Knee Injuries

An acute knee injury usually occurs suddenly through either trauma or a twisting action. Pain in the knee can vary in severity from very mild to very severe and this depends on the injury mechanism (how the injury occurred) and the forces involved during the impact. It is strongly advised not to carry on playing if you have acute knee pain as this can easily progress to a chronic pain or to more complex knee injuries.

ACL Injury (anterior cruciate ligament sprain) or 'ACL injuries' are common in contact sports and especially those that are combined with sudden change of direction such as soccer or football. Often it will not occur in isolation but in most cases occur with damage to other structures within the knee such as the cartilage or ligaments. Medial meniscus tear or torn meniscus is a tear to the semi circular shock absorbing cartilage in the knee joint causing pain on the inside of the knee. It is commonly injured through direct impact to the outside of the knee in contact sports or twisting but can also occur in older athletes through degeneration.

Medial ligament sprain (MCL injury) is a tear of the ligament on the inside of the knee, usually a result of twisting or direct impact. Symptoms include pain and swelling on the inside of the knee, often along the joint line. Lateral ligament sprain (LCL) is a knee ligament injury involving a tear to the ligament on the outside of the knee and is most likely following a direct blow to the inside of the knee or twisting.

Patella dislocation occurs when the kneecap dislocates outside of its normal position, usually round the outside of the knee. It can also partially dislocate, called a subluxation. Pain will be felt immediately at the time of injury. There is likely to be swelling in the knee joint and there will be an obvious displacement of the kneecap.

Knee contusion or bruised knee occurs due to a direct impact or trauma to the knee. This can be due to a fall directly onto the knee or something hitting the knee, such as a ball or club. Contusion is the medical term for a bruise. The area will be tender to touch and there may be some swelling. The bruising will change color and start to fade after a few days.

Hip Injuries

Hip pain in athletes is a common cause of discomfort and can be a frustrating problem to treat. In the past, just about any hip pain symptom was attributed to a "muscle strain" type of injury. While this is a common cause of hip pain in athletes, we are learning more and more about other causes of hip pain that can sideline a player from the action.

Muscle Strains: The most common injuries of the hip and groin region in athletes are muscle strain injuries. Muscles around the hip joint are especially prone to this type of injury because they are subject to eccentric contraction. Eccentric contractions cause tremendous forces in the muscle and can lead to a muscle strain. Muscle strains around the hip include groin pulls and hamstring strains.

Hip Bursitis: Inflammation of the bursa over the outside of the hip joint, so-called trochanteric bursitis, can cause pain with hip movement. Treatment of hip bursitis is often effective, but the condition has a problem of coming back and sometimes becoming a persistent problem.

Contusions (Hip Pointer): A direct blow to the outside of the hip causes an injury to one of the large bones of the pelvis, the ileum. When a contusion is sustained in an athlete over the outside of the hip, the injury is called a hip pointer.

Stress Fractures: Stress fractures of the hip are usually seen in long distance runners, and much more commonly in women than in men. These injuries are usually seen in endurance athletes with deficient nutrition or eating disorders.

Hip Labral Tear: The labrum of the hip is a cuff of thick tissue that surrounds the hip socket. The labrum helps to support the hip joint. When a labral tear of the hip occurs, a piece of this tissue can become pinched in the joint causing pain and catching sensations. Much more has been learned about hip labral tears, to the point that some orthopedic surgeons are concerned these injuries are overdiagnosed. However, some patients with hip labral tears can find improvement with treatment of this condition.

Femoroacetabular Impingement: Femoroacetablar impingement, often referred to as FAI, is a condition where bone spurs form along the edges of the ball-and-socket hip joint and cause limited mobility of the joint and damage to soft tissues including the labrum. FAI is thought by many surgeons to be a precursor to arthritis of the hip joint.

Osteitis Pubis: Osteitis pubis is thought to be due to the repetitive pull of muscles over the front of the hip joint. Usually, pain is activity related and often seen in runners, soccer players and hockey players. The x-rays may show signs causing concern for infection, but osteitis pubis usually resolves with rest and anti-inflammatory medications.

Sports Hernias: Sports hernias are a problem seen most commonly in hockey players, but can be seen in other sports that require repetitive twisting and turning at high speeds. The problem is thought to be due to an imbalance of the strong muscles of the thigh and the relatively weaker muscles of the abdomen.

Snapping Hip Syndrome: Snapping hip syndrome is a word used to describe three distinct hip problems. The first is when the IT band snaps over the outside of the thigh. The second occurs when the deep hip flexor snaps over the front of the hip joint. Finally, tears of the cartilage, or labrum, around the hip socket can cause a snapping sensation.

Traumatic Hip Subluxation & Dislocation: Complete dislocation of the hip joint is a very unusual hip injury--most commonly hip dislocations occur in high-speed car crashes. However, hip subluxations, an injury where the ball of the ball-and-socket hip joint is pushed part of the way out of joint, are being recognized as a possible cause of hip pain in athletes. A hip subluxation is the type of injury that is thought to have ended Bo Jackson's athletic career.

Hip Arthritis: Arthritis of the hips is increasingly seen in athletes as the age in which we participate in sports increases. Older athletes can experience joint stiffness and pain as a result of hip arthritis.

Shoulder injuries

The shoulder joint is particularly susceptible to injury because the is a very large range of movement that can occur at this joint and relatively small joint surfaces (in comparison to hip or knee). This means that the joint itself is much less stable and therefore requires a number of strong muscles, tendons and ligaments to enhance the stability. The following conditions are the most common causes of shoulder pain:

Rotator cuff strain
A rotator cuff injury is damage or overuse of one or more, or the muscles and tendons around the shoulder joint, known as the rotator cuff muscles. They are so called because their job is to rotate the arm at the shoulder and provide a supportive cuff around the joint.

Glenoid labrum tear

The glenoid labrum is a ring of tissue which attaches to the rim of the shoulder socket where the ball of the humerus or arm bone sits. Symptoms include pain in the shoulder joint which can often not be localized to a specific point. It is usually caused by repetitive overhead throwing, lifting or catching heavy objects below shoulder height or falling onto an outstretched arm.

Shoulder instability

Shoulder instability occurs when the humerus (upper arm bone) pops out of the shoulder joint. There is a milder version of this injury called a subluxation where the humerus only partially comes out of the joint and pops back in immediately. The first time that a dislocation occurs it can cause severe shoulder pain and therefore requires professional medical attention to put the bone (“relocate”) back into the joint. Never attempt to put it back in (reduction) yourself as you can cause serious and permanent damage to the joint surfaces or more importantly the nerves in the arm. Dislocations of the shoulder often reoccur and lead to log term instability which is only addressed through surgery.

AC joint injury

An AC joint injury is may also be referred to as 'shoulder separation' or AC joint sprain and should not be confused with a shoulder dislocation. It is usually caused by a fall onto an outstretched arm or through direct trauma in contact sports. Symptoms may include pain in the shoulder, specifically pain at where the collar bone meets the shoulder. As a result, you may be able to feel a lump or bump on the top of the shoulder joint depending on how bad the injury is.

Frozen shoulder

Known as adhesive capsulitis, it is a painful condition resulting from chronic stiffness of the shoulder joint. A frozen shoulder goes through three phases; a freezing phase where shoulder pain is common and the joint tightens up, a stiff phase where the movement in the shoulder is significantly reduced and a thawing phase where the pain gradually reduces and mobility increases.