Scaphoid Fracture

The scaphoid is a bone in the wrist joint which is the most fractured of all wrist bones in young people. It is nevertheless very strong, and takes a major impact to break.

Symptoms

Occurring within a joint, the severity of the fracture is often hidden from the sufferer, to whom it may feel like a relatively minor sprain. There is usually tenderness in the affected area. Pain varies from case to case, and the only other prominent symptom is usually inflammation which might disappear within days. The pain may be localised to the area below the thumb where the hand meets the wrist. The wrist is unlikely to appear 'broken', and this can make diagnosis difficult as many people initially overlook the injury, categorising it as a pulled muscle.

Causes

A significant fall can lead to a scaphoid fracture, with the sufferer landing on their hand and causing hyperextension of the wrist. Horse riders and cyclists are among the athletes at risk from such accidents. The fall can also be from a standing height as it is the impact which does the damage. Footballers and basketball players have been known to break their scaphoid, as have players of most contact sports. Hyperextension causing a fracture can also be provoked by incorrectly carrying a heavy object.

Possible Complications

Treatment is most successful if the patient is diagnosed within the first month. Due to the deceptive nature of the symptoms this often does not occur. If the initial medical treatment fails, or if the injury remains untreated because it has not been diagnosed, the loose chunks of bone in the wrist can eventually provoke wrist-specific traumatic arthritis. This worsens the pain and rigidity in the wrist, and can ultimately result in a joint unusable for many everyday activities. It is a serious condition but develops at different speeds in different people and can be avoided with swift treatment of the fracture.

Medical Treatment

If you suspect a fracture, consult a medical professional. They will perform a physical exam and are likely to use an x-ray or a bone scan to make a diagnosis. Occasionally a scaphoid fracture does not appear on an x-ray until some time later. The treatment required will depend on the severity and location of the fracture and how it has affected the associated ligaments. A doctor will talk you through the relevant options, which may involve surgery or a cast. This varies because certain sections of the bone are more receptive to casts than others, and fractures that leave the wrist particularly unstable should be treated with immediate surgery to avoid complications like prolonged pain or arthritis. Ask the doctor questions if you are unsure about treatment.

Returning to Activity

After successful treatment you should still refrain from sports or other activities with a contact component until the bone fully recovers. Also reduce your risk of falling wherever possible. Speak to your doctor for exact figures, but the time away from contact sports can often range between 2 and 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

Sacral Stress Fractures

The sacrum bone is found in the pelvis. Sacral stress fractures are a lot less common than stress fractures to lower extremities like the metatarsal, but they frequently occur in long distance runners and also military personnel. These sorts of groups have a higher incidence of sacral fractures due to their physical activities.

Symptoms

Lower back pain, which can manifest in sharp, steady attacks or be almost continuous. Any pain of this sort should be examined by a doctor as there are multiple back conditions and injuries that can lead to this aching. The pain of a sacral stress fracture can also mimic the symptoms of sciatica – the shooting leg pain caused by lower back nerve root compression (see our article for more details). Reflexes or motion in the back may be compromised, though this is not always the case.

Causes

There can be several factors involved in the development of sacral stress fractures depending on the specific circumstances. However, there are recurring elements that contribute to such injuries. Repetitive pressure to the pelvis and lower spine, due to the force of the legs hitting the floor and concurrent muscle contractions, can lead to gradual damage in the area. This is why mid- and long distance runners are particularly prone to the condition (and activities like jumping can also lead to the injury).

Another risk factor is failure to maintain suitable fitness prior to such activities, especially aerobic fitness. Stretching, warming up and exercising should all be used appropriately, catering to the difficulty and approximate length of your activities. This is linked to overuse, which is often a problem resulting from poor stretching and from overestimating the amount of sports and exercise one is able to take on.

Prior stress fractures might indicate a propensity towards the injury, and women are typically more prone to stress fractures than men.

Treatment

Consult a doctor, who will assess the cause of your symptoms using a physical examination and relevant scans if necessary. This stage is important because the fracture is sometimes misidentified as sciatica.

The sacral stress fracture mainly requires a period of full rest from activity that causes pain or places strain on the pelvis or spinal column. During this period, anti-inflammatory medication such as ibuprofen can be used to treat pain. When pain has diminished, you may undertake low impact activities such as swimming and cycling to avoid rigidity in the local muscles.

