Sports medicine

MercyAscot - Sport medicine

CME event held on the 20th March 2017

Part of the MercyAscot Education Series

Programme

Topic 1        Presented by Philip Clark

Community Musculoskeletal and Sports Medicine Imaging – beyond the X-ray

Exercise prescriptions

Physical activity is a highly effective treatment for many types of chronic disease.

Pharmacology in sports medicine

There are a variety of medications which are commonly used in a sports medicine setting. These are usually used to manage pain or in an attempt to reduce inflammation. Elite athletes may be subject to drug testing. For these athletes, doctors can be very ‘dangerous’ people as the use of many common medications can lead to a positive drug test. 

Radial head fractures

Fractures of the radial head are common, they are seen in 20% of all acute elbow injuries and make up one third of all elbow fractures. These fractures typically occur after a fall when an axial load is applied to the forearm, causing the radial head to hit the capitulum of the humerus (fall onto the outstretched hand). Radial head fractures are more common in females and occur most frequently between 30-40 years of age. Patients typically present with relatively localised pain and swelling around the lateral elbow.

Acute low back pain

Acute low back pain is common and can occur without any definite event or injury. Back pain is second only to URTI in terms of days lost from work due to illness or injury. There are a large number of causes of low back pain and a definitive structural diagnosis is possible in less than 10% of patients.  

Concussion

Head injuries sustained during sport can appear quite dramatic and evoke a strong emotional response from athletes, coaches, spectators and the media. This can mean they are difficult to assess and manage. It is important to have a consistent approach to the assessment and management of head injuries to ensure that an accurate diagnosis is made and to allow athletes to safely return to sport and to the workplace. 

After studying this topic, you should be able to:

Achilles tendon rupture: diagnosis & treatment

The Achilles tendon attaches the gastrocnemius, the soleus and plantaris muscles to the calcaneus. It is one of the longest and thickest tendons in the body and is a powerful plantar flexor of the foot and ankle.

The two most common pathologies involving the Achilles tendon are tendinopathy and rupture. Patients with tendinopathy typically describe a gradual onset of pain, while ruptures are associated with an acute event.

Rotator cuff: acute injuries

Rotator cuff pathology comprises a wide range of different problems. At one end of the spectrum is a patient with acute rotator impingement. These patients may have an anatomically normal rotator cuff and have symptoms which have been provoked by an acute bout of activity. In this situation the problem will generally settle with a short period of rest.

Patellofemoral pain syndrome

Patellofemoral pain is a common presentation in primary care. It is most commonly seen in those below the age of forty years; however it can affect people of all ages and activity levels. In adolescents the onset of pain can coincide with periods of accelerated growth, while in older patients it often co-exists with degenerative joint changes.

The term ‘patellofemoral syndrome’ is usually reserved to describe the younger patient with an anatomically normal (or near normal) knee.

Shoulder instability

Shoulder instability is a relatively common injury. The incidence of traumatic shoulder instability in the athletic population is approximately two times greater than in the general population, especially amongst those involved in contact or overhead sports. Instability can be due to acute trauma, repetitive microtrauma or related to congenital issues like generalised laxity. 

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