Navicular Fracture

The navicular bone is located near the top of the calceneus bone, which is the main heel bone in the ankle at the back of the foot. The navicular bone spreads further forward to midway along the top of the foot. A stress fracture to the navicular bone is a common injury to various sportspeople such as track athletes.

Symptoms of Navicular Fracture

Pain will be present midway along the top of the foot, and this is likely to be worse during physical exercise. It can be dull, aching and even vague pain, and may go away during periods of rest but will start up again with activity. The ache can radiate into the arch of the affected foot and potentially cause abnormal walking. You can usually recreate the pain when pressing your thumb into the top of the foot at the navicular position. The area on the upper inside of the foot may be tender to touch, and swelling can accompany the injury.

Causes of Navicular Fracture

Navicular fractures are predominantly caused either through a single incident or over a longer period due to overuse or other repetitive strain. Single traumatic blows to the area can arise due to an accidental fall, a hard collision with an object or fellow athlete, or as a result of major twisting of the foot and ankle. This twisting is a regular risk for track athletes such as sprinters, hurdlers and various jumpers. High impact sports involving repetitive large forces to the feet can lead to a single injury of this sort, or contribute to a fracture sustained over time. These sorts of sports include tennis, football, gymnastics and basketball, and can lead to a navicular fracture particularly if you exercise with fatigued muscles, for too long, or without proper warm ups or stretching. Bone conditions like osteoporosis can also contribute to the injury.

Medical Treatment for Navicular Fracture

In most cases a navicular fracture can be treated conservatively by implementing a cast that immobilises the injured foot for around 6 weeks while the fracture heals. During this period it will be necessary to use crutches to walk and to avoid much weight bearing. The doctor will then remove the cast and assess whether more time is needed (by testing for tenderness) or if you can move on to physical rehabilitation.

Occasionally the injury will be severe enough to warrant realignment surgery, in which a metal plate or other method is used to keep the bone in position. This will also require wearing a cast and using crutches after the treatment has been successfully carried out.

Rehabilitation from Navicular Fracture

Physical therapy will involve mobilisation of the ankle joint to remove rigidity and build strength in the area. Stretching and strengthening exercises are key to this process, as is a gradual recommencing of your former physical activities. This process can last for a month or slightly longer.

Prevention of a Navicular Fracture

Always wear shock absorbent and supportive footwear suited specifically for your activities. To avoid overuse, warm up correctly and be responsible with your exercise, learning to stop if your muscles are 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

5^th MT Stress Fracture

A stress fracture to the 5^th MT (metatarsal) is commonly known as a 'Jones fracture' and strikes along the bone coming off the little toe into the body of the foot. It is less common than many sports injuries but can be problematic where it does occur. This injury is distinct from a 5^th MT avulsion fracture, which is provoked by force from a foot ligament and mostly connected to trauma or ankle twisting (see our article for further details).

Symptoms of MT Stress Fracture

Pain will be present midway along the outside of the foot, which can be a sharp pain or a chronic ache depending on the severity of the stress fracture. The pain is worsened during physical activity, especially weight bearing, and walking can become very difficult as a result. The injured party will often report some pain in the foot before the fracture is sustained; this is due to the gradual deterioration that leads to the injury. Most of the time it is easy to identify the moment of the fracture, and sometimes the symptoms arise on both feet.

Causes of MT Stress Fracture

A 5^th MT stress fracture is caused due to repetitive motions involving the outside of the foot, especially weight bearing or other movements characterised by high pressure to the mid foot. This happens over time, and is linked to overuse failures such as training with weakened muscles, lack of warm ups, and exercising for longer than you can feasibly sustain. However the final incident that leads to the fracture usually involves a heavy landing, such as in a fall or high impact sport like basketball, football or rugby. Other fairly demanding yet ordinary motions can also be the final movement before the fracture. Track athletes including sprinters and jumpers can be at risk. High arches on the feet are another common shared factor among those with the fracture, meaning that excess pressure is placed upon the outside of the foot. Worn and ineffectual shoes are also frequently reported.