Returning to Activity

Patients generally recover after 4 to 6 weeks of rest, but it is crucial to recommence your regular activities gradually, especially those as strenuous as sprinting. You should only do this when you are pain free, preferably with a doctor's approval, and it will be helpful in the rehabilitation stage to start a training program of strengthening exercises (for the hips and the back) to help support the lower back area.

Prevention

To avoid overuse injuries always make sure to warm up and stretch properly, bearing in mind the intensity of your training regimes and suitable techniques, and never exercise with fatigued or weakened muscles.

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

Rotator Cuff Injury

The rotator cuff connects the bone of your upper arm to the shoulder blade and helps to keep the joint in place. It is comprised of a group of tendons and muscles, damage to any of which can cause a rotator cuff injury. Partaking in sports with repetitive arm movements increases the risk of such injuries.

Symptoms

You will experience pain and tenderness in the shoulder area. The pain may increase when you perform reaching or lifting activities that place strain on the shoulder (these can be as minor as reaching over your back to put on some clothing), and through leaning on the injured area while sleeping. The shoulder's regular range of movement might be greatly diminished, replete with strong physical urges to keep the joint motionless. With severe injuries the pain may be chronic.

Causes

Repetitive motion of the arm over a long period can lead to a rotator cuff injury. In sport this often involves overhead movements such as throwing balls, performing strokes in swimming, and hitting over-arm racquet shots. This can cause inflammation of crucial tendons, known as tendonitis. Incorrect posture during activity can also contribute to a rotator cuff injury, as the space assigned for the muscles can shrink. Other causes include a bad fall in which your arm takes the brunt of the force, and excessive lifting of a large weight to which your body is not accustomed. The general accumulation of wear on the muscles after age 40 is another common cause.

Self-Treatment

Take a break from all activities that cause the shoulder pain until the injury is healed. In addition to sport this may include everyday movements with an overhead dimension, as it is of utmost importance to rest the muscles properly. However, when a couple of days have passed you should begin a careful program of stretching and strengthening the muscles in order to combat stiffness.

Reduce swelling and pain by icing the affected area regularly, and perhaps taking anti-inflammatory medication after checking with a doctor. Heat therapy can be beneficial when a few days have passed and pain is decreasing, applying heat pads or similar remedies to the area.

Medical Treatment

If you are incapable of using your arm, experiencing debilitating shoulder pain, or if lesser pain continues for over a week, consult a medical professional. Talk with your doctor about healing exercises for your rotator cuff muscles. This physical therapy should help to steadily develop your muscle flexibility and to strengthen and balance the shoulder muscles where necessary. The length required for the therapy will depend on the severity of the condition. For extreme pain, corticosteroid injections may be implemented. If a rotator cuff muscle has become severely torn then a doctor might recommend minor surgery.

Prevention

Regular stretching and strengthening of the rotator cuff area should help to avoid the injury returning. Try to develop all of your shoulder muscles so that they are balanced in strength; your doctor can assist in suggesting helpful exercises. Always take regular rests during activities necessitating repetitive shoulder movements, switching arm occasionally if feasible.

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

Rib Fracture

A fracture to the ribs is a common sports injury, especially in contact sports. A doctor can mostly do very little about such fractures other than assisting in managing the symptoms while the rib recovers. It is up to the athlete to rest and remain responsible to allow full recovery.

Symptoms of Rib Fracture

Following the direct trauma or motion that lead to the fracture, pain will be noticeable at a point within the ribcage. This is likely to be worsened during deep breathing and also with coughs and sneezes. Often this breathing symptom means that the sufferer will begin to make quick, shallow breaths. They might also be prone to clutching at their chest in an attempt to reduce their pain. The area surrounding the injury can be bruised. If even minimum pressure is applied to the ribcage, pinpointed pain may arise around the fractured rib.

Causes of Rib Fracture

Contact sports carry particularly high risks of rib fractures, and these injuries are regularly caused by a fast and intense blow directly to the chest by an elbow. Other body parts can also cause a hard enough strike, as can bats, sticks or projectiles. Golfers and rowers are also regularly afflicted by rib fractures. Outside of sport, fractured ribs can be brought on as the result of a coughing fit or even from sneezing violently. Some diseases and infections can also lead to fractures; this is known as a pathological fracture. The ribs have occasionally been weakened prior to the injury, due to a bone structure problem such as osteoporosis.

