Sports Injuries

Rib Injuries

Physiotherapists can effectively assess and treat rib injuries from the acute presentation through to chronic rib lesions. Acute rib injuries are usually traumatic and occur most commonly as a result of a sporting incident. However, rib injuries may have an insidious onset and gradually get worse without any specific incident of note.

With acute rib you can experience sharp, locailsed pain with deep breathing and coughing. Pain can be felt at the costovertebral joints (middle of the back), sternocostal joint (front of the chest wall) or right through the chest wall. Chronic rib injuries can result due to repetitious activities placing stress on the costovertebral or costosternal joints, over a period of time leading to pain and dysfunction

Rotator Cuff Injuries

Rotator Cuff Injuries are quite a common occurrence in both the sporting and the older populations. These injuries can range from a minor local inflammatory reaction to a partial to full thickness tear (single rotator cuff tendon/muscle involvement to multiple tendon/muscle involvement). Physiotherapists are able to treat rotator cuff injuries throughout the healing phases.

Common presentation is the feeling of a sudden tear with severe pain, decrease shoulder ROM due to pain (predominately abduction), muscle spasm, pain with sleeping, weakness in the shoulder

If there has been a minor tear of the rotator cuff, conservative management, similar to that for subacromial impingement, will generally lead to excellent results. For larger tears you may require surgical repair and intense physio treatment.

Acute ankle

The most common type of ankle sprain is due to excessive inversion and plantarflexion, called an “inversion sprain”, and stretches or tears the lateral and anterior ankle ligaments. It can also damage the retinaculum and often impinges the medial ankle structures. Egg-shaped swelling appears on the outside of the ankle.
A grade one injury is caused by mild over-stretching with less than 10% of ligament fibres are torn. A grade two injury involves considerable tearing of the ligament fibres and a grade three injury is a complete rupture or avulsion of a ligament
How does injury happen? Forceful, high impact sports that involve jumping, or sprinting often lead to ankle sprains. Some sports that are associated with ankle sprains are basketball, football, cross country, and hockey. Common presentation First degree: little or no swelling, mild pain, stiffness in joint Second degree: moderate to severe pain, difficulty with weight bearing, more swelling and stiffness Third degree: severe swelling and pain, inability to bear weight, loss of function in joint

Patello-femoral pain

Patello-femoral joint pain can occur in both children and adults and usually responds extremely well to physiotherapy treatment. Scientific research has confirmed that physiotherapy intervention is the most effective long-term solution for kneecap pain.
Approximately 90% of patello-femoral syndrome sufferers will be pain-free within six weeks of starting a physiotherapist guided rehabilitation program. For those who fail to respond, surgery may be required to repair any severely damaged joint surfaces.

Common presentation is medial knee pain with a gradual onset. Patello-femoral pain can also refer to the lateral, inferior and posterior knee regions. There can be tenderness on the medial patella facet (underneath the patella), and you can have pain with a squat, standing up after prolonged sitting, and walking up and down stairs. Children may complain of knee pain during or after sport. Often in children there has been a change in activity levels or a growth spurt associated with the increase in knee pain.

Swimmers Shoulder

Swimmers Shoulder is a general term used to describe impingement pain occurring at the shoulder as a result of swimming. Swimmers shoulder can occur in both social and serious swimmers and is not an uncommon problem..

Swimmers Shoulder is pain occurring around the front shoulder region as the result of repetitive overuse with usually the overhead strokes (freestyle, butterfly and backstroke). The major contributing factor is often restricted internal rotation of the glenohumeral joint that leads to over protraction of the shoulder complex to compensate for this decreased range during the pull through. Swimmers shoulder (impingement pain) can also occur at other points through the range, and a thorough biomechanical assessment of the upper quadrant (cervical spine and shoulder joint complex) is required for an accurate diagnosis.

Tennis elbow

Tennis elbow can certainly be caused by racquet sports, but it is common in any sport or occupation that involves gripping or throwing eg weightlifting or canoeing, or carpentry and brick laying. You can feel pain with gripping and lifting.