Medical Treatment for MT Stress Fracture

These fractures can often be treated conservatively without any surgery, but they are regularly recurring due to the repetitive pattern of pressure on the foot remaining unchanged. This is exacerbated by the inadequate blood supply to the area, which can slow healing time. Conservative treatment usually utilises a cast or protective boot to restrict the amount of weight bearing for around 2 months, with the patient required to rest and to use crutches to get around. Anti-inflammatory pain medication can help to reduce some of the symptoms. The doctor will then assess the injury and inform you when you are ready to bear weight again and move on to gradual physical rehabilitation, stretching and strengthening the surrounding muscles before a full return to activity.

Surgery for MT Stress Fracture

Approximately 25% of cases result in operative treatment, particularly repeated fractures. The site of the fracture will be stabilised using a method such as fitting a metal screw, and after surgery the physical rehabilitation will follow a comparable program to that described above.

Prevention of MT Stress Fracture

The best method of prevention is to modify your sporting activities to consciously apply less pressure to the outside of the foot, and to use stretches to build strength in the feet.

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

5^th MT Avulsion Fracture

Often referred to as a 'Dancer's fracture,' an avulsion fracture to the 5^th MT (metatarsal) affects the bone that connects the little toe to the main body of the foot. An avulsion fracture involves a fragment of bone being pulled off. This injury is different from a 5^th MT stress fracture, which strikes further along the 5^th metatarsal and is rarely connected to trauma (see our article for further details).

Symptoms of a 5^th MT Avulsion Fracture

Localised pain in the area around the outside of the small toe, which can be debilitating and greatly interfere with your ability to walk. Exercising or weight bearing on the injured foot will exacerbate the pain. Another common symptom is accompanying inflammation around the small toe. This swelling can be severe and in the days after the fracture arises, the skin around the injury regularly becomes black and blue or bruised looking. The area will be tender to touch at the base of the 5^th metatarsal.

Causes of 5^th MT Avulsion Fracture

The name 'Dancer's fracture' was coined due to the high incidence of the injury in relation to stepping on a dancing partner's foot. A blow of this sort can also occur in contact sports like football or rugby, and the fracture is also associated with twisting injuries to the foot and ankle which can arise in many sports. The injured party often reports a history of ankle sprains or similar injuries, suggesting that the 5^th MT has been weakened over time as a result of wearing down sustained through multiple injuries. The mechanism of the injury involves a huge pulling force from a powerful tendon on the outside of the foot, which is forced into yanking a fragment of bone from the metatarsal.

Medical Treatment for 5^th MT Avulsion Fracture

Usually there is no need for surgery; the doctor can use a cast or other method to hold the injured foot in place while the fracture recovers. This takes approximately 6 weeks of total immobilisation but time varies depending on severity. You will need to rest and refrain from much walking until the doctor says otherwise. Pain medication can relieve the symptoms. When the doctor gives approval you can begin to gradually build your activity level, starting slowly by stretching and strengthening the rigid muscles in the affected foot. A physical therapist will be able to assist with recommending suitable training and guiding you at the correct speed. Full recovery may take up to 3 or 4 months, but this is essential for regaining total strength and control in the region and for minimising the chances of further injury.

Prevention of 5^th MT Avulsion Fracture

Carefulness and awareness of your surroundings is important in terms of anticipating when somebody might accidentally step on your foot or in avoiding obstacles that could provoke ankle twisting. It is always beneficial to strengthen your ankles as much as possible and to rest during activity if you are feeling tired. Shoes with appropriate ankle support are invaluable.

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

Meniscus Tear

The medial and lateral menisci are extra layers of cartilage tissue in the knee joint. They help to lessen the everyday pressure that the upper leg puts on the lower leg; this pressure is increased during high impact sporting activities such as jumping and sprinting. The menisci also assist in maintaining the knee's steady movement and general stability. Injury to a meniscus can cause irritation and reduce your ability to partake in physical activities until it has healed.