Medical Exam for a Rib Fracture

Although a doctor can usually do little in the way of treatment, it is important to consult a professional in case of complications, and particularly if your breathing is strained. This might involve taking an x-ray. They may prescribe you appropriate pain medication in order to relieve pain and swelling symptoms during the recovery process.

Rest and Rehabilitation after a Rib Fracture

Stay away from strenuous physical exercise and do not partake in contact sports or any other training that could further damage the chest. Resting should be maintained until you are pain free and any other symptoms have also subsided. You must consume fluids frequently to ward off constipation. A few times per day, breathe deeply so that lung infections can be avoided. Heat therapy can be useful for reducing pain and keeping relaxed; heating pads or wet towels are perfect for this, but carefully taking a warm bath can work just as well.

Recovery time depends on the severity of the fracture, but a relatively normal fracture should heal with rest in 1 to 2 months. At this point it is vital to return gradually to your regular activities so that no excessive pressure is put on the rib at too early a stage.

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

Repetitive Strain Injuries

Repetitive strain injuries (RSI) occur primarily in the hand, arm, foot and ankle, and are sustained gradually over a long period of time due to incorrect use or cumulative overuse. Such injuries can also affect the back, neck or eyes.

Symptoms

Pain in the ankle or foot, hands or arms, regularly including the fingers, wrists or shoulders. The type of pain (e.g. aches or sharp sudden pain) varies from person to person, and can be present in a small area or an entire limb. It will often worsen after activity, especially those in which posture or repetitive movements are key. RSI can also present without pain symptoms, and other warning signs in the affected body parts include fatigue, numbness, an inability to sufficiently control their motion, and coldness.

Your behaviour may also be affected, for instance by relying on one hand or foot more than the other, frequently dropping items, having trouble wearing certain clothing due to pain, or your sports activities becoming more difficult to pursue.

Causes

Overuse combined with unsuitable posture or technique is the general cause of RSI. Relying heavily on the same muscles for prolonged periods puts them at risk of becoming weakened and thus prone to injury. While RSI is often associated with computer work, damaging repetition is also common in many sports, such as tennis, golf and long distance running. These can lead to maintaining abnormal posture or continuing an activity without sufficient rest. Your pain might also be caused in part by psychosocial aspects such as the stresses of the related job or activity.

Treatment

Cease the sport or activity that led to the RSI in order to take a break and reduce the repetitive strain. Icing the affected area can help with pain and reducing any accompanying swelling, as can anti-inflammatory medications like ibuprofen (always check with a doctor before starting a new program of medication). Lessen the muscle tension with gentle stretching and massage techniques if feasible. Consult a doctor to determine the specific cause and type of your RSI, as they can differ in severity and the amount of medical treatment required. Some injuries classified as RSI are discussed in more detail in other articles on this site, such as tennis elbow, stress fractures, and shin splints.

Prevention

If an activity repeatedly causes you pain it is important to avoid it, at least until you can identify the issues involved and modify your behaviour accordingly. Warm up the specific areas needed for an activity, and strengthen them regularly with suitable stretches and exercises. Good posture, without unnaturally curving your spine or placing inordinate weight on your neck or back, will significantly reduce the likelihood of RSI. Always rest whenever possible, adding breaks to your work or training routine. Do not strain excessively by overstretching smaller muscles; gripping items such as balls or pens too tightly can lead to this strain. Be prepared to significantly alter how you conduct your daily activities, as the repetitive nature of RSI means that a frequent aspect of your lifestyle will have caused the injury.

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

Radial Tunnel Syndrome

A squeezed nerve in the radial tunnel close to the elbow causes radial tunnel syndrome, which is a form of repetitive strain injury (see our RSI article for more information). This condition is often linked to long term overuse in athletes, and can be difficult to diagnose due to the similarity of its symptoms to those of tennis elbow.

