SPORTS

INJURIES
of The Lower
Extremities

By: Jasneel Chaddha

Stanford CSSSI 2013
 AGENDA

 Classification of Sports Injuries

 Types of lower body injuries
 History of lower body injuries
 Causes of lower body injuries
 Signs and Symptoms of lower body injuries
 Treatment and Prevention of lower body injuries
 WHAT ARE SPORTS INJURIES?
 Sports injuries result from acute trauma or repetitive
stress associated with athletic activities.
 Sports injuries can affect bones or soft tissue, such as
ligaments, muscles, and tendons.
 CLASSIFICATION OF SPORTS
INJURIES
 Direct and Indirect
1. Direct injuries are sustained from an external force causing injury at the
point of contact.
2. Indirect injuries usually involve the athlete damaging the soft tissues
such as the ligaments, tendons or muscles of the body through internal
or external forces.

 Soft and Hard Tissue

1. Soft tissue injuries are any injuries to the skin, muscles, tendons and
ligaments.
2. Hard tissue injuries occur in bones and cartilages.

 Overuse
1. Overuse injuries are sustained from continuous or repetitive stress,
incorrect technique or equipment, or too much training.
 GENERAL FACTS ABOUT SPORTS
INJURIES
 About 95% of sports injuries are minor soft tissue traumas.
 The most common sports injury is a bruise (contusion). It is
caused when blood collects at the site of an injury and discolors
the skin.
 Sprains account for one-third of all sports injuries.
 Fractures account for 5-6% of all sports injuries. The bones of the
arms and legs are most apt to be broken.
 Stress fractures are especially common in ballet dancers, long-
distance runners, and in people whose bones are thin.
 LOWER BODY INJURIES AND
TERMS
Sports Injuries can be found in both the upper and lower body.
2 common lower body sports injuries (focus on this presentation):

I. Anterior Cruciate Ligament Tear (ACL) - An anterior cruciate

ligament injury is the over-stretching or tearing of the ACL in the knee.

I. Torn Achilles Tendon - Overuse injury causing pain and

inflammation over the Achilles tendon at the back of the lower leg.
 VISUAL ILLUSTRATION OF LOWER
BODY INJURIES

ACL Tear


Achilles Tendon
Tear 
HISTORY OF ACL INJURY
• Ernest W. Hey Groves (Germany)
 In 1917, performed first successful ACL
reconstruction using an iliotibial band
transplant.
• First reports of ACL related injuries came
from military recruits during/after training.
• Willis Campbell (United States)
 In 1935, performs first ACL reconstruction
with tendon, using the patellar tendon located
in the tibia.
• ACL Injuries extremely common today with
athletes.
HISTORY OF ACHILLES TENDON
• Achilles, the Greek Hero
 Achilles Tendon gets its name from this
Greek Hero.
 Legend says Achilles’ mother dipped
Achilles in the River Styx to protect him
in battle. She forgot to dip his heel in the
water, and he was killed in battle by
Paris, who wounded Achilles in the heel.
• Achilles Tendon injuries are common with
athletes who actively use their heel, such
as basketball, football, and soccer
players.
 PATHOPHYSIOLOGY
ACUTE INJURY PROCESS

 ACL Tear  From abnormal motions of the knee. Subluxation (partial

dislocation) episodes occur, creating abnormal shear forces on the meniscus.
This will cause meniscus injuries, and ACL tears.

 Achilles Tendon Tear  Minor complications may occur, such as Achilles

infection and/or reduced sensation near the tendon. Scarring and reduced
Achilles size will almost always occur. Re-rupturing of the Achilles is a
possibility.
 CAUSES OF THESE INJURIES
Achilles Tendon Tear

 Overuse of tendon.

 Stepping up your level of physical activity too quickly.

 Not stretching enough before exercise. (especially the Achilles tendon)

 Wearing high heels, which increases the stress on the tendon.

 Problems with the feet. An Achilles tendon injury can possibly result from flat
feet.
 Muscles or tendons in the leg that are too tight.
CAUSES OF THESE INJURIES
ACL Tear

 Intense Impacts or Collisions

 A Rapid Change in Direction
 Suddenly Stopping
 Landing incorrectly from a Jump
 SOCIAL FACTS AND
EPIDEMIOLOGY
 Young women are two to eight times more likely than young men
to injure the ACL..

 Among high school athletes in 2005, 2,298 of 4,350 injuries

(52.8%) were Lower Extremity sports-related injuries. Of these,
25% were due to knee injuries (ACL tear).

 There are over 250,000 Achilles tendon injuries each year in the
US.

 3-5% of athletes are forced to leave their sports career due to

Achilles tendon overuse injuries.
 SIGNS AND SYMPTOMS
ACL Tear
 Feeling or hearing a pop in the
knee at the time of injury.
 Severe pain on the outside and
back of the knee, causing
inability to continue activity.
 The knee swelling, which
progressively worsens.
Achilles Tendon Tear
 A sudden, sharp pain that feels like
a direct hit to the Achilles tendon.
There may be a pop when the
rupture occurs. This may be
followed by swelling and bruising.
 Heel pain.
 Not being able to go on tiptoe with
the hurt leg.
 If a partial rupture (tear) occurs, you
may have near-normal strength and
less pain after the initial injury.
 TREATMENT, MEDICATION AND
MANAGEMENT
ACL Tear  Depending on level of injury, surgery may be needed to
reconstruct the ACL within the knee. If surgery is not needed, then another
form of treatment would be physical rehabilitation.

Achilles Tendon Tear  In severe cases, a cast is needed for 6-10

weeks and surgery to repair the tendon/remove excess tissue. In minor
cases, the tendon should heal on its own. Taking anti-inflammatory pain
killers can help alleviate the pain.
ACHILLES TENDON SURGERY
http://www.youtube.com/watch?v=nYeHu0-Viyg
 PREVENTION
ACL Tear Achilles Tendon Tear

 Avoid wearing shoes with cleats  Stretch and strengthen calf muscles.
in contact sports.  Vary your exercises.
 Avoid wearing high-heeled
 Choose running surfaces carefully.
shoes.
 Increase training intensity slowly.
 Avoid sports that involve lots of
twisting and contact.
 Stretch and strengthen the leg
muscles (quadriceps and
hamstrings).
 Practicing landing with the
knees bent after jumps.
 REFERENCES
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Clinic . Web. 27 Jul 2013. <http://www.sportsinjuryclinic.net/sport-injuries>.
II. "Sports Injuries Directory." Knee and Foot Injuries (2012): n.pag. WebMD.
Web. 28 Jul 2013. <http://www.webmd.com/fitness-exercise/sports-injuries-
directory>.
III. "Sports Medicine ." How are sports injuries classified and managed? n.pag.
NSW HSC Online. Web. 28 Jul 2013.
<http://hsc.csu.edu.au/pdhpe/options/medicine/4035/3-1/op3_1_1.htm>.
IV. "An Athlete's Nightmare." Tearing the ACL. 3.3 (2008): 24-26. Web. 28 Jul.
2013.
<http://www.nlm.nih.gov/medlineplus/magazine/issues/summer08/articles/sum
mer08pg24-26.html>.
V. "Everything About Achilles Tendon." Achilles Tendon Injury (2012): n.pag.
AchillesTendon.com. Web. 28 Jul 2013. <http://achillestendon.com>.
VI. Mayo Clinic Staff, . "Plantar Fasciitis." All about Plantar Fasciitis (2013): n.pag.
MayoClinic . Web. 28 Jul 2013. <http://www.mayoclinic.com/health/plantar-
fasciitis/DS00508>.