Common Hockey Injuries | Prevention and Treatment

Field hockey is one of the most popular sport, with an injury rate of 6.3% per 1000 athletes. The mechanism of injury can be intrinsic or extrinsic, the extrinsic injury may be caused by a stick or a ball and intrinsic injury may be caused due to overuse or internal force acting on the muscles that include, shin soreness, tendonitis, plantar fasciitis, and many more. Being a fast-paced collision sport with non-stop furious action, players in this game are at risk of injury at any moment. They can sustain injuries to the head, face, shoulder, arm, thigh, and knee and to prevent these injuries the players need to ensure that the muscles and the joints are properly warmed up. These warm-up exercises should be done under the guidance of a physiotherapist. In this blog, we will discuss the common injuries suffered by field hockey players and tips for their prevention.

Prevention of Hockey Injuries

To help prevent or reduce the risk of hockey injuries the player should follow a proper conditioning training program.

• Proper Warm-up exercises like stretching should be done to prepare the body for activity.
• Wear proper protective gear.
• Maintain proper nutrition and hydration to help perform better during training and to heal faster after injury.
• Cooldown and stretching exercises should be done after the game.
• Proper Exercise programs should be maintained to build endurance and balance thus preventing injury.

 Common injuries in hockey players

Concussion

• Concussion is a brain injury the can occur due to a sudden blow to the body and head by a stick or elbow or by bone crunching. Symptoms may include headaches, dizziness, nausea, balance issues, mood changes, etc. Immediate medical advice is required in case of concussion. If a concussion is suspected, the player should not return to play until the symptoms decrease. The physiotherapist recommends rest in the initial days both mental and physical rest.

 Bruises and Contusions

• Contusions or bruises occur due to the rupture of the small blood vessels. Resulting in the discoloration of the skin, it might appear black and blue, due to the leakage of the blood under the skin. The player feels pain with a swollen red bruised area if it is a large bruise then immediate rest is the best treatment.

Whiplash injury

• Whiplash injury can happen by an abrupt or unexpected backward or forward motion of the neck. Falling suddenly or getting hit causes the head to jerk and the neck gets strained. It occurs commonly in contact sports, like hockey causing pain, numbness in the arms due to minor or major soft tissue damage to muscles and ligaments in the neck and vertebrae. The recovery of the player depends upon the severity of the injury.

 Acromioclavicular joint injury

• The prevalence of shoulder injuries is high in hockey. The most commonly seen shoulder injury is Acromioclavicular (AC) joint injury, also known as a shoulder separation. This injury occurs due to direct contact hit into the shoulder. The severity can vary from a sprain to a complete tear of the involved ligaments. The physiotherapy treatment includes immobilization by rest in a sling followed by isometrics and gentle ROM exercises.

Rotator cuff injury

• The most common cause of a rotator cuff tear is repetitive microtrauma, which can occur over some time. Bruising or swelling occurs due to the repeated rotator cuff injury by pinching or straining, catching, or squeezing the rotator cuff tendons. Physiotherapist focuses on reducing inflammation and pain. The therapist recommends ROM exercises, isometric exercises, and capsular stretching, followed by isotonic exercises and aggressive pain-free strengthening.

 Groin strains

• Groin or medial thigh pain is the most common injury in hockey players. The player feels tenderness and swelling. The strain of the hip flexors and adductors occur as a result of quick movements and change in the direction while playing. Initially, RICE is given. Gradually ROM, stretching and strengthening exercises including, active ROM exercises of hip and isometric exercises, straight leg raises (SLR), quadriceps are recommended. Followed by aquatic deep water pool running, stationary bicycling with no resistance.

Hamstrings injury

• A hamstring injury occurs due to a lack of flexibility, strength, and muscle imbalance of hip flexors, quadriceps gluteals, and lower back muscles.  Muscle imbalance and fatigue between hamstring, quadriceps, and gluteal. The injury also occurs due to a lack of warm-up exercises so the muscles are making it vulnerable to injuries. Physiotherapy treatment is directed towards the restoration of strength and flexibility of the muscles. After RICE, Isometric exercises are initiated, further replaced by isotonic exercises with light weights. When the player is pain-free.  a high-speed, low-resistance isokinetic exercise program is initiated with pool walking and stationary bicycle with no resistance.