Symptoms

Pain along the outside of the elbow, usually accompanied by tenderness. This pain generally begins a short distance from a bony protuberance (the lateral epicondyle) on the outside of the joint, where the nerve crosses the supinator muscle. Pain may also be present as an ache in the forearm. The radial nerve assists in the movement of your forearms and hands as it interacts with various muscles, and therefore the pain is likely to increase when you perform tasks such as turning or bending your wrist, extending your palm upwards, or lifting objects with a straight arm. Your arms and hands can also feel weakened. The elbow joint might feel rigid in the morning. In particularly serious cases, the condition may result in temporary paralysis of the fingers or wrist.

Causes

There are at least five places in the radial tunnel where the nerve can become pinched. Repetitive movementsassociated with many sports can cause excessive pressure on the radial nerve, leading to unnatural stretching and pinching of the nerve. Over time, strenuous gripping, wrist bending, arm twisting, and hard pushes and pulls can all contribute to the injury. Potentially damaging repetitive motions are common to sports including golf and tennis. Occasionally a strike. to your elbow spontaneously squeezes the nerve.

Treatment

The injury is sometimes misdiagnosed as tennis elbow and medical tests can prove futile in distinguishing between these conditions. Nevertheless it is important to see a doctor, who will conduct a physical exam and ascertain the cause of the injury. The better they can identify the exact location of the pain, the greater the chances of a correct diagnosis.

Treatment is often not easy. You should refrain from continuing with any repetitive activity that provoked the pinched nerve, and other activities that may worsen the injury. Add breaks to your training or work routine, and be sensible with lifting, pushing and pulling, avoiding these as much as possible. With persistent night pain, the doctor may recommend an arm splint to hold your elbow in a relatively fixed position. It will be beneficial to speak to a physical therapist who can assist both with limiting strenuous activities and gently maintaining strength in your arms and hands through stretching. Icing the area can reduce pain and any inflammation.

Symptoms are not always resolved, and may last for anything from a few weeks to a number of years depending on severity. Surgery might be employed in major cases to reduce pressure on the radial nerve.

Prevention

Strengthen your muscles gradually during recovery to avoid intense strain. Take frequent breaks, and remember that repetitive strain injuries are incremental, so that little aches and damages add up over time. Therefore modify your sporting or other habits to avoid repetitive movements where feasible, and do not grip objects too tightly or place a lot of pressure on the arm.

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

Popliteus Tendinitis

The popliteus tendon runs across the rear of the thigh up to the knee and curves to the front of the shin. It helps both to keep the femur in position and to avoid unnatural outward twisting of the lower leg while you are running. Inflammation of the tendon is common for certain track athletes and runners, and will necessitate rest and possibly other treatment until the injury has healed.

Symptoms

Acute pain experienced behind the knee immediately after the injury strikes. This is often accompanied by redness and swelling. The pain may prohibit successful walking, especially soon after the injury is sustained. However, in some cases the pain can be less pronounced or even unnoticeable to start with. The area around the popliteus tendon is likely to be tender to touch. Symptoms worsen over time, thus if you have experienced the above symptoms but not yet sought medical attention, the inflammation may become exacerbated and leg training can become extremely problematic, causing severe pain. It is essential to cease physical activities involving the knee while pain is present; failure to do so can result in scar tissue, which can be permanently damaging.

Causes

Pressure is placed on the popliteus tendon during such everyday movements as the feet hitting the ground. Running downhill can put an inordinate strain on the tendon if practiced excessively. This occurs more often than in general sprinting because the surface is not flat; other factors that can contribute to straining the tendon include overuse: running with fatigued muscles, for too great a length of time, or without suitable warm ups or other stretches. The injury is regularly felt after an ankle rolls unusually inwards, causing a tear in the tendon.

Treatment

Consult a doctor as soon as possible so that the symptoms do not have time to progress. The doctor will be able to ascertain whether there are any more serious injuries linked to your tendinitis, but in general the condition is easily treatable. Along with any medical advice, you should primarily take a break from all strenuous physical activities involving the legs until the symptoms have subsided, which may take around 6 weeks. Ice the area to reduce pain and swelling, and take anti-inflammatory pain medication if necessary. If the tendinitis is severe then the doctor might recommend taping the area of the injury or appropriate surgery if the condition is extreme.

When the pain has diminished, incremental physical therapy can help to build up strength and maintain movement in the area. The doctor or therapist can suggest appropriate alternatives to running, such as cycling.

