Sports medicine is a diverse medical specialty focusing on those people that have suffered and injury during sport, exercise, work or as a part of every day life.

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Where our sports doctors are involved in elite sport, most of the patients seen at Bounce are normal people just wanting to achieve their personal sporting goals, or get active again. Sports injuries occur when playing indoor or outdoor sports or while exercising. They can result from accidents, inadequate training, improper use of protective devices, or insufficient stretching or warm-up exercises. The most common sports injuries are sprains and strains, fractures and dislocations.
 

The most common treatment recommended for injury is rest, ice, compression and elevation.

• Rest: Avoid activities that may cause injury.

• Ice: Ice packs can be applied to the injured area, which will help reduce swelling and pain. Ice should be applied over a towel on the affected area for 15-20 minutes, four times a day, for several days. Never place ice directly over the skin.

• Compression: Compression of the injured area also helps reduce swelling. Elastic wraps, air casts and splints can accomplish this.

• Elevation: Elevate the injured part above your heart level to reduce swelling and pain.
   

Some of the measures that are followed to prevent sports-related injuries include:
 

• Follow an exercise program to strengthen the muscles.

• Gradually increase your exercise level and avoid overdoing the exercise.

• Ensure that you wear properly-fitted protective gear such as elbow guards, eye gear, facemasks, mouth guards and pads, comfortable clothes, and athletic shoes before playing any sports activity, which will help reduce the chances of injury.

• Make sure that you follow warm-up and cool-down exercises before and after the sports activity. Exercises will help stretch muscles, increase flexibility and reduce soft tissue injuries.

• Avoid exercising immediately after eating a large meal.

• Maintain a healthy diet, which will nourish the muscles.

• Avoid playing when you are injured or tired. Take a break for some time after playing.

• Learn all the rules of the game you are participating in.

• Ensure that you are physically fit to play the sport.
   

Some of the common sports injuries include:
 

Foot and Ankle Injuries

Foot and ankle injuries include the injuries in the leg below the knee, and they are common in athletes and while playing sports such as football, hockey and skating. Common sports injuries to the foot and ankle include sprains and strains, ankle fractures, and Achilles tendinitis. Treatment for these conditions may include orthotics, braces, physical therapy, injections or surgery.
 

The foot and ankle is a complex joint involved in movement and providing stability and balance to the body. The foot and ankle consists of 26 bones, 33 joints, and many muscles, tendons and ligaments.

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Bones of the Ankle

The ankle joint connects the leg with the foot, and is composed of three bones: tibia, fibula and talus. The tibia or shin bone and fibula or calf bone are bones of the lower leg which articulate with the talus or ankle bone, enabling up and down movement of the foot.

Three bony bumps present on the ends of the tibia and fibula form parts of the ankle joint:

• The Medial malleolus, formed by the tibia, is found on the inside of the ankle;

• Posterior malleolus, also formed by the tibia, is found at the back of the ankle and the

• Lateral malleolus, formed by the fibula, is found on the outer aspect of the ankle
   

Bones of the Feet

The foot acts as a single functional unit, but can be divided into three parts: the hindfoot, midfoot and forefoot.

The hindfoot forms the ankle and heel and is made up of the talus bone and calcaneus or heel bone. The heel bone is the largest bone in the foot.

The midfoot connects the hindfoot to the forefoot, and consists of one navicular bone, one cuboid bone, and three cuneiform bones. The navicular bone is found in front of the heel bone, and the cuneiform and cuboid bones are arranged in front of the navicular bone.
 

These bones are connected to five metatarsal bones of the forefoot, which form the arch of the foot for shock absorption while walking or running. The forefoot is also made up of the toes or digits, formed by phalanges, three in each toe, except the big toe, which has only two phalanges. The big two has two additional tiny round sesamoid bones in the ball of the foot, which help in upward and downward movement of the toe.
 

Ankle and Foot Joints

There are 33 joints in the ankle and foot. They include the

• Hinge joints in the ankle, which allow flexion (bending) and extension

• Gliding joints found in the hindfoot, which allow gliding movements

• Condyloid joints found in the forefoot and toes, which allow the flexion (bending) and extension, adduction and abduction (sideward movement).

The joints of the foot and ankle provide stability and support the weight of the body, helping you to walk or run, and to adapt to uneven ground.

The joint surface of all bones of the ankle and foot are lined by a thin, tough, flexible, and slippery surface called articular cartilage, which acts as a shock absorber and cushion to reduce friction between the bones. The cartilage is lubricated by synovial fluid, which further enables smooth movement of the bones.
 

Soft Tissues of the Ankle and Foot

Our feet and ankle bones are held in place and supported by various soft tissues such as cartilage, ligaments, muscles, tendons and bursae.

Cartilage is the flexible, shiny, smooth tissue on the ends of bones that meet to form a joint. Cartilage provides cushioning between the bones allowing smooth movement.

