Sports participation is important from a public health perspective. There is no longer any doubt that regular physical activity reduces the risk of premature mortality in general, and of coronary heart disease, hypertension, colon cancer, obesity, and diabetes mellitus in particular.
The question is whether the health beneﬁts of sports participation outweigh the risk of injury and long-term disability, especially in high-level athletes.A study has investigated the incidence of chronic disease and life expectancy of former male worldclassathletes.
The overall life expectancy was higher in the high-level athlete .They also showed that the rate of hospitalization was lower for endurance sports and power sports .This resulted from a lower rate of hospital care for heart disease, respiratory disease, and cancer.
However, the athletes were more likely to have been hospitalized for musculoskeletal disorders. Another study revealed that former team sport athletes had a higher risk of knee OA, and other studies have documented an increased risk of hip and knee arthritis among former football players.
Thus, the evidence suggests that although sports participation is beneﬁcial, injuries are a signiﬁcant side effect. To promote physical activity effectively, we have to deal professionally with the health problems of the active patient. This does not only involve providing effective care for the injured patient, but also developing and promoting injury prevention measures actively.
Why is injury prevention in sports important?
Injury prevention is a complex process. To prevent injury, scientists must ﬁrst correctly identify one or several risk factors, the mechanisms of injury, devise an effective intervention to modify it, implement the intervention with sufﬁcient compliance, and study the outcome of the intervention with a method that is sensitive enough to detect reductions in the injury rate which are clinically meaningful. When prevention is successful or fails, it may not always be clear which step in this chain of events was deﬁcient. This complexity makes injury prevention difﬁcult, but not impossible.
A number of interventions have shown a reduction in injury rates, that is, ACL injuries in team handball and soccer; ankle injuries in soccer, basketball and volleyball. The list is increasing year by year for the beneﬁt of the athlete and the sports.
The future of injury prevention
Do we need to further develop prevention programs in the future? Year by year we seem to have more information about risk factors and their relative roles. If the relative additional risk of having speciﬁc risk factors is known, some individuals should probably be advised against participation in certain sports where the risk factor cannot be eliminated.
On the contrary, if the effect of eliminating one risk factor after another is known, individuals may be able to participate in sports with low risk if they are compliant with their speciﬁc training program.
The goal must be to reach a stage where the risk factors are known and where we can assign a relative risk of an injury to individuals. During the preseason examination, individuals with risk factors can then be assigned training programs that have been validated. Thus, research on risk factors and injury mechanisms must be ongoing and intervention studies crucial.
Intrinsic risk factors
• Age • Gender • Body composition • Health (e.g., history of previous injury, joint instability) • Physical fitness • Anatomy • Skill level
Inciting event:• Playing situation • Player/opponent “behavior” • Biomechanical characteristics
Exposure to extrinsic risk factors:
• Humanfactors • Protective equipment (e.g., helmet, shin guards) • Sports equipment • Environment
Common sports injuries include:
• Sprains and strains
• Joint injuries (knee, shoulder, ankle)
• Muscle injuries
• Achilles tendon injuries
• Pain along the shin bone
Predisposed athlete, Susceptible athlete, Athlete Technique, Neuromuscular function,Training status, Falling techniques,rehabilitation,surroundings, floor friction, playing rules should be looked into.
Safety nets ,Equipment Shoe friction Tape or brace, Ski bindings, Leg padding, First-aid equipment, Ambulance , Personal protective equipmentcan be other things to be taken note of before prevention can be attempted.
The following are some basic steps to prevent a sports injury
• Develop a fitness plan that includes cardiovascular exercise, strength training, and flexibility. This will help decrease chance of injury.
• Alternate exercising different muscle groups and exercise every other day.
• Cool down properly after exercise or sports. It should take 2 times as long as your warm-ups.
• Stay hydrated. Drink water to prevent dehydration, heat exhaustion, and heat stroke.
• Stretching exercises can improve the ability of muscles to contract and perform, reducing the risk for injury. Each stretch should start slowly until a point of muscle tension is reached. Stretching should not be painful. Each stretch is hold for up to 20 seconds.
• Use the right equipment or gear and wear shoes that provide support and that may correct certain foot problems that can lead to injury.
• Learn the right techniques to play sport.
• Rest when tired. Avoid exercise when tired or in pain.
• Always time should be taken during strength training and go through the full range of motion with each repetition.
• Aftersustaining a sports injury, participation in adequate rehabilitation is needed before resuming strenuous activity.
• Taping is a form of strapping that attaches tape to the skin in order to physically maintain a certain joint position.It stimulates additional nerve receptors and to avoid any excessive joint movements.One of the greatest beneﬁts of taping is that one can adjust the method of taping to the needs of the athlete.
• Braces are currently being used instead of traditional taping by many athletes at all levels of competition. They offer several advantages in that they are self-applied, reusable, and readjustable.
(Shrestha is Orthopedic surgeon, Bluecross hospital)