Tuesday, January 6, 2015

Cumulative or Acute Injuries

Soccer, one of the most popular team sports in the world with over 200 million registered players worldwide, is a game of nonstop action. Most injuries in soccer occur in the lower body, mostly to the knees and ankles. The rate of injury in soccer has been reported to be between 15 and 20 injuries per 1000 hours of play. The rate is slightly higher for female players than male participants. Injuries range from a severe bruise to more traumatic type injuries (broken bones). Overuse injuries are responsible for almost 30% of the injuries in soccer and range from mild tendonitis (swelling of a tendon) all the way to a stress fracture. Soccer injuries are generally defined as either cumulative (overuse) or acute (traumatic) injuries. Overuse injuries occur over time due to stress on the muscles, joints and soft tissues without proper time for healing. They begin as a small, nagging ache or pain, and can grow into a debilitating injury if they aren't treated early. Acute or traumatic injuries occur due to a sudden force, or impact, and can be quite dramatic.

Youth and adolescent players are most at risk for overuse injuries during times of rapid growth. Strong muscle pull at the tendon-bone junction and at the attachment to the growth plate can cause inflammation. One common adolescent overuse injury is Osgood-Schlatter's disease. It is a painful bump where the patella (knee cap) tendon attaches to the tibia, or shin bone. This can become inflamed by repetitive running or jumping. Tight hamstrings seem to go hand in hand with this injury. An injury such as this should not be ignored because it could lead to a complete separation of the tendon from the bone.

An ACL rupture is certainly is one of the most serious knee injuries in sport, but with surgery and rehabilitation, most athletes return to play within 6-12 months. The actual rate of ACL injury varies according to sex, age, sport and more. Surgical records of physicians show that ACL injuries in sports are mostly non-existent before puberty. The numbers begin to climb beginning about the age of 14 and peak in high school, and then drop a bit to a plateau during college years before dropping again. ACL injuries can happen from direct contact to the knee, but most often the injury happens in the absence of any direct impact on the knee. The usual description is a rotation of the femur over a fixed tibia when the knee is near full extension. During play, this could be when a player plants their foot and changes direction. A specific and complex sequence of events has to happen to tear the ACL. Most feel that if the knee is near extension and then collapses inwards, the ACL is placed under considerable strain and can tear. When it does tear, the athlete feels immediate pain and instability of the knee. They many even hear an audible ‘pop’ when it ruptures.

Sports injuries may result from overuse, lack of proper rest, lack of proper warm ups or poor conditioning. Many prevention programs have been attempted, but the most effective and successful programs combine core strength and neuromuscular control of the knee during landing and cutting. While each program has some variations in technique, they all have similarities. Focus on overall conditioning, even during the off-season, to reduce the chance of injury. In addition, athletes should warm up and stretch before any physical activity, increase training gradually and avoid sudden changes in exercise intensity.

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