Symptoms

Symptoms of a meniscus tear are dependent on the specific incidence of tear, with some forms of the injury occurring asymptomatically. The most common symptoms, however, are pain, inflammation and reduced knee movement. The pain may be exacerbated when straightening your leg, and in some cases it can be so severe as to make walking difficult. Swelling will be present within the first few days, and can remain for months depending on the cause of the injury. It might be impossible to fully straighten your knee joint, and it can become locked in position.

Causes

These tears are regularly caused while playing sports. This can result from carrying out a vigorous knee motion (such as twisting) while your body or another force is simultaneously maintaining heavy pressure on the leg. A common movement that provokes a meniscus tear is rotating the knee, on a stationary leg, while hitting a tennis ball. Other sports often associated with movements causing the injury include football, skiing and rugby. When the tear is not caused by a single incident, it is likely to be related to degeneration or the build up of multiple, smaller injuries to the area.

Medical Treatment

Occasionally an injured party's symptoms disappear with rest and without medical treatment; however it is important to see a doctor because many more meniscus injuries require attention before they can successfully heal. The area is prone to poor healing due to the lack of blood supply to the middle of the cartilage.

A doctor will conduct a physical exam and might take an x-ray or similar scan. When diagnosed you will then be advised to rest the affected leg until the pain diminishes, and to ice the area a few times per day to reduce pain and swelling. Anti-inflammatory medication can also be beneficial if approved by your doctor. A bandage may be necessary to compress the area and you should keep the leg elevated for at least the first few days.

Medical treatment will vary depending on the scale and severity of the meniscus tear. Conservative methods and physical therapy to stretch and strengthen the knee are often sufficient for milder injuries, but surgery (arthroscopy) is sometimes recommended for major tears which show few signs of recovery after a number of weeks. After surgery it is necessary to undergo a program of gradual physical therapy to maintain movement in 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

Medial Ligament Sprain

Part of the inner surfaces of the shin bone (tibia) and thigh bone (femur) are connected by the medial collateral ligament. This ligament acts to absorb and combat pressure to the knee’s outer surface so that the inner part of the joint does not widen or form a detrimental gap. The medial ligament’s other main section joins to the meniscus cartilage.

Symptoms by Grade of Injury

Ligament injuries are graded from 1 to 3 depending on their severity, with grade 1 indicating that less than 10% of fibres are damaged and grade 3 being a total rupture. Grade 2 injuries therefore range greatly in severity. The typical symptoms of each grading are as follows:

GRADE 1

Tenderness may be present at a point on the inside of the knee, but this will not be major for a grade 1 sprain. There should generally be no swelling, and pain will arise only while bending the knee and applying force on its outer surface to test the medial ligament.

GRADE 2

Grade 2 symptoms are the most variable, but in many cases the grade 1 symptoms will arise more intensely. For instance the pain during knee bending and pressurising will be worse, and you should feel a noticeable loosening in the knee that indicates joint instability. The tenderness is often considerable, and swelling can appear at the site of the sprain.

GRADE 3

A complete rupture or grade 3 sprain is associated with a more extreme feeling of looseness in the knee joint. While trying to bend or put pressure on the knee, this excessive looseness can make the joint feel actively unstable and unsafe. Everyday movements can draw attention to the wobbly knee. Yet the pain can be deceptive as it might not be as strong as the pain of some grade 2 injuries.

Causes

A medial ligament sprain is regularly caused by a forceful blow to the outside of a bent knee, as can occur in innumerable sporting events including contact sports, track events and gymnastics. Falling accidents can also lead to such damage. The knee is not usually fully bent at the time of injury. In some cases the deeper section of the medial ligament also incurs damage, which can result in further injury to the medial meniscus (or cartilage).

Treatment

Your doctor will take the necessary tests to assess the grade of injury and thus form a basis for treatment. Grade 1 injuries often only require conservative treatment and a commitment to resting from all possibly damaging activities. Icing the area can help to reduce pain and any swelling. The doctor might recommend a knee support for more serious sprains, and a heat retainer can aid the healing process by assisting the blood supply to the injury site. Occasionally they fit the patient with a cast for grade 3 ruptures. Some sprains necessitate aspiration of the knee joint, in which fluid is taken out with a needle. Very severe cases can require surgery in order to correct instability.