Prevention

Warm up before activity and warm down afterwards so that your muscles and tendons remain in premium condition. Try to limit downhill running, using flat, even surfaces where feasible. If you have any biomechanical foot problems (a doctor can test for these), wear the correct shoe orthotics to fix them. Make sure that you are wearing suitable shoes for your activities. Running shoes should be replaced at least every 500 miles, and worn shoes need immediate replacement.

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

Plantar fasciitis

A very common inflammatory condition of the foot, plantar fasciitis causes pain at the base of the heel and may also result in problems with bending the foot.

Symptoms

Stabbing pain of the heel, often concurrent with your first steps of the day. Pain is frequently lessened as the foot has time to flex throughout the day. Similarly, the pain may return more violently after sitting down or extended periods of standing. You can also experience difficulty bending the foot upwards so that the toes move closer to the leg, known as decreased dorsiflexion. The condition usually affects only one foot, but can present in both.

Causes

The plantar fascia is a broad band of tissue that connects the heel bone to the toes, running along the bottom of the foot. Tears can form in the tissue when subjected to great tension. When this tearing and stretching is repeated the fascia becomes inflamed, causing the pain associated with plantar fasciitis. Damage to the plantar fascia commonly occurs in people who are required to spend a lot of time moving on their feet or standing on hard surfaces; in sport it is most typically found in runners.

The shape of your feet and the manner in which you walk can also instigate the condition, such as having flat feet or a high arch (instep) on the bottom of the foot, as this can mean that weight is not distributed correctly when you stand, putting increased stress on the plantar fascia. Inefficient shoes without suitable support for your feet also leave you at risk, with looseness, excessively thin soles and insufficient shock absorption all potential contributing factors.

Medical Exam

A doctor will make a diagnosis through a physical exam and imaging tests if necessary. They will inspect sites of tenderness in order to establish whether plantar fasciitis or another injury is causing the pain and inflammation. They may also test the strength and reflexes of your ankle.

Self-Treatment

Crucially, keep away from standing or running activities as much as possible until the pain becomes less intense. Change these high-impact activities for a pursuit such as cycling or swimming to maintain fitness without provoking further injury. If you feel you have to run, be conservative and cover shorter distances.

Ice the appropriate area for approximately 15 minutes, 3 times per day, or following any exercise. Massaging the area with a frozen cup full of water can also help to diminish the pain. Stretch and strengthen the significant muscles associated with your ankle and foot arches: the Achilles tendon, plantar fascia, and calf muscles. Stretching these muscles in bed can significantly reduce the pain felt with the first steps of the morning. Buy arch supports for your shoes from a specialist to mitigate the tension placed on the underside of the foot.

Prevention

Inadequate support from the shoes is a high risk factor, so you should always purchase shock absorbent shoes with decent arch support. Never run barefoot, and try to replace old shoes before they lose their support and absorption benefits. A guide for runners wearing athletic shoes is not to exceed 500 miles in the same pair.

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

Piriformis Syndrome

Piriformis syndrome causes sciatica and involves pain to the buttocks and the affected leg or legs. The piriformis muscle of the hip assists with outward movement of the hip and leg, and if the muscle becomes damaged this can result in injury to the sciatic nerve where it crosses under the muscle. The sciatic nerve is located at the base of the back and runs into the buttocks and legs.

Symptoms

Pain is usually present in the buttock and along the back of one or both legs, sometimes extending to the foot. This can be accompanied by a slight tingling sensation. Sitting may become progressively more painful or hard to achieve, and you might notice that when sitting you avoid placing the body's weight on the injured buttock (or side), preferring to leave it elevated.

Causes

The sciatic nerve is liable to become pinched and irritated by an injured piriformis muscle. How this specifically starts is debated, though specialists often conclude that the muscle begins to spasm before squeezing painfully against the nerve, leading to the nerve being pushed against the pelvis bone. One of the causes of piriformis muscle injury is hitting the ground with the buttocks due to a heavy fall.

For athletes this can occur during almost any sport but the risk might be higher in those with either a strong contact element or those in which falling from a height is possible (e.g. cycling or horse riding). After such an impact the muscle can bleed (due to a hematoma) and become inflamed, causing it to press into the sciatic nerve. The weaker scar tissue that eventually forms over the injured muscle can also serve to prolong the problem.