Meniscal injury

• Medial meniscal injury usually occurs due to sudden rotation on a fixed foot. Damage occurs when the foot is partially flexed with the foot on the ground and rotational forces are applied to the knee. Lateral meniscal injuries occur less frequently than medial meniscal injuries. Damage to the lateral meniscus occurs when the foot is fully flexed with the foot fixed on the ground and both rotational and compressive forces are applied. Physiotherapy treatment aims to reduce pain and inflammation, maintain joint ROM, further improve strength, proprioception, and balance, using techniques like walking, running, squatting, and hopping and minimize chances of re-injury.

Anterior cruciate ligament (ACL)

• The anterior cruciate ligament (ACL) is the ligament in the front of the knee joint. Injuries to ACL occur most commonly in hockey, as there is a tremendous amount of side-to-side movement, cutting, pivoting movements, etc. An ACL sprain or tear occurs when an athlete turns while their foot stays on the ground. The physiotherapist recommends RICE and bracing. Followed by exercises for hyperextension- prone hang towel stretches, heel props, and wall slides.

 Shin splint

• Hockey players are often at risk of developing shin splints. This injury occurs due to the hard and unyielding nature of the artificial turf. Fascia, a connective tissue attaches along the edge of the tibia, when tension is put on muscles behind the leg, it causes inflammation or injury along this fascia. Repetitive bending and compression force may also cause bone stress. Physiotherapy aims to improve flexibility followed by isometrics exercises and progressed to Theraband practices and balance training.

Ankle strain

• Hockey puts a lot of stress on the ankles, causing ankle strain. This injury occurs when the ligament is stretched by rolling inward, causing a ligament tear. The damage can range from mild to severe. The patient feels immediate pain, swelling, and tenderness around the ankle. Physiotherapist instructs to take to RICE i.e. rest, ice, compress, and elevate. Followed by ROM, stretching, and strengthening exercises.

 Emotional stress can be caused due to pressure to win, sports are fun to play, and winning should not be considered as an important aspect of sports. Stress should be laid on being physically active and fit and above all feel good.

Sports Injury in Athletes

 

15 Most Common Sports Injuries in Athletes

Athletics is known to be the mother of all the games. An athlete is an all-rounder sportsperson, having immense control over his sense and body movements. The events involved are competitive walking, jumping, throwing, and running. These games not only build physical strength but also maintain the function of the heart, respiration, mental health, and body coordination. Some athletic sports involve high-intensity physical stress or thrills and hence are not always without risk. While playing, an athlete might move in the wrong ways, trip or fall, sudden contact with the ground or with other players resulting in various injuries. Other common injuries in athletics are caused by poor motor skills or poor technique, overtraining, and a lack of rest. Steps can be taken to reduce the risk of getting hurt thus preventing the occurrence of injuries. This can be done by building and maintaining muscular strength under the guidance of a physiotherapist. The therapist helps in early diagnosis followed by the treatment, resulting in quick recovery of the player to get him back in the game. In this blog, we will discuss the most common athletic injuries and the possible preventive measures that can be taken.

Sports injuries prevention

Injuries may occur due to insufficient warm-up and stretching, poor training practices, or lack of conditioning.

•  Cold muscles (muscles lacking warm-up exercises), when overstretched are more prone to injury and tears, as compared to warm muscles (muscles after warm-up exercises), which are more flexible. As they can absorb bends, quick movements, and jerks, making the athlete less prone to injury.
• During sport or activity, movement should be done properly. Different types of exercises require different positions and postures. For example, in some sports, bending your knees at the right time can help avoid an injury to your spine or hips
• Wear protective gear and proper shoes to prevent the risk of injury.
• Overexertion should be prevented, in cases of injury, start the activity again only after getting healed properly.
• Cooldown exercises like stretching exercises should be done after the sports.

Common injuries in athletes

Strains: Strains occur due to overstretching of muscles or tendons, which are commonly used by athletes therefore strains to occur often in athletes. All the body parts are susceptible to strains due to being overstretched while moving in ways they shouldn’t move, causing damage and tear. Common muscle strains include strained quads pulled hamstrings, and pulled groin muscles. Pre-session stretching exercises and warm-ups can help decrease strains.

Sprains: Sprains occur when ligaments are overstretched. Ligament pull or tear occurs when it is turned in the wrong way. Ankle sprains are the most common type of sprains among athletes, followed by knee sprains, wrist and elbow sprains, etc. Sprains can be painful, require immobilization to prevent further injury. Pre-workout stretches and warm-ups can help decrease sprains. Sprains often make the ligament weak and susceptible to re-injury, so it is good to support the joint with a brace while playing.