Rehabilitation

A physical therapy and rehab program should last approximately 2 months, though sprains that needed surgery take considerably longer to heal before this process can begin.

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

MCP Thumb Injury

The ulnar collateral ligament links to the MCL (metacarpophalangeal) joint at the bottom of the thumb at the point where the thumb is attached to the hand. Injury to this band of tissue affects the MCP joint and can often result from a forceful outward yank or other pressure on the thumb.

Symptoms of MCP Thumb Injury

The MCP joint at the bottom of the thumb will be painful and is likely to become inflamed. The thumb may feel frail or weakened during movements such as grasping and pinching, plus holding objects can become difficult, especially clutching things between forefinger and thumb. The area around the injury can become bruised or discoloured. Due to the nature of the injury, which involves tearing of the associated ligament, the loose portion of this ligament can often be felt as a bump on the edge of the thumb close to the palm.

Causes of MCP Thumb Injury

Excessive force on the thumb, extending it away from the hand, is the main cause of damage to the ulnar collateral ligament and the resulting MCP injury. The injury is sometimes known as 'skier's thumb' because the injury is regularly provoked when a skier falls onto their hand while holding their ski pole, causing the thumb to bend outwards. This can potentially occur after any fall onto the palm, particularly in a bat or racquet sport when holding something that can push back the thumb. The thumb's outward bending is called a valgus force and can tear or even rupture the associated ligament. Repetitive actions involving valgus force can also contribute to ligament damage over time.

Medical Treatment for MCP Thumb Injury

A doctor will conduct a physical examination on both hands and will take an x-ray and any other suitable tests to assess the exact nature of the injury and the damage. Some ligament damage might not show up on an x-ray. A valgus stress test may be used in order to test the ligament and stability of the joint; this will involve carefully moving the thumb into many positions, with an anaesthetic sometimes administered beforehand. The steadier the joint, the less severe the ligament damage is likely to be. In this case the doctor can recommend suitable conservative treatment, such as immobilising the thumb for 4 to 6 weeks followed by a course of exercises designed to help strengthen grip and improve motion in the thumb. Normal activity is usually resumed within another month.

Surgery for MCP Thumb Injury

However, an unstable joint can point to a total rupture and this might require surgery because the ligament will not be able to heal correctly. This involves looking for any signs of soft tissue damage and repairing the torn ligament and attaching it to the bone. Surgery is mostly successful and thumb movement and strength should return with time and exercise. In rare instances there can be numbness on the back of the thumb due to damage to nerves, but in this eventuality the numbness should recover by itself. You can expect to return to normal activity within approximately 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

Maxillary Injury

The maxilla is a combination of two bones and forms the upper jawbone. Direct facial trauma can lead to certain maxillary injuries in this area, and also in the lower jaw (the mandible; please find our mandibular injury article for more details). Such strikes to the face often occur in sports, and the most widespread maxillary injuries are fractures (transmaxillary, pyramidal, craniofacial dissociation) and damage to soft tissue in the face.

Symptoms of Maxillary Injury

If you experience any of the following symptoms you should seek immediate medical assistance, especially if they follow on from a facial impact. A wound to the mouth or face should be taken seriously, as should any bleeding. Other common symptoms include bruises around the jaw or cheeks, and problems with walking or standing that are caused by feelings of dizziness or vertigo. Some people find swelling around the eyes and loss of vision, strange reactions to light, or floaters (such as specks or webs) swirling in their eyes. You might feel nauseous, vomit, or even have a seizure. Breathing problems are a major concern, and other difficulties in the jaw and mouth can manifest in an inability to talk or open your mouth properly. Immediately notable injuries include a dislocated jaw and fractures to the cheekbones or nose. Skin infections can arise in the affected area.

