The ‘Big Four’ of sports injuries

The most frequent sports injuries are sprains and strains, which occur when an abnormal amount of stress is placed on ligaments and muscles.

By YONATAN KAPLAN
This week, I’d like to address the four most common types of sports injuries: Sprains, strains, tears and fractures.
The most frequent sports injuries are sprains and strains, which occur when an abnormal amount of stress is placed on ligaments and muscles.
Only about five percent of sports injuries involve fractures, or broken bones.
Let’s delve into each of these in slightly more detail: • Sprains: Sprains are injuries to ligaments, which are fibrous structures that connect bones to other bones. They serve as passive stabilizers of the joints.
There are five grades of sprains. Grade I sprains cause stretching of the ligament. The symptoms tend to be limited to pain and swelling. In lower limb sprains, patients can walk without crutches, but may not be able to jog or jump.
Grade II sprains involve a more severe partial tear of the ligament. There is usually swelling and bruising caused by bleeding under the skin.
Patients have pain while walking, but can take a few steps.
Grade III sprains occur when the ligament is completely torn. The joint is usually quite painful, and walking can be difficult. Patients may complain of instability, or a giving-way sensation in the joint. Depending on the anatomical area concerned, surgery may be a consideration.
The most common ligaments that are injured are those around the ankle.
In general, the degree of symptoms tends to correlate well with the extent of the damage to these ligaments.

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• Strains: Strains are injuries that occur regarding muscles.
Muscles are fibrous tissue that connect tendons to bones and produce force that causes voluntary motion in all the joints in the body. There are about 650 muscles in the human body.
Muscle injury is graded in a similar way that ligament injury is. The most common muscle group that is injured is the hamstring. These three muscles connect the pelvis to the knee, behind the upper leg.
• Tears: These are injuries that occur relating to tendons.
A tendon is a tough band of fibrous connective tissue that connects muscle to bone and is capable of withstanding.
The primary function of a tendon is to transmit the contraction force of its associated muscle to the bone. Consequently, the tendon needs to have sufficient tensile strength.
They are constructed with parallel collagen fibers running the length of the tendon. The longitudinal arrangement of the collagen fibers gives the tendon its tensile strength.
Tendon injuries are usually graded as partial or complete.
Tendons usually take six to eight weeks to heal.
The most common tendons that are injured in the body are those around the ankle, shoulder and knee.
• Fractures: These are injuries that occur relating to bones.
Bones are calcified connective tissues that help human beings move and provide protection to the inner organs. They further provide support to the body against constant gravitational pull.
A fracture is caused due to the inability of a bone to withstand the force exerted on it.
Most people get at least one fracture during their lifetime.
The elderly are more prone to fractures, as their bones get more brittle with age. Children suffer less from fractures as their bones are more flexible.
Fractures usually take between six to eight weeks to heal in adults and three to four weeks in children.
The most common bones that are injured are those around the ankle.

Yonatan Kaplan, PT PhD (Candidate), is the director of the Jerusalem Sports Medicine Institute at the Hebrew University’s Lerner Sports Center. He can be reached at sportmed@zahav.net.il or at (054) 463-9463.