Sports Injuries

1. Sports Injuries Dr Christopher Tong Sports Medicine Specialists 8/F AON China Building 29 Queens Road Central Hong Kong

2. Today’s talk • Overview of sports medicine • Review of anatomy • General principles of sports injuries management including clinical examination • lower limb injuries

4. Anatomy and Function

5. Symptoms of Meniscal tear • Symptoms • Pain • Locking • Knee swelling • Signs • Knee effusion • Joint line tenderness • Apley grinding test • McMurray test

7. Finished Product

8. Acute Knee Injury

9. Clinical Problem Clinical Examination (Anatomical Knowledge Needed) Diagnosis

10. Common Structures Damaged • Cruciate ligaments • Collateral ligaments • Menisci • Nerve (common peroneal)

11. Knee Arthroscopy

12. Normal ACL Ruptured ACL

13. Knee Arthroscopy

14. Management of acute knee injuries • Rest • Ice • Compression • Elevation • Complete examination to diagnose structures damaged • MRI or arthroscopy

15. Cartilage Injuries

17. The Challenge

18. Drilling

20. Replacement • Osteochondral graft • autograft, mosaicplasty, OATS • allograft

21. Ankle Sprains

22. Ankle Sprain Ankle Sprain

24. Acute Management ? C C I ? E R ?

26. Common Peroneal Nerve Function • Sensory • Motor • Anterior compartment (deep peroneal nerve) • Lateral compartment (superficial peroneal nerve)

27. My Work • PWH Orthopaedics Sports Team • Knee and shoulder surgery 80% • Foot and Ankle surgery 20% • Hong Kong Sports Institute • Honorary Sports Medicine Consultant • Care of HK elite athletes

28. Scope of Sports Medicine • Sports injuries and management • Sports psychology • Sports nutrition • Physical conditioning and training • Doping • Medical aspects of sports medicine • Rehabilitation • Sports physiology

29. Multidisciplinary Team • Sports physician • Orthopaedic surgeon • Sports psychologist • Sports nutritionist • Coaches • Physiotherapists • Sports physiologist

30. Sports physician • Overall care of athlete • Medical aspects • Non-operative aspects of sports injuries • Team doctor and travel medicine • Liaison role with other specialists

31. Sports psychology • Enhance performance • 100 m sprinter vs. Olympic archer • Injury prevention and rehabilitation • Tools: • Relaxation techniques • Goal setting • Visualization

32. Sports nutritionist • Macronutrients • CHO, lipids, protein • Micronutrients • Vitamins, minerals, antioxidants • Fluid balance • Supplements • Creatine, bicarbonates, caffeine

33. Doping • Blood doping • Anabolic steroids • Erythropoietin • Growth hormone • Stimulants • e.g. amphetamines • Diuretics

34. Coaching • Fitness • Strength training • Speed • Endurance • Flexibility • Injury prevention

35. Principles of training • Progressive overload • Specificity • Periodization • Tapering

36. Progressive overload • Overuse injuries are often the result of training which is ‘too much, too soon’. • Training load: • Frequency • Duration • Intensity

37. Sports physiology • Energy systems • Anaerobic • ATP + phosphocreatine system • Glycolytic system • Aerobic • Carbohydrate oxidation • Fat oxidation • Muscle physiology • Training implications

38. Sports Medicine Multidisciplinary business