SnoTap Medical: Breaking Down Typical Football Injuries

If you have been a long time fan of Sports News on Tap, you will know Seth Krueger graced the pages of SnoTap in the infant stages. He was known as The Big Cat at the time, but he rode off into the sunset with his mane flowing. He's back to write about injuries for SnoTap and the effects of it. If you ever wondered about an ACL or a shoulder separation, this is your post.  

Knee













ACL Tear- One of the four major ligaments in knee

The words torn ACL is just about as taboo as it gets in sports, whenever the word a player left with a “knee injury” everyone’s first thought goes to “HE TORE HIS ACL” (Charlie is notable for this) Why is the ACL such a notable and devastating injury? Well to summarize what I’m about to say below this, it is (relatively) easy to tear it, and it’s a major stabilizer of the knee joint, it keeps the tibia (leg) from displacing anteriorly (forward) in relation to the femur (thigh). Without an anatomically sound and strong ACL, we would all walk around like Bambi on ice.

Mechanism of Injury (MOI): Hyperextension of knee, deceleration (no contact needed), internal rotation of the tibia on the femur (no contact needed)
     -Two out of the three most common MOI’s do not require contact for this injury to occur.
     -In fact MOST ACL tears happen sans contact.

Recovery time: 4-6 months
   -This does not mean they can start to play after the six month mark rather just means they can return to exercises that mimic the sport they play whilst being monitored.
   -Nine to 15 months before an athlete can return to full contact and full tilt participation.

Rehab: Gain range of motion back to keep scar tissue from forming, get strength in quads, hamstrings and calves back to help stabilize the knee and take pressure off the new ACL graft, seven to 12 weeks allows for an athlete to do jogging and running and possibly lateral exercises. After 12 weeks, an athlete can begin to do more sport specific drills.

MCL-One of the four major ligaments of the knee
The medial collateral ligament (MCL) is located on the middle or medial part on you knee attaching femur to the tibia. Its role is to resist your knee from going inward via a valgus force. (Valgus= going from lateral or outside of knee to medial or inside of knee)















MOI: Valgus force to knee - An example would be running back running and a tackler coming from the side hitting his knee causing it to cave in. MCL sprains happen often in football because of this MOI.

Recovery: depending on severity (grade 1, 2, or 3) it is not as detrimental as ACL tear. Grade 1, a stretch or minimal tear requires anywhere one to 10 weeks for repair. Grade 2 or 3 partial tear to complete tear require 10 weeks to months.

Treatment: If surgery is required, rehab is similar to that of ACL (ROM, strengthen, etc.) If surgery is not required than ice to reduce swelling, keep ROM, brace to help stabilize and strengthen muscles around it.

Meniscus-shock absorbing cartilage in knee

C shaped cartilage that conforms to the shape of the knee joint and sits on the tibia plateau. Its role is to absorb shock from standing, walking and running by distributing the body weight on the knees. It’s an important structure for people to have to remain active.

MOI: Twisting of the knee, any traumatic knee injury (commonly seen with ACL tears and MCL tears)

Recovery: depending on severity anywhere from two weeks to several months. Mensici tears are odd because there are many different kinds (bucket handle, red-red, white-white, etc.) In all honesty, menisci tears could have their own blog post.

Treatment: Surgery either to trim up a slight tear or sew meniscus back into place.

The rehab is the same as almost all knee injuries, important to regain motion, then strength, balance and coordination.

Ankle

High ankle sprain
MOI: rolling, twisting ankle beyond the limits of the ligaments in ankle.More commonly see rolling outside of ankle as opposed to inside of ankle. Ligaments most commonly damaged are ATFL(anterior talofibular ligament), PTFL (posterior talofibular ligament), and calcaneofibular libament.

Recovery: Again, recovery time always depends on the severity, could be a day to day thing or if it’s severe enough and requires surgery (Brostom procedure) it could be a year ending injury.

Treatment: 110% the first thing Physical Trainers (PT) or Athletic Trainers (AT) do is try to limit the swelling in the ankle. Swelling is good acutely but not chronically, constant swelling causes fibroblasts so stick around and create scar tissue which is not desired because scar tissue is irrelevant tissue and takes away integrity of joint strength. Swelling also limits what the PT or AT can do for working on ROM and strength of muscles (fibularis longus, brevis, tertius, etc.) So as the old saying goes for sprained ankles it’s RICE, rest, ice, compression and elevation.

Shoulder-Most unstable joint in the body
Dislocation- When the head of the humerus comes out of the glenoid cavity of the scapula. Best comparison for how unstable this shoulder joint is is to look at a golf ball on a tee. Luckily we have rotator cuff (supraspinatus, infraspinatus, subscapularis and teres minor) to hold it into place but still the shoulder is very susceptible to dislocation.

MOI: most common is dislocating it anteriorly (forward), dislocations happen most commonly when arm is in an external position and some kind of force is applied taking the humerus past the resistance of the glenohumeral ligaments causing dislocation.

Recovery: If no structures are compromised then recovery is relatively quick from days to weeks but if structures are hurt in the process than the water gets a little murky and surgery may be needed to correct anatomical problems to keep from having a shoulder “pop out” chronically.

Treatment: Can be as conservative as the humerus being put back in its rightful home, the glenoid fossa, along with putting the arm in a sling to surgery that tightens the ligaments around the shoulder. Also strengthening the rotator cuff so the tension they provide on holding the humerus into socket increases thus lowering the chances of dislocation.

Separation-NOT the same as dislocation, a shoulder separation is an injury to the acromioclavicle (AC) joint in the shoulder. The AC includes the acromion process of the shoulder and the clavicle (collarbone), when someone says “shoulder separation” the integrity of this joint, held together by the AC ligament, is compromised leading to the clavicle and acromion no longer articulating.

MOI: falling on the tip of your shoulder or landing on an outstretched arm (see Charles Woodson in the Green Bay Packers Super Bowl victory or writer Pat Luce 3 years ago in my kitchen)

Recovery: Not to be a broken record but it solely depends on severity. Could be days/weeks if the AC ligament was just stretched to months if AC ligament was torn and surgery was required.

Treatment: Ice, reduce swelling and strengthen muscles around the shoulder. One type of surgery is to remove a small portion of the distal end of the clavicle and suture the acromion to the clavicle, also in other cases actually taking a screw and placing it through the clavicle to the coracoid process (coracoid process is below acromion and to find out yourself go from top of your shoulder/acromion and go down a bit and push in until you feel a bony projection {it’ll hurt pushing on it})

Thigh
Hamstring- Extremely strong flexor of the knee, very popular injury in sports

Hamstring is made up of three muscles, bicep femoris, semitendinosus and semimembranosus. To palpate them on yourself flex your knee 90 degrees and the back of the knee will have tendons tighten up and stick out. The most outside or lateral is bicep femoris, big tendon medial side of knee is semitendinosus, hence having the word ‘tendon’ in the name and the semimembranosus sits right behind the semitendinosus.

MOI: stretching muscle beyond its elastic properties causing a tear in the muscle fibers. Anything from acceleration to deceleration or changing directions hamstring is a very sensitive muscle.

Still think your favorite player is a pussy for not playing after a pulled hammy?

Recovery: Weeks to months, it’s a pretty serious injury in sports because it’s extremely important for running and backpedaling along with postural and balance responsibilities.

Treatment: Simple rest and ice and patience is the most important treatment for hamstring pulls. A lot of times an athlete will feel no pain and feel ready to go but by pushing it and going back out there could piss it off again and worse the second time around. That’s why athletes take such a long time to come back, have to ease back into it.