Causes of Maxillary Injury

The most prominent cause of maxillary injuries is a single hard blow to the face. This trauma can come from a participant in a sport, particularly fast paced contact sports such as ice hockey or rugby, or a projectile like a bat, puck or cricket ball. Falling flat onto the jawbone or face is another cause, and this can occur in sports that involve heights like cycling or jumping, plus during any high speed activity. Other incidents that can provoke the injury outside sport include car accidents and fighting. In sports like boxing and martial arts, an unprotected head could potentially lead to a maxillary injury.

Medical Treatment for Maxillary Injury

It is crucial to consult a doctor at the earliest possible time. Having first examined the injuries and ordered appropriate scans like an x-ray or MRI, they will want to close the wounds within 24 hours of the injury being sustained. In terms of bleeding it is also important to apply pressure to any profusely bleeding wounds at the scene of the injury in order to stop the bleeding. The treatment that the doctor recommends will vary depending on the particular maxillary fracture, and which other parts of the face were damaged. In most cases pain medication is beneficial, and open or closed reductions are used regularly to attend to a fractured maxilla.

Complications of Maxillary Injury

The doctor will explain the risk of complication for your specific condition. If you have sustained a transmaxillary fracture, the risk of infection and loss of teeth is generally increased. A pyramidal maxillary fracture might interfere with processes of the eye such as tear formation, and can lead to double vision. This type of fracture can also be more difficult to fix in terms of bone union. A craniofacial dissociation is a major injury that can be associated with serious damage to the skull and the brain.

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

Mandibular Injury

The mandible is the lower section of the jawbone, and many injuries to this area are commonly sustained during sports due to a direct blow to the face. This sort of impact can lead to a range of different mandibular or maxillary injuries (please see our maxillary injury article for more details). The most common mandibular injuries are fractures and dislocations.

Symptoms of Mandibular Injury

Symptoms vary depending on the depth of damage and the severity of injury, but there are a number of recurring symptoms to look out for, any of which should be taken seriously. These include facial bleeding, especially from the mouth or jaw, discolouration or bruising of nearby skin, and problems with breathing, talking, opening the mouth or swallowing. Changes and deficiencies in vision can arise, such as blurriness, dots or 'spider webs' in your vision or irregular reactions to light; swelling may be present around the eye. Some people experience nausea, and seizures are also common. Walking and even standing can be made difficult by a sensation of vertigo or intense dizziness. The face might also feel strange (skin infections often strike) or seem misshapen.

Many of these symptoms can be directly caused by the blow to the face and can point to a mandibular injury. Any of these symptoms combined with a wound to the face or mouth is cause for concern. Fractures in the nose or cheekbones can also occur, as can a dislocated jaw.

Causes of Mandibular Injury

Mandibular fractures or dislocations are regularly caused by a single traumatic incident in a rough contact sport, e.g. rugby, ice hockey or football. Any hard strike to the face can potentially cause such injuries, whether this comes from a competitor, a ball, a bat or racquet. These injuries are also provoked by falls onto the face or jaw, such as falling from a height in horse riding or cycling. Additionally they can be caused through fighting or vehicular accidents.

Medical Treatment for Mandibular Injury

At the scene of the injury it is important to stop the bleeding using pressure, ensure that breathing is safe, and to make sure no damaged bones are moved. See a professional as soon as possible; a doctor will examine the symptoms and assess the components of the injury with tests like an x-ray and MRI. From there they can recommend appropriate treatment, which usually involves conservative measures like pain medication and closure of any wounds within the first day. Surgical treatment is often necessary, including an open reduction in order to fix damaged mandibular structures. Sometimes the doctor might favour a non-surgical closed reduction.

Depending on the extent of function loss and cosmetic damage, it can be crucial to see a specialist like a neurosurgeon or to talk about reconstructive surgery in severe cases.

Rehabilitation from Mandibular Injury

These sorts of injuries can take physical and emotional toll, especially when major, so the utmost care will be taken by medical professionals to carefully outline the necessities of the rehabilitation period. The time this takes varies greatly from case to case.

