and a full physical exam conducted. You may be referred to an ophthalmologist, whereupon you will be advised on relevant treatment. This regularly includes careful rest at an elevated angle in order to maximise the chances of the blood being reabsorbed, as well as a course of appropriate eye drops. Occasionally a procedure is necessary to reduce risks of glaucoma and other conditions. In some cases the patient becomes at risk of chronic visual impairment and surgery is necessary. All treatment options depend on the severity and progress of the injury, which will be carefully monitored by your doctor.

Prevention

Wearing eye guards while playing sports, particularly high-speed ball games, significantly decreases your chances of being struck and developing hyphema.

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

Hamstring Tendinopathy

Hamstring Tendinopathy

Where the hamstring joins with the ischial tuberosity, the hamstring tendon can become inflamed. This is regularly the result of a pre-existing hamstring tear, strain or other similar injury, and affects the ability of athletes to partake in activity while left untreated.

Symptoms of Hamstring Tendinopathy

Aching pain can arise at the point of the ischial tuberosity, which is found near to the bottom of the pelvis and is often where we place our weight when sitting down. This area may also feel tender when touched. Pain is usually also found in the hamstring, especially during any activity that involves stretching of the hamstring muscles or flexing the knee outwards against weight or other resistance. The pain will thus be exacerbated during exercise and may lessen with periods of rest. Runners will often find that the pain arises gradually after completing the exercise.

Causes of Hamstring Tendinopathy

Any prior injury to the hamstring muscles or tendons should be kept in mind when the doctor assesses your injury. In many cases the injury is provoked by a hamstring tear that has either been treated inadequately or allowed to worsen again due to poor recovery and rehabilitation. Other pre-existing hamstring injuries like strain might also contribute to your tendinopathy. However, when a prior hamstring condition is not the primary cause, the tendinopathy is most commonly an overuse injury. This can arise in many track sports such as sprinting and jumping but is not restricted to this area, as hamstring overuse can occur in various people who use repetitive leg movements over time, especially with a lack of warm ups or sufficient muscle strength.

Treatment for Hamstring Tendinopathy

See a doctor so that they can diagnose the injury and advise on suitable treatment. Meanwhile you should rest completely from strenuous leg activities until you are pain free, applying ice or other cold therapies a few times per day to counteract pain and swelling. Anti-inflammatory pain medication can also be beneficial in this area. With patience, rest, and any specific instructions that the doctor gives you, the pain from the tendon should begin to lessen. At this point the doctor might recommend physical therapy that will be instrumental in regaining strength and power in your hamstring. A gradual program of stretching and strengthening exercises will build you up for a full return to activity, while professional massage can help to reduce any rigidity in the hamstring.

Possible complications of Hamstring Tendinopathy

In particularly severe cases in which the pain becomes chronic, irritating fibrous adhesions can sometimes emerge on the tendon. These can be nasty and might require surgery, but this is not the usual conclusion of hamstring tendinopathy.

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