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Sport Injuries
In the Martial Arts
Treatment and Prevention
Ihsan Antoine Azzam , MD, MPH
June 24, 2005
Today's Topics
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What are Martial Arts (Sports)
Injuries?
What is the Difference Between
Acute and Chronic Injuries?
What Should We Do in Case of
Injury?
How are These Injuries Treated?
Individuals/Groups at High Risk
How Can We Prevent These Injuries?
Recent Advances
Statistical Facts
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Most sports injuries can be treated
effectively
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Most people who suffer injuries can return
to a satisfying level of physical activity
after an injury
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Many sports injuries can be prevented if
people take the proper precautions
Sports Injuries - Definition
“Injuries that most commonly occur
during sports or exercise.”
What Are Sports
CouldInjuries?
Involve:
Could be due to:
 Unintentional accidents
 Poor training practices
 Improper equipment
 Lack of conditioning
 Insufficient or inadequate
warm-up and stretching
 Muscles
 Bones
 Associated tissues:
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Ligaments
Tendons
Cartilage
 Any part of the body
Sprains and Strains
Joint Sprain: Stretch or tear of a
ligament (the band of tough soft tissues that
Joint Strain: twist, pull, or tear of a
muscle or tendon (the band of tough soft
connects bones to bones)
tissue that connects muscles to bones)
Caused by trauma
Could be None-contact injury
May result from over-stretching or
Most vulnerable to sprains are:
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Ankles
Knees
Most vulnerable to sprains are:
Tenderness or pain
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Bruising
Signs include:
Wrists
Signs include:
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over-contraction
Inflammation
Swelling
inability to move a limb or joint
joint looseness, laxity, or instability
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Ankles
Knees
Wrists
Pain
Muscle Spasm
Loss of Muscle Strength
Swelling
Knee Injuries
knee is the most commonly
injured joint
Each year > 5.5 million
Individuals visit orthopedic
clinics for knee problems.
Ranges from mild to severe
Functionally limiting
Pain or tenderness
Causes of Knee Injuries
Running too Hard too Much
Training without Warm- up
Blow, Kick or Punch
Twist
Improper Landing
Compartment Syndrome
Ongoing overuse (chronic) or one-time traumatic
injury (acute compartment syndrome), such as:
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Fractured bone
Hard blow to the thigh (or repeated hard blows)
Occurs when muscles become swollen, and filled
the compartment to capacity, causing damage to the
muscles and interference with:
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Nerves
Blood vessels.
Achilles Tendon Injuries
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Stretch, tear, or irritation
Tendonitis
degenerative caused by
aging*or overuse
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Rupture.
Lateral View of the Ankle
* Healthy and active lifestyle may delay soft tissues degeneration
Shin Splints
Definition: Leg pain along the tibia
associated with exercise
 Running and Overtraining
 Jumping on hard surfaces
 Running in shoes that don't have enough support
 Overuse or incorrect use of the lower leg
 Improper stretching, warm-up, or exercise technique
 Flat (over-pronated) feet
Additional Images of the Knee
Joint
Common Types of Sports
Injuries
 Muscle sprains and strains
 Tears of the ligaments that hold joints together
 Tears of the tendons that support joints and
allow them to move
 Dislocated joints
 Fractured bones, including vertebrae
Hernias
Fractures
Broken bones
 Quick, Acute or one-time injury
 Repeated stress
 Simple and Clean break
 Compound
 Most acute fractures are emergencies
 Symptoms:
Pain
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 Tenderness
 Swelling
Broken Arm
Humerus Fracture
Dislocations
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When bones that
form a joint become
separated
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Due to excessive
force, stretching or
falling
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Emergency situation
Fractures and Dislocations
Acute Versus Chronic Injuries
Acute Injuries such
as:
sprained ankle,
strained back
fractured hand
Signs of an acute injury include
the following:
 Sudden, severe pain
 Swelling
 Inability to place weight on a
lower limb
 Extreme tenderness in an upper
limb
 Inability to move a joint through
its full range of motion
 Extreme limb weakness
 Visible dislocation or break of a
bone
What's the Difference Between
Acute and Chronic Injuries?
Chronic Injuries
Result from Overuse
When Injury Occurs
STOP IMMEDIATELY
When to Seek Medical Attention?
What Should We Do in
 Severe pain, swelling, or numbness
Case
of
an
Injury?
Can't
tolerate
any
weight on that area
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 Pain or dull ache of an old injury that is
accompanied by increased:
 swelling
 joint abnormality
 instability.
Managing Injuries at Home
Follow “RICE” for 48 hours
• R
I
•How
Are Sport Injuries
est
ce (for maximum 48 hours, no more than 10 times/day 20-30
minutes each)
C
•Treated?
• E
ompression (should be performed by skilled individuals
only)
levation (slightly above the level of heart)
If pain or other symptoms worsen
check with your healthcare provider
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How Are Sport Injuries Treated?
Start with “RICE”
Immediate Immobilization
Surgery
None Steroidal Anti-Inflammatory Drugs (NSAIDs)
Rehabilitation:
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Gradual Exercise
Early Mobilization
Avoid Pain
Avoid Re-injury
Other Therapies include:
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Electrostimulation (reduces pain, swelling, functionality, and produce
passive muscle contraction - not recommended in the first 72 hours)
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Cryotherapy
Thermotherapy (enhances and speeds up the healing process not
recommended in the first 72 hours)
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Ultrasound (not recommended in the first 72 hours)
Massage (not recommended in the first 72 hours)
High Risk Individuals (Vulnerable
Groups)
Children and Adolescents
 Bones, Muscles Tendons and Ligaments still Growing
 Neck, Spinal Cord and Growth Plates (contact Sports)
Middle Aged Martial Artists
 Aging (physical activity and some medical and food
Individuals and Groups at High
supplements*
Risk for
Sport Injuries
may delay the progress of arthritis)
Moving too Quickly to Active Lifestyle
Women (High Prevalence of Osteoporosis among
inactive women who are not on Calcium
supplements)
 Conditioning Levels
 Structural Differences
 Hormonal Levels
* NSADs, Glucosamine and Chondroitin may play a role in slowing the progress of arthritis
Preventing (Sports) Martial
Arts Injuries
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Do Warm-up Exercises.
Don't Overdo
Accept Your Body Limit
Modify Activities as Needed
Increase the Emphasis on Conditioning
Maintain “Normal” Body Weight (some cushion could be
helpful)
Avoid Twisting Knees by keeping feet as flat as possible
during stretches.
When Jumping, Land with your knees bent
Wear Protective Gear
Use Soft Exercise Surface
Increase Your Exercise Level Gradually
Avoid Excessive Activities
Strive for A Total Body Workout (Cardio, Strength and
Flexibility)
How Can We Prevent Sport
Injuries?
Hernias
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Hernias of the abdominal wall must be
considered in patients who present with
abdominal or groin pain
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Inguinal hernia pain can be confused with
pain due to chronic muscular-skeletal
conditions encountered in a variety of
sporting activities, especially Martial Arts and
Weight Lifting
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Herniated (prolapsed) inter- vertebral discs is
extremely common among over-achiever
martial artists
Recent Advances
Arthroscopy
Tiny Incisions (less trauma, swelling and
scaring)
Diagnostic Tool
Treatment
Tool (torn
meniscusAdvances
or ligament)
What
Are
Some
Recent
Better Healing
in Treating Sports Injuries?
Tissue Engineering
Cartilage Transplanting
Improve Healing
Targeted Pain Relief
Patches
I/Azzam - 2004