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

Maisonneuve's Fracture

The Maisonneuve fracture (named after a French surgeon) is an injury to the ankle involving both a fracture and a sprain. It often arises from painful falling accidents associated with sporting activities.

Symptoms

Pain consistent with a sprain will be present in the ankle, and may be worsened upon moving the foot. It might feel impossible to put your body weight on the foot. If this is accompanied by tenderness in the fibula bone, which extends from the ankle to below the knee, then a Maisonneuve's fracture is likely. The area can become inflamed, bruised or reddened, and the ankle will feel substantially unstable.

Causes

When the foot hits the ground or another surface in an awkward manner – generally as the result of a fall – and the leg rotates unnaturally around the foot, the ankle can become strained and the fibula cracked. This can also cause a fracture in the tibia, much lower than the fibula fracture is usually sustained, due to the way in which the harsh force of the blow and subsequent leg twisting runs up the leg at the moment of impact. These can all combine to create a Maisonneuve's fracture, and commonly occur in athletes who partake in sports with a major leg element, a moving surface, or a risk of falling. Examples include skiing, cycling, dancing or gymnastics, though a fall of the described nature can strike in almost any sport.

You may be at greater risk if you have a history of ankle injury, and especially if any previous injury was rehabilitated incorrectly. Reasons for this vary, but can include not allowing sufficient time away from strenuous activity following an injury or not adequately following a doctor's instructions.

Medical Treatment

It is essential to consult a medical professional immediately after the fracture is suspected. The injury might take time to properly diagnose, due to the fact that it may appear as a combination of injuries or even as another ankle condition. In general the doctor will recommend surgery, which can involve the temporary placing of a syndesmosis screw to hold the unstable ankle in position while the surrounding ligaments begin to heal.

Rehabilitation

It will be necessary to avoid activity involving the foot for a number of weeks, and the exact timescale will depend on the severity of the injury, the speediness of healing and your doctor's individual advice. Activities unrelated to the feet may be pursued, but if in doubt these should be checked with a doctor to make sure they will not exacerbate the ankle injury. Physical therapy might be beneficial after the ankle begins to recover. This will involve gentle stretching and strengthening exercises designed to maintain mobility in the area, and the doctor can advise you on appropriate training methods. You may be prescribed pain or anti-inflammatory medication to treat ongoing symptoms, and icing the area every so often can also be effective in combating pain and swelling. Recovery is often very gradual and can take many 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

Lumbar Spine Sprain

Lower back pain is most frequently caused by lumbar spine sprain or muscle strain. Lumbar sprain is a musculoligamentous injury that arises when ligaments become ripped from their attachments, affecting the important relationship between bone and ligament. Lower back pain is extremely common and should be checked by a doctor, especially if you are unsure of the cause.

Symptoms

Pain in the lower back which can radiate down into the buttocks. In general this pain will not spread into the legs, which differentiates lumbar sprain from certain other spinal injuries. Pain will be exacerbated during physical activity and should be reduced during periods of rest. You might experience occasional spasms in the lower back. These symptoms are all consistent with lumbar sprain and muscle strain, but if you feel the pain becoming chronic, great weakness in the back, or poor bowel or bladder control, this may be a more serious injury requiring immediate attention.

Causes

The structures of the spine are working almost constantly to maintain strength and balance during innumerable activities. This means that the muscles and ligaments of the lumber spine can be prone to injury through being overworked. A single incident involving a back twisting manoeuvre or sharp movement can also cause the injury. There are many other ways that the sprain can occur, but some recurring contributing factors have been singled out. Unsuitable techniques for weightlifting (or other lifting) can damage the lumbar spine. Another risk factor is a lack of sufficient stretching and strengthening in the muscles of the back, especially if you rely greatly on the lumbar spine. Obesity and smoking can also put you at risk.

Treatment

The initial pain is likely to be strong and debilitating. You should see a doctor to rule out any major spinal injuries and take any advice that they provide. Patients are often told to rest completely, and may be forced to stay in bed for a couple of days due to the severity of the pain. In this period the swelling and the muscle spasms should diminish or cause less damage. After two days you should get out of bed so that the muscles do not become rigid and weakened. The doctor may prescribe muscle relaxants for those sufferers with persistent spasms, while anti-inflammatory pain medication can relieve other symptoms.