Fractures: Fractures, mostly of arms, legs, and feet occur due to high impact and contact sports, which can cause pain, it takes weeks of immobilization to heal and may sometimes require surgery to correct. The risk of fracture can be reduced by wearing the braces, appropriate warm-up, padding, working out to keep muscles strong and flexible, practicing good technique, etc., and also avoid playing when in pain and untreated, as it can make the bone vulnerable to fractures.

Concussion: Concussions are brain injuries that happen when there is a sudden hit to the head, not all concussions result in a loss of consciousness. The player feels nausea, headaches, difficulty in concentrating, loss of balance, dizziness, amnesia, and other symptoms. Most commonly those athletes are at a higher risk of getting concussions than those who participate in contact sports like football, wrestling, hockey, boxing, and soccer. Skiers and Gymnasts are also at a risk. The player should not continue to play sports if symptoms of a concussion exist. It takes about 2 weeks to 4 weeks for a concussion to heal, which is achieved by resting. The best way to reduce the risk of concussion is to wear protective headgear when playing contact sports like football or hockey or when biking or skateboarding etc.

Rotator cuff injury: Rotator cuff injury occurs in players doing the overhead movement or due to overuse or continuous shoulder movement in one direction. Players like swimmers, weightlifters, baseball, tennis basketball, and volleyball players commonly face shoulder injuries. Shoulder injuries should be treated with RICE. The physiotherapist can guide the player to prevent shoulder injuries by making him do strengthening and endurance exercises. The RICE method is a common treatment regimen for athlete injuries. It stands for:

• R- Rest
• I-Ice
• C-Compression
• E-Elevation

This treatment method is helpful for mild athlete injuries, it can help reduce pain, swelling, and bruising in the early days after athlete injury. 

Tennis elbow & Golfer's elbow: Tennis elbow and golfer’s elbow occur due to overuse and repetitive activity, creating a tiny tear in the ligaments of the elbow. The player feels pain on the inside or outside of the elbow, but the outside injury is more common. In minor injuries, RICE is the best way to heal the condition. Forearm stretching strengthening exercises and elbow braces are the best way to prevent elbow injuries. To prevent the occurrence the player should take breaks in between the activity and always do warm-up and stretching exercises before playing. 

Groin Pull: Injury to the groin (inner thigh muscle) occurs in players moving in a side-to-side motion like soccer, hockey, and baseball, as they have high instances of groin pulls. The player feels pain and bruising on the inside of the thigh. It takes 1 to 2 weeks to heal, the physiotherapist recommends RICE as a treatment. Care should be taken not to return to normal activity too fast, this may cause significant problems. Groin pulls can be prevented by doing proper stretching exercises.

Hip Flexor Strain: An injury to the hip flexors occurs when these muscles are stretched too far and torn. It occurs due to having stiff or weak muscles, no proper warm-up, or a fall. This injury is commonly found in athletes like hockey, soccer, and martial arts players or those players who involve movement of suddenly changing the direction or sudden upward movements. The player feels pain, spasms, swelling, and bruising. A minor hip flexor injury can be healed at home with RICE. A physiotherapist may recommend hip-strengthening exercises. 

Hamstring strains: Hamstring strains occur in players who involve movements, such as sprinting, hurdling, and jumping. Commonly caused due to overtraining or overuse, poor technique or motor skills, and lack of rest. The physiotherapist can guide the player to prevent the hamstring strains by recommending warm-up, stretching, strengthening, and endurance exercise

ACL strain: The ACL or anterior cruciate ligament, strain occurs due to a high impact to the side of the knee or due to suddenly stopping and changing directions. Immediate treatment of RICE is beneficial. The physiotherapist recommends proper warm-up, stretches exercises, and good posture. Proper padding and bracing while playing contact sports can be used. 

Patellofemoral Syndrome: The patellofemoral syndrome occurs due to the repeated movement of the kneecap against the leg bone thus damaging the tissues of the kneecap. This type of injury occurs in cyclists, swimmers, runners, basketball, football, and volleyball players taking 6 weeks to heal. This injury can be reduced by wearing the proper shoes, softer running surfaces like indoor tracks have less effect on knees than concrete. The physiotherapist recommends RICE immediately to help speed up the healing process. To prevent the reoccurrence proper warmed-up exercises should be done before playing.