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Ligaments are tough rope-like tissue that connect bones to other bones, and holds them in place providing stability to the joints. The Plantar fascia is the largest ligament in the foot, originating from the heel bone to the forefoot, it extends along the bottom surface of the foot and is involved in maintaining the arch of the foot. The plantar fascia ligament stretches and contracts to provide balance and strength to the foot. Lateral ligaments on the outside of the foot and medial ligaments on the inside of the foot provide stability and allow up and down movement of the foot.
 

The foot is made up of 20 muscles, which help in movement. The main muscles include:

• Anterior tibial muscle: allows up and down movement of the foot

• Posterior tibial muscle: supports the arch

• Peroneal tibial muscle: controls movement on the outside of the ankle

• Extensors: enable the ankle to raise the toes just before stepping forward

• Flexors: stabilize the toes against the floor

Smaller muscles are also present to help the toes lift and curl.
 

Tendons are soft tissues that connect muscles to bones. The largest and strongest tendon in the foot is the Achilles tendon, present at the back of the lower leg around the heel bone. Other tendons include peroneal and anterior and posterior tibialis.
 

Bursae

Bursae are small fluid filled sacs that decrease friction between tendons and bone or skin. Bursae contain special cells called synovial cells that secrete a lubricating fluid.

Knee Arthroscopy
 

Knee Arthroscopy is a procedure that involves a surgeon investigating and correcting problems with a small tool called an arthroscope. It is a less invasive method of surgery used to both diagnose and treat issues in the joints. The arthroscope has a camera attached, and this allows doctors to inspect the joint for damage. The procedure requires very small cuts in the skin, which gives arthroscopy some advantages over more invasive surgeries.
 

Knee arthroscopy surgery has risen to popularity because it usually requires shorter recovery times. The procedure typically takes less than 1 hour, and serious complications are uncommon. Knee arthroscopy is less invasive than open forms of surgery. A surgeon can diagnose issues and operate using a very small tool, an arthroscope, which they pass through an incision in the skin.
 

Knee arthroscopy surgery may be helpful in diagnosing a range of problems, including:

• persistent joint pain and stiffness

• damaged cartilage

• floating fragments of bone or cartilage

• a buildup of fluid, which must be drained
   

In most of these cases, arthroscopy is all that is needed. People may choose it instead of other surgical procedures because arthroscopy often involves:

• less tissue damage

• a faster healing time

• fewer stitches

• less pain after the procedure

• a lower risk of infection, because smaller incisions are made
   

However, arthroscopy may not be for everyone. There is little evidence that people with degenerative diseases or osteoarthritis can benefit from knee arthroscopy.

Shoulder Arthroscopy

Shoulder arthroscopy is surgery that uses a tiny camera called an arthroscope to examine or repair the tissues inside or around your shoulder joint. The arthroscope is inserted through a small cut (incision) in your skin.
 

The rotator cuff is a group of muscles and their tendons that form a cuff over the shoulder joint. These muscles and tendons hold the arm in the shoulder joint. This also helps the shoulder move in different directions. The tendons in the rotator cuff can tear when they are overused or injured.
 

You will likely receive general anesthesia for this surgery. This means you will be asleep and unable to feel pain. Or, you may have regional anesthesia. Your arm and shoulder area will be numbed, as a result you do not feel any pain. If you receive regional anesthesia, you will also be given medicine to make you very sleepy during the operation.

During the procedure, the surgeon:

• Inserts the arthroscope into your shoulder through a small incision. The scope is connected to a video monitor in the operating room.

• Inspects all the tissues of your shoulder joint and the area above the joint. These tissues include the cartilage, bones, tendons, and ligaments.

• Repairs any damaged tissues. To do this, your surgeon makes 1 to 3 more small incisions and inserts other instruments through them. A tear in a muscle, tendon, or cartilage is fixed. Any damaged tissue is removed.
   

Your surgeon may do one or more of these procedures during your operation.

Rotator cuff repair:

• The edges of the tendon are brought together. The tendon is attached to the bone with sutures.

• Small rivets (called suture anchors) are often used to help attach the tendon to the bone.

• The anchors can be made of metal or plastic. They do not need to be removed after surgery.
   

Surgery for impingement syndrome:

• Damaged or inflamed tissue is cleaned out in the area above the shoulder joint.

• A ligament called the coracoacromial ligament may be cut.

• The underside of a bone called the acromion may be shaved. A bony growth (spur) on the underside of the acromion often causes impingement syndrome. The spur can cause inflammation and pain in your shoulder.
   

Surgery for shoulder instability:

• If you have a torn labrum, the surgeon will repair it. The labrum is the cartilage that lines the rim of the shoulder joint. 

• Ligaments that attach to this area will also be repaired.

• The Bankart lesion is a tear on the labrum in the lower part of the shoulder joint.

• A SLAP lesion involves the labrum and the ligament on the top part of the shoulder joint.

At the end of the surgery, the incisions will be closed with stitches and covered with a dressing (bandage). Most surgeons take pictures from the video monitor during the procedure to show you what they found and the repairs that were made.
 

When you need sports medicine treatment so you can return to play quickly and safely, turn to the skilled professionals at Aradhana Orthopaedic Center.