Exercising

When you are pain free and the doctor gives their approval, a course of careful physical training can help to build up strength and flexibility in the lumbar spine. Specially selected exercises will achieve this without causing pain, and prepare you for a full return to activity. Stretches for the lower back, abdomen and the hips are all beneficial for preventing weakness in the back.

Evaluation

Most sufferers of lumbar sprains recover within a month, but if the symptoms recur or do not diminish then a doctor’s evaluation will be necessary. They might take an x-ray or other suitable tests in order to assess whether there have been any complications or if the symptoms are caused by a different spinal 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

LOWER BACK NERVE ROOT COMPRESSION

LOWER BACK NERVE ROOT COMPRESSION

The nerves in the spinal column use a foramen to carry crucial sensory information to other parts of the body. This allows muscle movement, and is required for touching sensations to travel to the brain. Any compression of a spinal nerve will result in pain and is particularly common in the low vertebrae (the L4 and L5 region) near the base of the spine.

Symptoms

Nerve root compression causes sharp or burning pain known as sciatica, which travels down the leg and can reach the top of the thigh. It may not be restricted to a specific area and can be accompanied by a chronic ache, pins and needles or a lack of feeling. A major injury might also entail problems with motion, fatigue or slow reflexes. You may experience spasms in the legs or back. Sciatica pain and its concurrent symptoms usually occur simultaneously with back pain (which can also be present before the sciatica symptoms).

It is worth noting that injuries to different vertebrae can lead to pain in a wider variety of locations. Posterior sciatica, related to problems in the L5-S1 area, can cause pain in the foot and the large toe. Groin pain is associated with an L1 injury, while symptoms in the anterior thigh are regularly caused by the L2, L3 or L4 vertebrae.

Causes

Many incorrect techniques or unsuitable practices associated with sports injuries can provoke back conditions. A common example is lifting heavy weights with an unsuitable method that is damaging to the back. Failure to suitably stretch muscles prior to activity can also lead to injuries. Training for excessive lengths of time can cause muscle or ligament fatigue, increasing the risk of injury. Often a nerve root compression is caused by a degenerated or herniated disc, caused by one of the above or an abrupt motion during activity.

Treatment

A doctor will conduct a series of tests to ascertain the severity of the nerve root compression and how it is affecting the spine and other areas. In a majority of cases, and even if a herniated disc is suspected as the cause, this is unlikely to require surgery unless non-operative treatment fails to resolve the symptoms, most importantly pain. It is crucial to develop a rehabilitation program with the help of a doctor and perhaps a physical therapist. This will involve initial rest from sports or activities that put pressure on the spine, and may also include a prescription for pain medication. Exercise will be implemented in stages as the injury heals, as it is important to keep moving and exercising as much as possible without worsening the symptoms.

Prevention

To avoid a recurrence of back injuries, always warm up the muscles supporting the back and strengthen them over time. Learn correct lifting techniques, maintain good posture, and prevent overusing your muscles by curbing extreme levels of 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

Levator Scapulae Syndrome

The levator scapulae muscle extends along the back of the neck, with the function of assisting with various neck, arm and shoulder movements such as shrugging. When the muscle becomes rigid this can cause pain and reduced motion in the area.

Symptoms of Levator Scapulae Syndrome

Sharp pain in and around the neck, often radiating upwards and leading to headaches. The neck area may also become noticeably inflamed. It is not unusual to experience a prolonged feeling of discomfort in the area. Movement can be restricted in the neck and shoulders, with pain and stiffness worsening when attempting many everyday motions. The syndrome most frequently affects the left side of the body.