Common presentation is pain over the outside bump of the elbow (lateral epicondyle). As the condition deteriorates, the forearm muscles become tender and remain in a spasm-like contraction. It is most likely caused by repeated microtrauma. You may not have allowed the injury to ever fully heal and ultimately it becomes increasingly painful. It may also be caused if you do an activity that you are not used to, and your muscles are not strong enough to keep doing the activity (such as pruning in the garden).

AC joint

The acromio-clavicular (A-C) joint is found at the junction of the collar bone (clavicle) and point of the shoulder (acromion). It is held together by a series of strong ligaments which attach the bones and require a large force to disrupt and damage the joint.
The most common way to injure the A-C joint is a fall onto the point of the shoulder, elbow or outstretched arm. This may occur in contact sports like rugby, football and hockey or other sports like cycling and riding in which falls are common. There are varying degrees of severity depending on the amount of damage to the joint which can be assessed and investigated by the physiotherapist.
Common presentation is a step deformity near the point of the shoulder. This is usually accompanied by local pain and tenderness (which can be quite intense), swelling of the area and difficulty with certain arm movements like reaching across the body and overhead. Depending on the nature of injury, the symptoms may last for up to 6 weeks; and if problems persist further investigation may be required.

Achilles tendinopathy

Achilles tendinopathy is when pain develops in the achilles or calcaneal tendon regions. The Achilles tendon transmits the power generated in the calf muscles to the heel for the push off of the foot. It is casued by repetitive use of the muscle/ tendon complex which can lead to small cumulative tears in the tendon.
Common presentation is burning pain early in exercise, then becomes less severe during and then worsens after the exercise. The pain may be the worst first thing in the morning., there’s usually tenderness in the tendon 4-5cm above the heel and possible swelling and redness of the tendon.

ACL injury

The knee is comprised of the bottom end of the femur (thigh) and the upper end of the tibia (shin) and the patella (knee cap). The major ligaments of the knee are the Anterior Cruciate (ACL), the Posterior Cruciate (PCL), and the Medial (MCL) and Lateral (LCL) Collateral Ligaments. These, along with the muscles acting on the knee provide the joint’s stability
Injury of the ACL most commonly occurs when pivoting, decelerating suddenly or landing from a jump, or another player falling across the knee
Common presentation is a loud sound such as a ‘pop’ or ‘crack’ during the time of incident, followed by a few minutes of extreme pain. A torn ACL is often accompanied a large tense swelling of the knee. of the injury and to provide advice on treatment required.

Soft tissue injury

Soft tissue injuries are the most common injury in sport. Soft tissue refers to tissues that connect, support, or surround other structures and organs of the body. Soft tissue includes muscles, tendons, ligaments, fascia, nerves, fibrous tissues, fat, blood vessels, and synovial membranes. Acute injury can occur from a known or sometimes unknown incident. Bruises can arise that are caused by a direct force applied to the body such as being kicked or making contact with a player and result in compression and bleeding into the soft tissue (hematoma), resulting in swelling and/or discolouration.
A muscle over-stretching or contracting too quickly can result in a partial or complete tear of the muscle and/or tendon fibres known as a muscle strain. This results in swelling, discolouration and bruising and/or pain on movement. Muscle overuse injuries occur as a result of repetitive friction, pulling, twisting, or compression that develops over time resulting in the slow onset of pain and inflammation.

Osteitis Pubis

Osteitis Pubis has become a common condition in Australian Rules Football Players. It is a condition characterised by oedema of the bone marrow within the pubic rami. This can be confirmed with MRI.

Common presentation is groin pain aggravated by running and kicking activities. Treatment of the adductor muscles does not improve the condition. Any rotational activity can aggravate the pain, so often the player decreases running activities and increases cycling activities to maintain fitness, believing that the non-weight bearing cycling may be less painful. However, cycling, although less aggravating than running, still increases pain and the player comes in to be assessed. Resting for a few weeks can also settle the pain, but upon return to sport, the pain returns immediately.