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Physiotherapy


Introduction

Sports physiotherapy aims at complete Physical, Mental and Spiritual well being of a sportsperson. We Doctors and therapists aim to keep the sportsperson physically fit so that the rest of the above objectives can be attained automatically.

Sports Person Fitness Testing

• Check whether Muscle power is adequate.

• Check for the Active movements and Muscle strength of all parts of the body.

• Check Range of motion and Passive movements.

• Body balance and Co-ordinate skills.

• Symmetrical and Coordinated movements between limbs and the body.

• Elasticity and Extensibility of the muscles and ligaments.

• Presence of any unwanted or accessory movements.

These all factors determine whether a person is fit enough to take sports. These tests are not only done in initial stages but also done repeatedly at every stage of an athlete/sportsperson life.

Classification of sports injuries (By Williams)

Consequential

  - Primary

      a. Extrinsic

             Human (E.g.  Black eye due to direct blow).

             Implemental (E.g. Incidental injury due to blow from hard ball, Due to overuse of the part of the body).

             Vehicular (E.g. Clavicle fracture due to fall from cycle/bike).

             Environmental (E.g. Injuries in divers)

             Occupational (E.g. Jumper’s knee in athletes, Chondromalacia in cyclists).

      b. Intrinsic 

            Acute (E.g. Incidental strains, Sprains, Acute tenosynovities of wrist extensors).

            Chronic (E.g. March fracture in soldiers).

  - Secondary

     a. Short-term (E.g. Quadriceps weakness)

     b. Long-term (E.g. Degenerative arthritis of hip, knee and ankle).

Non-consequential

Common Sports Injuries

Sports usually deals with minor orthopedic problems like soft tissue injuries, Injury due to trauma etc. Very rarely Serious fractures, Head injuries/On field deaths seen.

Upper Limbs

  1.Shoulder complex

      a. Rotator cuff injuries

      b. Shoulder dislocations

      c.  Fracture clavicle

      d. Acromio clavicle injuries

      e. Bicipital tendinitis or rupture

      f.  Frozen shoulder

      g. Gleno-humeral arthritis

  2.Elbow

     a. Tennis elbow

     b. Golfer’s elbow

     c. Dislocation of elbow

     d. Bursitis of elbow

  3.Wrist

    a. Wrist pain

    b. Carpel tunnel syndrome

    c. Finger fractures

    d. Tenosynovities

  4.Hand

    a. Mallet injury

    b. Baseball injury

    c. Jersey injury

    d. Injuries of the finger joints

Lower Limbs

  1.Hip

    a. Iliotibial or tract syndrome

    b. Quadriceps strain

    c. Hip pain

    d. Groin pain due to adductor strain

  2.Knee joint

    a. Jumper’s knee

    b. Chondromalacia

    c. Fracture patella

    d. Knee ligament injuries

    e. Menisci injuries

 3.Legs

   a. Calf muscle strain

   b. Hamstrings strain

   c. Stress fracture of tibia bone

   d. Compartmental syndrome of leg.

 4.Ankle injuries

   a. Ankle sprain

   b. Injuries to tendo-achilles

   c. Tenosynvities

 5.Foot

  a. March fracture

  b. Jones fracture

  c. Forefoot injuries

 d. Injuries of sesamoid bone of great toe

Head, Neck, Trunk and Spine injuries.

 1. Head injuries

 2. Whiplash injuries

 3. Rib fractures

 4. Trunk muscle strains

 5. Abdomen muscle strain

 6. Low backache

 7. Disc herniation

Miscellaneous Pain and Injuries

 1. Blisters – They are fluid filled sacks on the skin surface. Most commonly seen in hands, feet etc.

 2. Delayed onset muscle soreness – Muscle pain, Stiffness/soreness in 24-48 hrs after intense exercise program.

 3. Sprains and Strains – Acute injuries resulting pain, swelling, bruising and inability to move the joint.

 4. Stress fractures – Due to overuse of the part.

 5. Muscle cramps – It means sudden, tight and intense pain due to muscle lock. Muscle cramp can be recognized as an involuntary, forcible contraction of muscle that does not relax.

General Physical Therapy Treatment

• Concept of R.I.C.E.M.M treatment is used.

  - Rest to the injured limb

  - Ice therapy

  - Compression bandage

  - Elevation of the injured part if needed

  - Medicines like pain killers

  - Modalities like heat, straps, and supports.

• After Immobilization and Rest, early vigorous Exercises are to be done to prevent muscle weakness and atrophy.

Passive movements- To prevent stiffness early mobilization

Active movements- To improve strength resistive exercises are done.

Muscle Strengthening Exercises

  - For upper limbs – Bench press

  - For lower limbs – Squatting exercises

Endurance Exercises

  - Isotonic, Isokinetic and Isometric exercises.

  - Warm-up exercises

      Done for 5-10 minutes

      Adapts the heart and lungs for future exercise.

      Stretches and loosens the Muscles, Ligaments, and Tendons etc.

 - Conditioning phase

     Done for 15-20 minutes, progressed to 30-45 minutes.

     Careful monitoring to maintain the heart rate.

 - Cool-down phase

     Gradually the exercise is reduced

     Relaxation techniques

Free-weight training Exercises.

Balance Exercises

 - One leg balance e.g. stand on one leg for 10-30 seconds

 - One leg balance with eyes closed.

 - Balance maintenance on wobble board, balance board etc.

 - Controlled half squatting on balance board.

Exercise to improve Agility levels.

 - One leg hop

 - Two leg hops

 - Cross over-run turning

 - Bending

 - Backward running

• Exercises to improve speed Polymetrics. (These Exercises done very fast with sudden burst of energy)

 - Hops

 - Speed jumps

 - Running drills

 - Graded resistance exercises.

Stretching exercises

 - All muscles and joints stretching to be done. This helps in preventing injuries.

 - Good stretching program for upper and lower limb muscles is to be done.

     Shoulder

     Back

     Quadriceps

     Hamstrings

 - Stretches should be static without any bounce and held for at least 30 sec.

• Start sporting activities only after getting 100% recovery.

• Psychological counseling is to be done to avoid depression, anxiety and negative attitudes which may develop during injury.

• Orthopedic and surgical treatments are to be undertaken at appropriate situations.

  Physiotherapy Topics

 

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