Patient Care

Sports Medicine & Sports Injuries

What is Sports Medicine?

In recent years, the general public became more aware of the health benefits reaped from physical activity. With an increase in physical activity amongst individuals who participate in regular exercise and sports, many of them are also engaging sports competitively.

Participation in sports increases one's risk being injured. To cater for the special needs of the active population, NUHS institutions do have clinical services to include sports medicine. The Sports Medicine teams usually include sports physicians, sports orthopaedic surgeons and physiotherapists, dedicated to support all competitive athletes and active individuals in achieving their sports and fitness goals. They are also strong advocates for safe sports through prevention and early management of injury.

What are Sports Injuries in the Upper Limbs?
Cuff tears / Tendinitis

Cuff tears or tendinitis usually presents with shoulder pain which can be exacerbated by abducting or 'lifting' the shoulder up by the side of the body. In many cases, there may be no history of a specific trauma to the shoulder and the pain develops slowly over a period of time. Wearing clothes and performing overhead activities or lifting heavy objects may result in an increase in the pain experienced.

Dislocations / Instability

In this condition, the shoulder usually feels unstable and patients may feel like the shoulder is 'coming out' when they are in certain positions or there may be a dislocation. There may be an episode of an initial injury to the shoulder during sports or after a fall.

Frozen Shoulder

As the name suggests, the shoulder joint feels 'frozen' as stiffness is frequently the main complaint, although patients may also experience varying amounts of pain associated with the stiffness.

What are Sport Injuries in the Lower Limbs?
Ankle Sprains

A sprain in the ankle causes an injury to the ligaments around the ankle. Such injuries can cause pain and swelling. In addition, the patients may feel as though the joint may give way.

Cartilage Damage

The cartilage of the ankle joint is susceptible to injuries if ankle sprains, fractures or other ankle injuries are left untreated.

Muscle Strains

Strains of the muscles around the hip and pelvis can cause pain and spasm. The most common strains are groin pulls and hamstring strains.

Meniscus Tears

The menisci can be torn by shearing forces of rotation that are applied to the knee during sharp, rapid motions. This is especially common in sports activities that require reaction body movements. There is a higher incidence with aging and degeneration of the underlying cartilage. More than one tear can be present in an individual meniscus. The patient with a meniscal tear may have a rapid onset of a popping sensation with a certain activity or movement of the knee.

You may experience pain on the inner or outer side of the knee during activities. Some patients also experience ‘locking’ which is a sensation of a ‘jammed’ knee that is unable to straighten fully.

Occasionally, it is associated with swelling and warmth in the knee. It is often associated with locking or an unstable sensation in the knee joint. The doctor can perform certain maneuvers while examining the knee which might provide further clues to the presence of a meniscal tear.

Routine X-rays, while they do not reveal a meniscal tear, can be used to exclude other problems of the knee joint.

The meniscal tear can be diagnosed in one of three ways:

  • Arthroscopy - A surgical technique where a small diameter video camera is inserted through tiny incisions on the sides of the knee to examine and repair internal knee joint problems. Tiny instruments can be used during arthroscopy to repair the torn meniscus.
  • Arthrography - A radiology technique where a contrast liquid is directly injected into the knee joint and internal structures of the knee joint so that they become visible on X-ray film. It is not used commonly used nowadays as MRI is getting more popular.
  • MRI Scan - A radiology technique where magnetic fields and a computer combine to produce two- or three-dimensional images of the internal structures of the body. It does not use X-rays and can give accurate information about the internal structures of the knee when considering a surgical intervention. Meniscal tears are often visible using an MRI scanner.

Once diagnosed, meniscal tears are generally repaired arthroscopically.

What other Sports Injuries are there?
Collateral Ligament Injury

A collateral ligament injury is felt on the inner or outer portions of the knee. A collateral ligament injury is often associated with local tenderness over the area of the ligament involved.

Cruciate Ligament Injury

A cruciate ligament injury is felt deep within the knee. It is sometimes noticed with a "popping" sensation with the initial trauma. The anterior cruciate ligament (ACL) is one of the most commonly injured ligaments of the knee, especially in sports such as basketball and football. The ACL stabilises the knee for cutting, twisting and jumping and pivoting activity. The anterior cruciate ligament is in the centre of the knee joint. When you tear an ACL, you will often feel or hear a pop, feel the knee shift out of place and develop significant swelling in just a few hours.

A ligament injury to the knee is usually painful at rest and may be swollen and warm. The pain usually worsens if one bends, puts weight on the knee or walks. The severity of the injury can vary from mild (minor stretching or tearing of the ligament fibres, such as a low grade sprain) to severe (complete tear of the ligament fibers). Patients can have more than one area injured in a single traumatic event.

What treatment options are there for Ligament Injuries?

Ligament injuries are initially treated with ice packs and immobilisation, with rest and elevation. We generally recommend that patients avoid bearing weight on the injured joint, and use crutches for walking, if necessary. Some patients are placed in splints or braces to immobilise the joint to reduce the pain and promote healing. Arthroscopic or open surgery may be necessary to repair severe injuries.

Surgical repair of ligaments can involve suturing alone, grafting, and synthetic graft repair. These procedures can be done by either open knee surgery or arthroscopic surgery. The type of surgery depends on the level of damage to the ligaments and the activity expectations of the patient. Many repairs can now be done arthroscopically. However, certain severe injuries will require an open surgical repair. Reconstruction procedures for cruciate ligaments are increasingly successful with current surgical techniques.

Find A Doctor

Click here to access our Find A Doctor directory for a list of doctors treating this condition across our NUHS institutions.

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