Medial tibial stress syndrome (MTSS): Medial tibial stress syndrome is known for shooting pain down the front of the leg. Leg muscles act as shock absorbers during high-intensity sport. Legs may not always be able to withstand the loading if the training becomes too intense or if the muscles become fatigued. In such cases, the player feels pain in the area where the muscles attach to the bone. Medial tibial stress syndrome is most often in runners or players who have increased their exercise intensity too quickly or who are not used to exercising. Can occur due to improper shoe type. Sometimes the syndrome can be a cause for a stress fracture in the bone. Minor injuries can be improved by RICE, wearing proper shoes, doing stretching exercises, massage, and taping may also reduce acute pain. The physiotherapist recommends taking a break in between the activities or training that causes pain.

Strained calf muscle: One of the common injuries in athletes is strained calf muscles Gastrocnemius and soleus are the two calf muscles, located on the back of the lower leg. These muscles are vulnerable to strains. The player has swelling, bruising, tenderness, or stabbing pain. The physiotherapist recommends RICE treatment which helps to reduce pain, swelling and prevent further damage. To avoid re-injury proper rehabilitation should be followed.

Achilles tendinopathy: The Achilles tendon can get strained while playing sports, this tendon can rupture or break. The player experiences sudden, severe pain and difficulty walking. The physiotherapist recommends RICE as the immediate treatment, followed by Eccentric exercises where the leg muscles are slowly lowered from a tip-toe position. Appropriate treatment and load management are taught that helps the player to return to their previous level of activity. 

Plantar fasciitis: Plantar fasciitis occurs due to over-activity combined with a lack of proper support. The player experiences sharp pain with every step, commonly found in runners, joggers, soccer and basketball players, etc. Proper stretching exercises and occasional rest are the two best preventions.

The recovery time of the muscle depends on the extent of the injury, severe injuries can take up to several months. There is a high risk of reoccurrence for those who do not follow a comprehensive rehabilitation program. Measuring the amount of pain can be important throughout the rehabilitation process therefore the help of an experienced physiotherapist is required. 

 

Cricket Injuries

Common Cricket Injuries | Prevention and Treatment

Cricket is a very common game known to everyone. It is a game that involves the physical engagement or involvement of the player depending upon his role in the team. Although, during this game, all the body parts are susceptible to injury there are some parts of the body that are more vulnerable to injuries such as the lower back, hamstrings, shoulder, and ankle. The chances of injury may vary according to the position of the player in the field. Moreover, the T20 matches, which are more intense and played in a short duration, results in a significant increase in injuries due to more load on the players. There are various ways by which the player can get hurt, and simultaneously there are ways to manage and reduce the risk of these injuries by doing proper exercises. These exercises can be done under the guidance of a physiotherapist, who can help you to identify weak spots through a musculoskeletal screening, and thus help you to recover. So, let's take a look at some of the most common injuries and their prevention strategies.

 

Prevention of cricket injuries: Although many injuries in this game are not entirely preventable, there are some prevention strategies such as warm-up or cool down, proper conditioning, and maintaining strength that the player can follow to reduce the risk of injury.

 Warm-up and cool-down exercises: Warm-up and cool-down exercises should be done as a routine. Warm-up includes dynamic exercises, these should be done pre-session, and cool down includes static stretches, which should be done after the game. Doing pre and post-session exercises can reduce the risk of muscle strains.

Strengthening exercises: Strengthening exercises can reduce the risk of injury. Core stability training is particularly useful for bowlers, as it can help reduce the risk of low back pain and side strains.

 Most Common injuries in cricket players are:

 Rotator cuff injuries: The shoulder is the most mobile joint in the body, it has an amazing range of motion. Rotator cuff injuries occur due to overhead movement during bowling, throwing, fielding, and wicket-keeping.

In case of injury, your physiotherapist recommends the POLICE principle:

·   Protection: This includes initially resting the injured part and after a few days starting gentle motion.

·   Optimum Loading:  This Starts with a passive range of motion (PROM) followed by an active range of motion (AROM).

·   Ice: Applying ice for 10 minutes every hour.

·   Compression: Compression bandages of the injured part if possible.

·   Elevation: Elevation of the injured area while sitting down or lying to increase blood flow to the area.

Your physiotherapist designs an exercise program that can help you to prevent the recurrence of any shoulder injury and improve the overall performance. Your physiotherapist will also guide you for appropriate loading of the joint and rest, following a shoulder injury.