Treatment

Consult a doctor to assess the extent of the damage. Often the initial treatment will be conservative and may incorporate checkups over a period of weeks in conjunction with anti-inflammatory pain medication like ibuprofen. In addition to relieving pain this medication will seek to reduce the swelling around the piriformis muscle in order to take the damaging pressure off the sciatic nerve. The doctor will also recommend physical therapy, with a professional helping to alleviate your symptoms and maintain movement and strength in the affected muscle.

If the symptoms do not improve despite the above, other methods may be required. A common treatment is injecting stronger drugs straight into the muscle to lessen the pain and swelling or, in some cases, to paralyse the muscle entirely with the result of relieving the strain on the sciatic nerve. In rare cases surgery may be necessary to cut directly through the muscle and ease the pressure. Sometimes this involves removing a section of the piriformis muscle, which should not affect your ability to partake in sports activities because the muscle is not crucial for leg movement and is supported by others.

Rehabilitation

Without surgery you can expect to recover in 2 to 3 months. This includes substantial time spent with a physical therapist and a long program of effective stretching. A professional will guide you through this course of action. Recovery time for patients who have undergone surgery will vary depending on the procedure.

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

Phalangeal Fractures (Hand)

The phalanges in the hand are the bones of each finger, with the distal phalanges at the top, the intermediate phalanges below (except for on the thumb), and the proximal phalange attaching the fingers to the metacarpals in the hand. Fracturing a phalange is a common injury in sports activities and other traumatic incidents, often estimated as being the most common of all fractures, and the injury can compromise finger or hand movement. Without proper treatment this can result in ongoing problems.

Symptoms

The symptoms will vary depending on the specific injury and how it was caused. For instance, if the fingertip is struck or crushed then the tissue beneath the fingernail might be damaged along with the distal phalange, leading to discolouration. Intermediate phalanges regularly become inflamed and bruised when fractured, and such fractures can also result in reduced range of finger motion. Many phalangeal fractures can also lead to visible deformities, either at the location of the fracture or the end of the bone. Most of the subtler symptoms, such as rotational abnormalities, are best checked by a doctor.

Causes

Several mechanisms can provoke a phalangeal fracture, but younger athletes are particularly prone to fracture by sports injury. Any severe strike that hits or crushes into the finger can potentially cause a fracture, and this can occur during many high speed contact sports in which the frequency of collisions is high (e.g. rugby or hockey). A bad fall onto the fingers can also result in a fracture. Outside of sports, fractures are often caused through accidents involving machinery.

Medical Treatment

See a doctor quickly so that they can examine the injury and check for various deformities and symptoms. This is especially important in determining whether the fracture is stable or unstable, which can radically alter the course of the treatment. Surgery (e.g. pinning, or fitting plates or screws) may be required for a number of fractures and this will be assessed on a case by case basis. If the phalangeal fracture requires only conservative treatment then a period of immobilisation is usually commenced, during which it is important to rest and stay away from strenuous activities. This period should not exceed 3 weeks because that could lead to inflexibility in the fingers. Removable splints are often used after this point.

Complications

Complications affecting finger motion can arise depending on individual circumstances. The most widespread complication is mal-union of the fracture, meaning that the finger does not heal in its exact previous shape or alignment. This can affect your ability to perform intricate motions or grip with normal strength. Repeated fractures to the same finger increase the risk of ongoing poor movement. Non-union can occur in a fracture involving more severe bone or tissue damage, though this is rare.

Rehabilitation

Hand therapy is a key factor to successful recovery. A specialist in the field should be able to lead you through the initial stages of regaining successful motion in the affected fingers. Stiffness may have accumulated due to a period of immobilisation, so a gradual build up in flexibility will be needed.

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

Peroneal Tendinopathy

Peroneal tendinopathy is a painful condition which afflicts the tendon that extends along the lateral malleolus on the outside of your ankle and under the foot into the 1^st MT (metatarsal). The associated muscle assists in plantar flexion, in which the foot is pointed downwards.