Causes of Levator Scapulae Syndrome

In athletes and others involved with physical activities, the most prominent cause of levator scapulae syndrome is overuse. This can arise due to multiple factors. Failure to warm up correctly before activity or to stretch and strengthen the neck muscles regularly is a common contributing factor. Another is to train for extensive periods when the muscles have become noticeably weakened. Similar damage can be caused due to greatly increasing your exercise program very quickly, as this does not allow the muscles sufficient time to adjust. Outside of sport, the syndrome can be caused by maintaining bad posture, usually as a result of sitting for long periods such as in a desk job. Prior injury to the shoulders or neck, or any pre-existing deficiency in those areas, can also put you at higher risk.

Treatment for Levator Scapulae Syndrome

It is a good idea to see a doctor about the injury as they can ascertain the seriousness of the injury and identify if there are any complications, such as with vertebrae or the spine of the scapula. In general, levator scapulae syndrome can often be treated conservatively, first by ceasing any physical activity that could exacerbate the condition and taking rest until the symptoms have diminished. Limiting arm and shoulder movements can be beneficial. Anti-inflammatory pain medication can help to reduce aching and any swelling, while icing the area approximately 3 times per day can provide non-medicinal relief.

In some cases there might be a need to correct a component in the spine of the scapula with a chiropractic procedure. Rare cases can require surgery.

Rehabilitation of Levator Scapulae Syndrome

As long as there are no complications and you rest appropriately, the injury should soon begin to clear up. When you are pain free, you will be able to commence physical therapy with the doctor's approval. This stage is important for gradually replacing the lost strength in the neck and building up flexibility in the area before attempting to return to activity. Your doctor or a physiotherapist can assist with recommending suitable neck and shoulder exercises, while massage can also be helpful.

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

Lens Dislocation

The lens in the eye is found behind the pupil and assists in providing clear vision by directing light towards the retina. When the supporting and very thin ligaments are disturbed, often through being knocked out of position, the lens can become dislocated. The injury is not necessarily serious but can leave permanent symptoms.

Symptoms of Lens Dislocation

Blurred vision is the most prominent symptom, though this depends on the severity of the lens dislocation. A lens only partially detached can sometimes occur asymptomatically, whereas blurred vision most regularly strikes those with full dislocation or detachment. This is due to the lens moving away from the line of vision and settling unnaturally in the vitreous humour. The greater the intensity of blurring, the more detachment this suggests. Another possible symptom is shaking of the iris caused by the surrounding ligaments becoming weakened or broken.

Causes of Lens Dislocation

In sports and other physical activities, lens dislocation is usually provoked by direct trauma to the globe of the eye. Blows to the upper face like this can be sustained during many sports due to accidents, but are a continual risk to boxers and martial artists, and are more common in contact sports such as rugby or football or sports involving fast moving projectiles like tennis or cricket balls. The injury can also be hereditary, and in that case it is likely to be linked to other conditions that cause weakness in the ligaments, such as Marfan syndrome or aniridia; please check with a doctor.

Medical Attention for Lens Dislocation

Consult your doctor so that they can diagnose the condition using a relevant eye exam, often implementing eye drops to dilate the pupil and improve visibility of the lens. They will be able to identify any possible cataract complications or associated disorders, such as glaucoma or iritis. They can also determine whether all of the fine ligaments are broken and the lens is fully detached, or whether the dislocation is only partial.

Corrective Measures or Treatment for Lens Dislocation

Unfortunately in most cases, especially those involving total lens detachment, the injury remains due to the inability of the ligaments to reattach. This means that any symptoms such as blurry vision will persist, and need to be corrected using methods such as seeking appropriate glasses or contact lenses. However if the injury is accompanied by another condition then surgery might be necessary to replace the lens with an artificial alternative. The doctor should check the state of the affected eye at regular intervals, as surgical options may also be considered following an initial period of conservative corrective measures if the problem becomes more serious.

Prevention of Lens Dislocation

In order to protect the eyes from traumatic strikes, always wear the correct recommended equipment for potentially risky activities. Headgear is available for boxers and martial artists, and helmets for various sports. Eyewear or goggles can also be vital in directly shielding the eyes from injury, especially from a hard blow coming from a ball, bat, or the elbow or fist of a fellow athlete.

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