Hamstring strains: A hamstring strain is usually caused when the muscles become overloaded, leading to a strain, or a complete tear. The severity of the hamstring strain ranges from a minor strain that may feel like an ache, or a major strain that is extremely painful making it difficult to walk or stand. Hamstrings are usually injured during sprinting i.e during fast bowling while fielding or running between wickets as a batsman. The player feels a sudden or severe pain during exercise, pain or tightness while straightening or bending the leg, and weight-bearing. Physiotherapy treatment starts by POLICE principle followed by progressive strengthening through exercise, soft tissue massage, scar tissue mobilization, dry needling, and taping. And helps to enhance healing and prevent a recurrence.

Ankle sprains: An ankle sprain is a common injury in cricket. The ankle becomes stressed when the player suddenly stops or runs at high speed causing the ankle to bend further crossing the limit.  Initial treatment includes the POLICE principle and follow-up with a physiotherapist to promote recovery. An exercise program can help to increase ankle mobility and strength hence preventing reoccurrence. Depending on the severity, your physiotherapist may decide to provide you with bracing, taping, strapping, or crutches to assist in the protection of the ligaments allowing appropriate healing. Soft tissue therapy, joint mobilization, and dry needling can also be used as a pain treatment for quicker recovery.

Abdominal side strain: Side strain occurs in the side of the body involving the Oblique muscle, commonly seen in bowlers. Due to the forcible contraction of the muscle the injury occurs on the opposite side of the bowling arm. Side strains also occur because of repetitive arm action. The player feels pain and tenderness associated with internal swelling.

Treatment requires adequate rest. After examination of the injured part, for appropriate strength and conditioning, the player can gradually return to activity,

Contusions: In cricket direct impact on the muscle is commonly caused by the ball, this injury is known as contusions. The faster the speed of the ball that hits the player more severe the injury is, resulting in swelling and bruising of the area.

The POLICE principle is recommended for treatment, and medical assistance may be required for more severe contusions.

Medial epicondylitis: Medial epicondylitis or thrower's elbow is caused due to the repetitive strain of throwing a cricket ball. The player feels the weakness of the wrist and pain on the inside of the elbow. Physiotherapy treatment starts with the POLICE principle, followed by exercise regime and prevention.

 Low back pain: Low back pain is very common in fast bowlers, due to the long periods of repetitive actions when bowling or batting to diving for the wicket. The player feels pain and inflammation as a result of overstretching of a ligament of the lumbar spine. Application of ice and rest is the best treatment for lumbar pain followed by exercises.

 Lumbar Stress Fractures: Lumbar stress fractures are commonly seen in fast bowlers. Bowling, batting, and some fielding positions can strain the spine. Excessive shoulder rotation, excessive sideways trunk flexion, and greater pelvic rotation can cause a lumbar stress fracture. Huge forces and unavoidable repetition in fast bowling can cause a lumbar stress fracture.

The treatment part focuses on load management and appropriate recovery between bowling sessions. A physiotherapist does a thorough assessment and identifies any imbalance or technique issues. An exercise program is recommended to aid recovery and help to improve bowling performance.

Groin injuries: The hip flexor and adductor muscles are injured during batting, bowling, leaping, and running or while moving the thigh upwards or moving the leg across the body. Repetitive movement or quick movement can result in injury to muscle fibers and put pressure on the hip joint surfaces and bony attachments.

The physiotherapist examines the muscle strength and movement control, to identify why the problem has occurred and helps in the prevention. Recommends pre-season drills and strengthening exercises.

Wrist and hand injuries: Bones, joints, tendons, ligaments, and nerves of cricketers are injured due to the impact of playing with a heavy ball traveling at different speeds. Physiotherapists do examination and provide management with compression and ice stabilizes the joints and bones with taping and bracing.

Other injuries like Knee injuries and Head, neck, facial injuries are less common than other injuries, but it is important to note the potential for varied knee injuries in cricket. Compulsory protective headgear while batting has decreased the incidence of such injuries significantly. Those fielding close to batsmen often wears a helmet for protection and in front of the crease wear helmets for protection.

The physiotherapist works closely with the cricket fraternity to identify and analyze the risk factors. He/she helps to minimize the risk factors and progress exercises to help the player safely return to sport. If injuries occur, physiotherapy can help with effective strengthening, conditioning, and fitness strategies to improve muscular balance thus the player can return to the game as soon as possible.