Symptoms of Patellofemoral Syndrome

Pain will be present in and around the bony protuberance on the edge of the ankle (lateral malleolus), and can radiate down the heel. This is made more intense during physical activity and can be relieved during periods of rest. Pushing on the lateral malleolus with a finger can usually replicate the pain, and the aching may also be present when performing movement such as plantar flexion that rely on the peroneal tendon. Swelling might also arise in the area, and the calf muscles can often feel excessively tight.

Causes of Patellofemoral Syndrome

There are various causes of the condition, but a prominent cause is a tendency to run down slopes or on other uneven surfaces, making your foot repeatedly roll outwards (eversion). This can place inordinate pressure on the tendon and the surrounding muscles. Existing rigidity in your leg muscles, particularly the calf muscles, can also contribute to peroneal tendinopathy. Typical overuse practices can provoke the condition, especially in sports or activities that involve intricate foot motions such as dancing and basketball. Overuse can occur due to inadequate stretches or warm ups, inappropriate gear for your activities (particularly footwear in this instance), and as a result of continuing to exercise on muscles weak with fatigue. Uncorrected biomechanical errors in the feet like overpronation can also put you at higher risk.

Treatment for Patellofemoral Syndrome

It is important to rest from all strenuous activity involving the affected foot and ankle until your symptoms have diminished and you have approval from your doctor. They will be able to examine you in order to assess the injury and dismiss any more serious injuries. In general you will be asked to ice the injured area a few times per day to reduce pain, and may be prescribed anti-inflammatory pain medication like ibuprofen to combat any swelling. When you are pain free, a gradual course of supervised physical therapy can help to successfully build back the strength in the peroneal and calf muscles, while massaging these areas can relieve much tension and help the muscles in other ways. In very severe instances the doctor might recommend surgery due to great damage to the tendon, but usually the prognosis is good.

Prevention of Patellofemoral Syndrome

You may want to alter your running exercises to incorporate more flat surfaces, thus putting your peroneal muscles and tendons under less strain. If you have biomechanical foot problems, these can easily be corrected by wearing the correct orthotics in your shoes; see your doctor for more details. In terms of overuse, always conduct a suitable warm up and try not to continue a training or sports session if your muscles feel noticeable weakened.

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

Perforated Eardrum

Perforation of the eardrum occurs when a hole or tear appears in the tissue between the external and middle ear. This is a common condition that generally heals without complications in a few weeks, and in sport it is associated with trauma to the side of the head.

Symptoms

A noticeable change in hearing ability, such as hearing muffled noises or simply less than usual. This is rarely more than moderate impairment. Sometimes it is accompanied by earaches or other pain. The ear is more likely to bleed or secrete another discharge if the injury was caused through blunt trauma or the invasion of an object. Pus emission may indicate aninfection, which may arise simultaneously with cold symptoms such as headaches, fatigue, congestion, sore throat or a high temperature. A high-pitched ringing (tinnitus) might be present on occasion but is unlikely to become chronic.

Causes

Athletes mainly suffer from a perforated eardrum as the result of a hard strike to the ear, either in contact sports or from a fast ball or similar projectile. If a sharp or small object is pressed into the ear with force then this can also provoke the injury. This includes ear cleaning products like cotton buds, which professionals do not recommend. Another common cause is strenuous pressure in the ear; this can arise after an extremely loud noise or at high or low altitudes (for example, during deep swimming). The injury is regularly sustained due to an ear infection, and should always be reported to a doctor.

Treatment

Be careful not to let water into the affected ear when showering or bathing, and if you partake in water sports you must either protect yourself carefully with adequate headwear or refrain from such activities until the eardrum has healed. Consult a doctor to ascertain the cause and rule out other possible injuries. They may prescribe antibiotics as necessary. Pain medication can be necessary if the condition proves painful. You should generally recover within a month, and the doctor will examine your ear again to make sure there are no complications. In rare instances, surgery called myringoplasty is used to repair a particularly severe hole or tear.

Possible Prevention

A perforated eardrum is often linked to infection, and you may be at greater risk of a recurring perforation if you regularly suffer from ear infections. In terms of preventing blunt trauma to the ear or excessive force from objects, you can invest in the correct headgear for your activities. Boxing helmets, for instance, use large pads to protect the ears, and most cycling helmets do likewise. Ear specialists do not endorse cleaning your ear using products such as cotton buds, as this can cause injuries like perforated eardrums. Earwax is actually beneficial unless it has built up excessively.

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